title: Zanamivir prophylaxis: an effective strategy for the prevention of influenza types A and B within households.
abstract: A double-blind, randomized study of inhaled zanamivir for the prevention of influenza in families was conducted. Once a person with a suspected case of influenza was identified (index patient), treatment of all other household members (contacts) > or =5 years old was initiated. Contacts received either 10 mg zanamivir or placebo inhaled once daily for 10 days. Index patients received relief medication only. In total, 487 households (242 placebo and 245 zanamivir) were enrolled, with 1291 contacts randomly assigned to receive prophylaxis. Four percent of zanamivir versus 19% of placebo households (P<.001) had at least 1 contact who developed symptomatic, laboratory-confirmed influenza, representing 81% protective efficacy (95% confidence interval, 64%-90%). Protective efficacy was similarly high for individuals (82%) and against both influenza types A and B (78% and 85%, respectively, for households). Zanamivir was well tolerated and was effective in preventing influenza types A and B within households where the index patient was not treated.
authors.affiliation: School of Public Health, Department of Epidemiology, University of Michigan, Ann Arbor 48109, USA. asmonto@umich.edu
authors.forename: Arnold S
authors.initials: AS
authors.lastname: Monto
authors.forename: Michael E
authors.initials: ME
authors.lastname: Pichichero
authors.forename: Steve J
authors.initials: SJ
authors.lastname: Blanckenberg
authors.forename: Olli
authors.initials: O
authors.lastname: Ruuskanen
authors.forename: Chris
authors.initials: C
authors.lastname: Cooper
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Fleming
authors.forename: Caron
authors.initials: C
authors.lastname: Kerr
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018890:Chemoprevention; D002648:Child; D002675:Child, Preschool; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D004311:Double-Blind Method; D005191:Family Characteristics; D005260:Female; D006146:Guanidines; D006801:Humans; D009980:Influenza A virus / Q000187:drug effects* / Q000302:isolation & purification; D009981:Influenza B virus / Q000187:drug effects* / Q000302:isolation & purification; D007251:Influenza, Human / Q000517:prevention & control* / Q000821:virology; D008297:Male; D008826:Microbial Sensitivity Tests; D011714:Pyrans; D012794:Sialic Acids / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D053243:Zanamivir
chemical_list: D000998:Antiviral Agents; D006146:Guanidines; D011714:Pyrans; D012794:Sialic Acids; D053243:Zanamivir