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We have all become acutely aware of how easily respiratory infections can spread within households and in schools, dormitories, or other places where people gather together closely for long periods of time. A prophylactic drug with the potential to significantly reduce the incidence of pandemic influenza is very welcome news indeed.
In households that received the placebo, 13.6% of the residents contracted influenza. Only 1.9% of those that received baloxavir came down with the flu, and there were no serious side effects noted in the treatment group.
But there are several caveats. Two strains of influenza typically circulate in the fall and winter months, influenza A and B. Although baloxavir is approved for use against both influenza A and B, influenza B was not active in Japan during the 2018-2019 flu season. The hope, though unproven in this study, is that the drug also protects against infection by influenza B.
The success of baloxavir against the transmission of influenza is significant, and provides hope that drugs directed against other viral enzymes could be developed to treat and prevent Covid-19.
In the critical condition many health care systems find themselves in today — with hospitals and providers already overwhelmed after months of treating Covid-19 infections — an approved drug that could help reduce the number of people falling ill from the flu this winter will be a welcome relief. It is unlikely that effective antiviral Covid-19 drugs will be available for prophylactic treatment for the majority of those at risk for Covid-19 by this fall and winter. Similarly, a vaccine that is both safe and effective may also not be widely available.
A combination of a seasonal flu vaccine and an effective prophylactic drug such a baloxavir — in addition to personal protective behaviors already being practiced across the US — could significantly reduce the severity of the coming influenza epidemic and spare our hospitals the worst of the combined effects of simultaneous epidemics.
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