Antiviral Drugs Can Ease Flu Frenzy

Even though the influenza season has barely begun, millions of Americans are in a frenzy over flu. You can hardly blame them.
Earlier this fall, public health officials were emphasizing the dangers of influenza. They pointed out that each year tens of thousands die from this infection or its complications and urged everyone to get vaccinated.
Then came the great flu shot fiasco, and the supply of vaccine fell by half. In an amazing turnaround, the public health message shifted. No longer was flu such a big deal. President Bush recommended that healthy Americans should forgo flu shots this year.
But older people were justifiably alarmed that they would be left unprotected. Many stood in long lines for hours waiting for shots that never materialized. Because of the scarcity of vaccine, scalpers were charging exorbitant prices. Vials that would normally sell for $85 were being hawked for over $700.
Some desperate seniors are willing to pay anything for protection. Others are going to Canada to get their shots.
To ease the panic, Health and Human Services Secretary Tommy Thompson has told seniors to stop standing in long lines and to relax. Health officials are recommending that people wash their hands frequently and stay home if they’re sick.
The trouble is that this advice is not especially helpful. People can be contagious even before they are very sick. And influenza can be spread by airborne droplets from a cough or sneeze.
So what can you do either to prevent the flu or to recover quickly before it causes complications? If you can’t get a flu shot, your best bet is an antiviral medicine. Although such drugs have been prescribed for decades, most physicians and patients are still unaware of their existence.
Amantadine (Symmetrel) was first approved for type A influenza in 1966. But hardly anyone noticed except the Russians. They bought over 10 million doses from Dupont to use against the Hong Kong flu pandemic of 1968 and 1969.
Now, there are three other antivirals. Rimantadine (Flumadine) was approved in 1993, also for type A flu. Both drugs can prevent infection when taken prophylactically or speed healing when taken within a day or two of symptom onset.
More recently, Tamiflu and Relenza have become available. These drugs work against both type A and type B flu.
All these medicines work as well as the vaccine. For some, they may be even better. Last year, for example, the flu shot protected about half the healthy adults who were immunized. But only 38 percent of those with chronic illnesses were protected by the flu shots they got.
This was due in part to the fact that last year’s vaccine did not match the strain of influenza that was dominant. This year, the shot may be a better match for the flu viruses in circulation, but because of the shortage it won’t matter to most people.
Unfortunately, there may not be enough antiviral flu medicine to cover the millions of people who can’t be vaccinated this year. Although Roche, the maker of Tamiflu, is doubling its output, the total is still just a few million five-day treatment packs.
To avoid suffering when flu season really hits, high risk patients who can’t get a shot may want to ask about having a prescription for flu medicine on hand.