Have you noticed that friends, family and co-workers are sick? Perhaps you too have fallen prey to this year’s influenza virus. Well, the CDC has just acknowledged that the country is in the midst of a nasty flu epidemic.
Keep in mind that The Centers for Disease Control and Prevention are usually a week or two behind in collecting such statistics. The latest map on the CDC’s website is for the week ending December 20, 2014. It shows “widespread” influenza activity involving virtually all states.
H3N2 Is Causing 90 Percent of the Misery
The viral strain that is causing most of the mischief is H3N2, and as you have probably heard by now, the flu shot is not a good match for this mutated viral version. We won’t know for months whether the vaccine worked partially or not at all. What we do know is that hospitals are overwhelmed with cases of very sick people.
We suspect that the situation is likely to get substantially worse before it gets better. Holiday travel, family get-togethers and New Year’s Eve parties have brought a lot of people together in close quarters. That means the H3N2 virus is likely to spread faster and farther.
How Bad Is It?
At last count, 837 deaths have been linked to this flu bug or its complications in 2014. Pneumonia is often a secondary consequence of influenza infection. Children, older people and those with chronic health conditions are especially vulnerable. Be vigilant! If you think your symptoms are getting serious, contact your health professional or head directly to the emergency department of your local hospital.
What About Antiviral Drugs?
Amantadine (Symmetrel)
We have been writing about antiviral medicines for over 30 years. For reasons that mystify us, many health professionals have been slow to acknowledge that there even are such drugs.
The very first medication to fight influenza was amantadine. On February 7, 1983 we wrote the following article for our syndicated newspaper column:
“The flu is back. If it follows the pattern of the last epidemic, thousands of people will die needlessly.
“Anyone who has suffered knows that the flu is a lot worse than a bad cold. During the 1980-81 epidemic, influenza and its complications were responsible for 60,000 deaths. Though your doctor may tell you otherwise, this killer can be prevented or treated with a drug that’s readily available but rarely prescribed.
“One of the biggest scandals of American medicine is the failure of the profession to recognize the benefits of Symmetrel (amantadine). This extraordinary anti-viral agent is widely used in the Soviet Union and studies in this country have repeatedly proven that it is highly effective in preventing or treating the flu.
“A recent study published in the New England Journal of Medicine has confirmed that over 90 percent of the people taking Symmetrel didn’t get type A influenza. This rate of success is significantly higher than that seen with vaccinations…
“It’s a mystery why doctors have been slow to prescribe Symmetrel. Dr. Arnold Monto, Professor of Epidemiology at the University of Michigan School of Public Health, suggests that doctors are not yet accustomed to the idea of antiviral drugs. He also believes that initial reports of side effects were ‘overblown.”
“Experience has shown that only 7 to 10 percent of the people taking Symmetrel develop adverse reactions. The most common complaints include insomnia, jitteriness and difficulty concentrating. These problems tend to diminish after continued use and disappear completely after the drug is discontinued.
“A recent editorial in the New England Journal of Medicine (Sept 2, 1982) stated quite unequivocally that ‘in an epidemic of influenza, amantadine (Symmetrel) would be indicated fore many persons…Perhaps the drug should also be used more widely for the treatment of influenza.'” [The People’s Pharmacy, 2-7-83]
Please keep in mind that that was written more than three decades ago. Since then more effective antiviral drugs with fewer side effects have become available.
Rimantadine (Flumadine)
A decade later on October 11, 1993, we wrote about a new oral antiviral drug, rimantadine (Flumadine), that was also effective against type-A influenza. We noted that if Flumadine was taken early in the illness, “it can shorten recovery time and diminish the risk of dangerous complications.” We also wrote that, ” Flumadine appears to have fewer side effects than amantadine. Some people may complain of insomnia, nausea or dizziness, but such reactions are far less serious than a bad case of the flu.”
To our surprise, rimantadine never really caught on. Most physicians just did not believe in prescribing antiviral drugs against influenza. Vaccination was the one and only accepted approach, even though the data suggested effectiveness was not all that great, even when there was a good match to the prevailing virus.
Oseltamivir (Tamiflu), Zanamivir (Relenza) & Peramivir (Rapivab)
The latest generation of antiviral medications against influenza has also been slow to catch on. At least the CDC is now recommending such medications when people come down with the flu, especially since the vaccine is such a bust this year.
The latest addition to the antiviral armamentarium is Rapivab (peramivir). The FDA approved this injectable drug on December 19, 2014. It should start showing up in hospitals within the next few weeks and will be administered to the sickest patients first. For more information on Rapivab, check out our overview at this link.
What about Tamiflu?
This drug remains hugely controversial. The number crunchers say it is barely beneficial and doesn’t prevent serious flu complications. For The People’s Pharmacy assessment, check out our recent “Inside Story on Tamiflu.”
The problem with all of the antiviral medications is that they must be administered within 24 to 48 hours of symptom development. Getting doctors to prescribe drugs like Tamiflu or Relenza in time to do any good is a challenge. Just try getting an appointment with your physician in the middle of flu season. It can take weeks! By then, the drugs will do no good.
Most physicians are unwilling to prescribe antiviral medications unless they see you and test you for type-A influenza. We do not have an answer to this conundrum. For ourselves, we have asked our primary care provider to supply us with Tamiflu in advance so that if we develop serious symptoms of influenza we have the drug on hand. Most doctors have a hard time with this concept, however.
All we can do is wish you a healthy 2015 and hope that you can avoid H3N2 in this new year!
