Arbovirus seroprevalence in Nasiriyah Iraq

Abstract

No: 1696 Presentation at ESCV 2015: Poster 1 Antiviral use in Glasgow during influenza season 2014–15 C. Murphy1,∗, C. Jackson2, C. Aitken2 1 Brownlee Centre for Infectious and Communicable Diseases, Gartnavel General Hospital, Glasgow, United Kingdom 2 West of Scotland Specialist Virology Centre, Glasgow Royal Infirmary, Glasgow, United Kingdom Background: Public Health Scotland released guidance during this influenza season regarding the use of antiviral medication in patientswith suspected or confirmed influenza infection. Their recommendations, along with Public Health England and WHO, state that oseltamivir should be prescribed in all patients with severe disease consistent with possible influenza infection and in those at high risk of severe disease and displaying symptoms. Case definition of severe disease includes all patients requiring hospital admission. Guidance states antiviral medication should be prescribed immediately, and not be delayed by waiting for laboratory confirmation. Zanamivir is only recommended as first line therapy if there is a concern regarding gastrointestinal absorption, or the predominant circulating strain is likely to be oseltamivir resistant. Methods Using a large city centre teaching hospital, we looked at all inpatients during a 24 week period over winter 2014/15. 148 patientswerePCRpositive in throat swabsor gargles for influenzaA virus during this period. Datawas collected regarding their virology results, admission details, risk factors, disease severity and use of oseltamivir and zanamivir during their admission, from patient’s notes and electronic records. Results: During our data collection 90.5% of patients were positive for influenza A serotypeH3N2, and 3.38% for H1N1. Typingwas not completed for the remaining samples. Using the guidelines outlinedbyPublicHealth Scotland, 85.1%ofpatientshad risk factors for severe disease and 15.5% were immunosuppressed. Further, 87.2% had evidence of severe lower respiratory tract symptoms including hypoxia, dyspnoea and lung infiltrations. Of these patients positive for influenza A 50.6% of antiviral prescriptions were empirical with only 57.4% of patients ever receiving treatment. The remaining cases were prescribed treatment following a positive virology result. The majority of treatment was started at day 1 (23.5%) with a range of 0–12 days following admission. Conclusion:Despite national guidelines only half of the eligible patients were treated for their influenza infection. The reasons for low prescribing rates need to be investigated. This highlights an area in which clinician education and confidence can be improved. http://dx.doi.org/10.1016/j.jcv.2015.07.146