Oops—score one for people who don’t think very highly of flu vaccinations. Every year, the World Health Organization and the FDA try to predict which three or four strains of flu virus will be most prevalent in the next flu season, and vaccines are made to target those strains. But this year, one of the strains has mutated, which means that, if you’ve already been vaccinated against the flu, you may not be as well-protected against it as you thought. As we’ve told you before, the flu vaccine can help protect you against the flu and, overall, it significantly reduces the number of people who land in the hospital or die during annual flu outbreaks, but it isn’t a guarantee of protection. Complicating this year’s flu situation is that the particular virus that is on the rampage, H3N2, is known to be more intense and deadlier than other flu strains. So, the CDC is telling doctors to prepare for a severe flu season.
What is your best line of defense if you get the flu, particularly if you have a health condition that puts you at risk for a severe infection or complications?
The good news first: There are two readily available prescription antiviral drugs that can help tamp down flu symptoms and shorten the time you spend being sick. They are oseltamivir (Tamiflu) and zanamivir (Relenza).
Now for the bad news: Too many doctors are failing to prescribe these antiviral medications to those who can really benefit from them. In fact, the CDC reported that, in seasons past, many doctors were not properly treating patients with serious flu symptoms. The CDC caught them red-handed in a study that looked at prescribing practices during the 2012 to 2013 flu season. The study, headed by Fiona Havers, MD, a medical epidemiologist at the CDC’s National Center for Immunization and Respiratory Diseases in Atlanta, looked at prescriptions of 6,766 patients given a diagnosis of “acute respiratory illness”—that is, a serious lung infection that can land you in the hospital. Although many of the patients could have benefited from an antiviral because they probably had the flu, only 8% were given a prescription for one. When the study’s researchers looked at patients who were at high risk for deadly flu complications because they were very young or old or had more than one chronic illness, they discovered that only 19% of them were given a prescription for an antiviral.
And—you aren’t going to like this—when researchers looked at patients whose lab tests positively confirmed that they had the flu, they saw that an antiviral was prescribed to only 15% of these people…and instead of an antiviral, patients were often prescribed an antibiotic.
It means that doctors are missing opportunities to improve health care for high-risk patients who have the flu and could benefit from antiviral treatment, said Dr. Havers…while giving them antibiotics, which are generally useless for the flu!
Antiviral drugs can lessen symptoms and shorten the time you are sick by up to two days, she said. More importantly, these drugs can prevent serious complications, such as pneumonia. For some people, namely those with medical conditions such as heart and lung diseases, treatment with an antiviral drug can mean the difference between having a mild illness and a very serious one that could result in a hospital stay. The CDC recommends prompt treatment with antivirals primarily for these high-risk people.
WHAT TO DO IF YOU GET THE FLU
If you feel flu symptoms coming on, time is of the essence. If you are in the high-risk category (if you have heart or lung disease or another chronic illness), get to your doctor for antiviral treatment as soon as possible, Dr. Havers said. If you are not in the high-risk zone and want to lessen the impact of flu symptoms, you can still be prescribed an antiviral, although there is disagreement among medical researchers about whether antivirals really make that big a difference in lessening flu symptoms in otherwise healthy people.
If you do have an interest in taking an antiviral for the flu, you will need to get to your doctor for a prescription within 48 hours of feeling sick. That is when an antiviral will be most effective, said Dr. Havers. The usual length of treatment is five days. Flu antivirals can have side effects, including nausea, vomiting, diarrhea and headache. The gastrointestinal effects can be reduced if the antiviral is taken with food, said Dr. Havers.
Whereas Tamiflu is approved for people as young as two weeks old, Relenza is recommended for treatment of adults and for children who are seven years or older. It is given via an inhaler, though, and should not be used by people who have breathing problems, such as asthma.
The CDC has issued an alert to doctors that they should get on the ball and prescribe these antivirals this flu season to those who need them to dampen the effects of the mutated flu virus. With all the news about the mutated H3N2 virus, I think we can expect more doctors to do so. But if you visit your doctor with flu symptoms and he or she wants to hand you a prescription for an antibiotic, be sure to thoroughly question the doctor about why.