Information for patients
Swine flu advice for patients with lupus or related disorders
The Lupus Unit has received the following advice from the Infection department regarding swine flu.
Patients on no treatment or on Hydroxychloroquine alone.
Patients with mild lupus on no treatment or antimalarials alone such as Hydroxychloroquine are not considered to be immune suppressed. The advice for these patients is the same as for the general population. Please see the Department of Health website:
http://www.direct.gov.uk/en/Swineflu/DG_177831
Patients on steroids or immune suppressing agents such as azathrioprine, methotrexate, mycophenolate, cyclophosphamide or similar drugs.
If patients develop 'flu like' symptoms including a documented fever, they should immediately contact their GP or NHS Direct to commence treatment with Tamiflu (or Relenza). Immune suppressed patients are more likely to get swine flu and to suffer symptoms for longer than healthy individuals.
If possible, the General Practitioner or Health Professional should attempt to confirm the diagnosis of swine flu by collecting nose and throat swabs. Treatment should be commenced as soon as possible. The standard course of treatment is for 5 days but a longer course my be appropriate and if symptoms persist or worsen the patient should be reviewed clinically. Treatment for lupus should not be discontinued unless a bacterial infection such as a chest infection develops. Methotrexate should not be taken with Tamiflu because of a potential interaction.
Patients with severe lung disease.
Patients who have had previous lung damage from lupus or a related connective tissue disorder will be at greater risk of pneumonia if they develop swine flu. In addition to treatment for swine flu their Health Professional will need to consider early treatment with antibiotics if patients develop symptoms of chest infection, eg ishortness of breath or discoloured spit. Patients who have had previous heart or kidney complications should ensure that their GP or health professional is aware of this.
Vaccination against Swine Flu.
The Department of Health is planning a vaccination programme. The vaccine is a 'killed' vaccine so it is suitable for patients taking steroids and immune suppressing agents. A small proportion of lupus patients may have a mild reaction to the vaccination but on balance the benefits outweigh the risks. Lupus patients are therefore encouraged to have the vaccination.
