I was watching the evening news last night, and was interested in the mixed messages being conveyed by the news and by the commercials. Influenza is at epidemic levels locally, and hospitals are restricting all children from visiting and asking adult visitors with influenza symptoms to stay away to protect their patients. The reports further advise that anyone with a cold or influenza should not go to work or school. Instead, rest at home, drink plenty of fluids, and take over-the-counter medications to relieve congestion, cough, fever, and body aches. If symptoms get worse, then a doctor visit should be considered. This is all reasonable, effective advise–common sense. The mixed message comes from a commercial for Tamiflu, which urged people to see their doctor right away for medication to treat influenza. Common sense would suggest that it is better NOT to fill up a doctor’s waiting room with people with influenza.
If Tamiflu were as effective as the commercial claims it might be reasonable. Unfortunately, Tamiflu only shortens the duration of the flu by about 2 days at best–if you start taking it as soon as symptoms develop. After the first 48 hours, it is of little benefit. This is because Tamiflu does not kill the influenza virus, but simply prevents it from invading the respiratory cells. Once it has invaded, the immune system has to do the heavy lifting to get rid of it–which is where the rest, fluids, and good diet come in. Tamiflu also has unpleasant side effects such as nausea, vomiting, and vertigo. There are situations where it may be appropriate to use Tamiflu to help prevent transmission, for example, patients in long-term care facilities, but influenza vaccine given early in the season is better for prevention in those cases and actually has less side effects.
It is not too late to get an influenza vaccine, by the way. It takes about 2 weeks to be full effective, but we still have several weeks left in flu season. Yes, the flu vaccine is less effective this year, but it still cuts your chance of getting the flu by 50% (usually it is closer to 90%). If you had a 50% chance of winning the lottery, wouldn’t you buy a ticket? In this case, you win by not getting sick, not losing money by missing work, and not taking flu home to your family. Even if you do develop the flu, you are likely to be less miserable for a shorter time, and it costs much less than Tamiflu.
And please wash your hands…there is nothing easier or more sensible to prevent any infection than that.
For more information on influenza and prevention, please visit http://www.niaid.nih.gov/topics/flu/pages/default.aspx
Best wishes in this New Year for health and happiness,
Dr. J