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Q: My apparently healthy patient has requested Tamiflu for prophylaxis. Should I provide it? Should I provide antivirals prophylactically for hunters?  Top
A: Because H5N1 highly pathogenic avian influenza (HPAI) virus has not yet been identified in the United States, we are not aware of any valid reason for prescribing antiviral prophylaxis at this time, even for those in potentially higher risk groups (including hunters). Doing so may be in conflict with recommendations issued by a number of public health experts.
In 2005, the World Health Organization (WHO), Food and Agriculture Organization (FAO), and Office International des Epizooties (OIE) issued a joint statement (see http://www.who.int/foodsafety/micro/avian_antiviral/en/print.html) urging Member States not to use antiviral drugs in animals so that the efficacy of these drugs can be preserved for treatment of influenza infections in humans and strongly requested Member States to ban the use of antiviral drugs in animals. On March 22, 2006, the FDA published a final rule prohibiting the extralabel use of adamantine and neuraminidase inhibitor classes of antiviral drugs in chickens, turkeys, and ducks.
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