title: Abnormal behavior during influenza in Japan during the last seven seasons: 2006-2007 to 2012-2013.
abstract: A few mortalities and cases of severe abnormal behavior have been reported after oseltamivir administration for influenza, thus increasing medical and public concerns regarding the drug's safety. We investigated the association between oseltamivir and abnormal behavior for seven years. All outpatient clinics and hospitals all over the country were requested to report severe abnormal behavior that could have resulted in a fatality if nobody intervened, such as abrupt running outside the home or intention of jumping off a building. The survey was performed prospectively between the 2007-2008 and 2012-2013 seasons, and retrospectively for the 2006-2007 season. As the result of the investigation, eight-hundred fifty-eight cases were reported and among of them 95.7% were positive by the influenza rapid diagnosis test. The epidemic curve of severe abnormal behavior showed a pattern similar to influenza-like illness. The same pattern was observed regardless of age group, gender, or timing of the incidents after waking. Consequently, specific association between the types of medications used or the types of antiviral and abnormal behavior was not observed clearly. The reported abnormal behaviors include fatal cases that would have died if nobody had stopped. This suggested that patients with influenza should be observed with caution for possible abnormal behavior whether taking oseltamivir or other neuraminidase inhibitor anti-influenza drugs.
authors.affiliation: Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan; Graduate School of Pharmacy, Nihon University, Japan.
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan.
authors.forename: Tamie
authors.initials: T
authors.lastname: Sugawara
authors.affiliation: Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan. Electronic address: ohkusa@nih.go.jp.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ohkusa
authors.affiliation: Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan; National Hospital Organization Mie National Hospital, Japan.
authors.forename: Kiyosu
authors.initials: K
authors.lastname: Taniguchi
authors.affiliation: Fukuoka Welfare Center for the Disabled, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Miyazaki
authors.affiliation: International University of Health and Welfare, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Momoi
authors.affiliation: Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Japan; Kawasaki City Institute for Public Health, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Okabe
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001526:Behavioral Symptoms / Q000139:chemically induced* / Q000821:virology; D002648:Child; D005334:Fever / Q000821:virology; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D053139:Oseltamivir / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir
keywords: Abnormal behavior; Antiviral drug; Influenza; Oseltamivir