Guidance 1.1 For otherwise healthy adults with influenza, the use of zanamivir is not recommended.
1.2 Zanamivir is recommended, when influenza is circulating in the community, for the treatment of at-risk adults, who present within 36 hours of the onset of influenza like illness (ILI) and who are able to commence treatment within 48 hours of the onset of these symptoms.
1.2.1 Based on the evidence from clinical trials, at-risk adults are individuals falling into one or more of the following categories: - age 65 years or over - chronic respiratory disease (including chronic obstructive pulmonary disease and asthma) requiring regular medication - significant cardiovascular disease (excluding individuals with hypertension) - immunocompromised diabetes mellitus
1.2.2 Community based virological surveillance schemes should be used to indicate when influenza is circulating in the community.
1.2.3 Effective targeting of zanamivir for the at-risk adult population with a high incidence of true influenza is essential to maximise both the clinical and cost effectiveness of this therapy.
1.3 The guidance does not cover the circumstances of a pandemic or a widespread epidemic of a new strain of influenza to which there is little or no community resistance. In such circumstances, the Department of Health and the National Assembly for Wales might wish to consult the Institute on the need for supplementary guidance.