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Children with severe swine flu who do not take Tamiflu could face serious complications and even death, a leading family doctor has warned parents.
The antiviral medicine has been surrounded in controversy after two studies found more than half of youngsters who took the drug suffered side effects such as nausea and nightmares.
Another study published in the British Medical Journal (BMJ) suggested antiviral medication does not prevent complications in children with flu.
But Dr Caroline Jessel, deputy medical director at NHS West Kent, urged parents to continue giving Tamiflu and other antivirals to their children if they are prescribed.
“If the child was quite unwell and I was a parent, then the risk of taking them is less than the risk of not taking Tamiflu and getting really ill with swine flu,” she said.
“You have to weigh up the risks and benefits. Parents are not obliged but if it is advised I would certainly think about it because they might be life saving in some situations.”
In response to the BMJ study, the Department of Health (DoH) said the study was based on seasonal flu and so may not apply to swine flu.
The two studies by the Health Protection Agency were carried out in the containment stage of the pandemic when everyone sharing a classroom with a child who had the H1N1 virus was given Tamiflu, even if they showed no symptoms, in a bid to stop its spread.
In a study of 103 pupils at three London schools, 53 per cent suffered side effects including nausea, stomach pain and problems sleeping.
Asked if there was a danger in parents not giving their children antivirals due to fears over side effects, Dr Jessel said: “I think it would not be sensible to withhold it particularly where they are severely affected.
“Some of the complications may well be prevented and the complications may be more severe and longer in duration [if Tamiflu is not taken].
“For friends and family it is less infectious so there are definitely benefits. With all medication it is not of total benefit without risks. It is the same situation with antibiotics.”
She said the number of patients being prescribed Tamiflu had fallen significantly in recent weeks due to the summer holidays and people spending more time outdoors.
But the virus has not disappeared, she warned.
NHS Eastern and Coastal Kent also said that the number of people with swine-flu like symptoms in its area had also decreased over the past week.
“The research has thrown a different perspective on Tamiflu and helped us to understand its impact better,” Dr Jessel added.
“It is not really relevant in a flu pandemic because it is based on seasonal flu. It is interesting but not necessarily going to change the advice.
“More research is needed but our advice is still relatively straight forward - if symptoms are quite severe, obviously they need help and it is effective in reducing the duration and symptoms of the swine flu.
“For very mild cases it has always been the case not to give anvirals. Some people do not even realise they have it and others can be treated perfectly well with over the counter medication.”
Matthew Thompson, author of the BMJ study, told New Scientist: “It may be worth the DoH taking the new research on board and perhaps having a more targeted approach to the use of antivirals.
“Or urgently conducting randomised controlled trials of children and adults to identify whether there are subgroups of children who will benefit from antivirals, and whether they do have an impact on severe complications such as pneumonia or hospitalisation.”
In Canada and the US antivirals are only recommended for patients at particularly high risk or with severe illness, he said.
Reports say that in Japan GPs have been advised not to give the drugs to youngsters between 10 and 19 because of high rates of ‘neuropsychiatric side effects’ such as nightmares and feeling confused.
POSTED: 16/08/2009 18:00:00