We do love a good health scare in the UK press, so the current H1N1 outbreak has been a boon to journalists. The latest stir concerns a new study that suggests giving Tamiflu to children could be a bad move.

Researchers at the University of Oxford reviewed all the available evidence on oseltamivir (Tamiflu) and zanamivir (Relenza) in the treatment of seasonal influenza. Writing in the BMJ they note:

It is difficult to know the extent to which these findings can be generalised to children in the current A/H1N1 pandemic. At present, most cases in children have been mild, but recommendations in several countries encourage treatment of children with suspected or confirmed A/H1N1 flu.

While morbidity and mortality in the current pandemic remain low, a more conservative strategy might be considered prudent, given the limited data, side effects such as vomiting, and the potential for developing resistant strains of influenza.

The UK’s Department of Health defended its current policy, saying a “safety-first” approach of offering drugs to everyone was “a sensible and responsible way forward”.

Poor old health secretary Andy Burnham was even harangued by “Britain’s former top tennis player” on television (see here and here). Andrew Castle, who now works as a TV presenter, told Burnham, “I can tell you that my child – who was not diagnosed at all – she had asthma, she took Tamiflu and almost died.”

It’s also worth noting that the influential Cochrane review group has also looked at the use of these drugs in children. They decided that tamiflu could be considered for treatment of children with influenza, provided that near-patient testing was available to confirm flu and treatment was started within 48 hours of the start of the illness. These criteria will not be met in many cases in the UK.

“If near-patient testing is not available, the case for oseltamivir is less compelling,” stated the Cochrane review team.

Respected medical doctor and blogger ‘John Crippen’ notes:

I am continuing to advise my patients not to take it. I would not take it myself and I would not give it to my children. How then can I possibly prescribe it?

I find that nearly all patients are happy with this advice.

Image: word cloud generated from full text of BMJ paper. Made with Wordle.