Health care personnel and risk of H1N1-chemoprophylaxis with oseltamivir

OBJECTIVES: To evaluate the efficacy of chemoprophylactic dose of oseltamivir in preventing H1N1 by comparing the rates of acute respiratory illness and H1N1 positivity of respiratory specimens between HCP with and without consumption of oseltamivir working in swine flu ICU. MATERIALS AND METHODS: The study was conducted on HCP posted in “Swine Flu Intensive Care Unit” from October 2009 to March 2010. Data on infection control measures, chemoprophylactic use of oseltamivir, flu-like illness, ADRs to oseltamivir, and contact history in family and neighborhood were collected by face-to-face interview conducted by investigator using a set of prespecified items in a questionnaire. RESULTS: All HCP used infection control measures like using long-sleeved cuffed gown, gloves, cap, shoe cover, and N95 mask, and frequent hand washing. There was no history of any unprotected contact with an H1N1-positive case. Out of 100 HCP, 69% took chemoprophylaxis. There was no significant difference in incidence of flu-like illness between HCP who took chemoprophylaxis (48%) and those who did not (29%, P = 0.18). H1N1 testing was done on 17 HCP, but all tested negative. Incidence of adverse effects to chemoprophylactic dose of oseltamivir was high (57%). The most commonly reported adverse effects were nausea (54%), gastritis (51%), and headache (38%). CONCLUSION: Chemoprophylaxis with oseltamivir is not recommended for HCP working in areas of high aerosol generation like ICU if infection control measures are adopted as there is no significant difference in the incidence of flu-like illness in HCP with and without intake of oseltamivir. This protects HCP from various adverse effects of the drugs, like nausea, gastritis, and headache.