Swine Flu & Steroid Treatment

Steroids can be given orally, by intramuscular or intravenous injection, or by inhalation to reduce swelling in airways and improve breathing. But the use of steroids for H1N1 influenza, or swine flu, is controversial.

History

• Clinicians have used steroids to treat patients who are very ill with similar respiratory viruses, including avian influenza and respiratory syncytial viral infection (RSV). According to the Infectious Diseases Society of America (IDSA), steroids didn't benefit those patients, though they did show some benefit in children with influenza or croup-related influenza.

Considerations

• On the other hand, there is a great deal of literature indicating that steroids cause secondary illnesses such as mold infections and cytomegalovirus (CMV), which can cause severe birth defects if a woman develops it during pregnancy.

Expert Insight

• The World Health Organization (WHO) recommends that steroids not be used routinely to treat the H1N1 flu. Steroids may be considered for complex life-threatening complications, including septic shock that affects adrenal glands and lowers blood pressure to dangerous levels.

Warning

• The WHO warns that using steroids for a prolonged period of time or in high doses can cause severe side effects in people with H1N1 flu, including opportunistic infections from other organisms.

Speculation

• Researchers from the U.S., France and Canada believe doctors will use steroids anyway. Consequently, they're planning a study to determine the safety of steroids for patients with H1N1 flu.