Hayden Frederick G, Belshe Robert, Villanueva Catalina, Lanno Riin, Hughes Claire, Small Ian, Dutkowski Regina, Ward Penelope, Carr Jackie
University of Virginia School of Medicine, Charlottesville, Virginia, USA.
J Infect Dis. 2004 Feb 1;189(3):440-9. doi: 10.1086/381128. Epub 2004 Jan 26.
We determined the efficacy of postexposure prophylaxis (PEP) and treatment of ill index cases with oseltamivir, in an attempt to prevent influenza transmission in households, in a study conducted in 277 households with 298 index cases (62% with laboratory-confirmed influenza) and 812 contacts aged > or =1 year. Contacts were randomized by household to receive treatment (5 days; n=402), if illness developed, or PEP for 10 days (n=410), and the number of households with at least 1 contact developing laboratory-confirmed influenza was measured. PEP provided a protective efficacy of 58.5% (95% confidence interval [CI], 15.6%-79.6%; P=.0114) for households against proven influenza and 68.0% (95% CI, 34.9%-84.2%; P=.0017) for individual contacts, compared with treatment of index cases alone. No oseltamivir-resistant variants were detected in treated index cases or contacts. PEP of household contacts of those with influenza reduces the secondary spread of influenza in families when the initial household case is treated.
在一项针对277户家庭开展的研究中，我们确定了使用奥司他韦进行暴露后预防（PEP）以及治疗发病的指示病例对于预防家庭内流感传播的效果。该研究中有298例指示病例（62%经实验室确诊为流感）以及812名年龄大于或等于1岁的接触者。接触者按家庭随机分组，若发病则接受为期5天的治疗（n = 402），或接受为期10天的PEP（n = 410），并统计至少有1名接触者经实验室确诊感染流感的家庭数量。与仅治疗指示病例相比，PEP对家庭预防确诊流感的保护效力为58.5%（95%置信区间[CI]，15.6% - 79.6%；P = 0.0114），对个体接触者的保护效力为68.0%（95% CI，34.9% - 84.2%；P = 0.0017）。在接受治疗的指示病例或接触者中未检测到对奥司他韦耐药的变异株。当对家庭中的首例病例进行治疗时，对流感患者家庭接触者进行PEP可减少流感在家庭中的二次传播。
