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Why Does the Flu Kill So Many Healthy People?

By all accounts this year's influenza epidemic is nasty. Hospital are overwhelmed. How does the flu kill otherwise healthy people? Is there anything to prevent flu complications?

Influenza continues to make millions of people sick around the country. There have been way too many deaths. Clearly, this year’s influenza epidemic caught health professionals by surprise, even though the Australian experience should have alerted us to the danger ahead. Australia is six months ahead of us when it comes to influenza. The vaccine was relatively ineffective there. And people were sicker than usual. We should have been better prepared. Could the flu kill someone you love?

The Old Man’s Friend?

It used to be said that the pneumonia brought on by a bad bout of flu was the old man’s friend. That’s because this lung infection is a not uncommon complication of influenza. According to the Harvard Health Letter (July, 2007):

“Sir William Osler, sometimes called the father of modern medicine, famously called it ‘friend of the aged’ (often rendered as ‘the old man’s friend’) because it was seen as a swift, relatively painless way to die. But that was over 100 years ago. Today, vaccines, antibiotics, and improved supportive care mean doctors can do a lot more about pneumonia, although it remains a major killer, capable of thwarting the best efforts at prevention and treatment.”

How Can the Flu Kill Younger, Healthier People?

Public health officials seem mystified why so many of the deaths from influenza this year have been in otherwise healthy people. We’re not talking about 80 or 90 year-olds with COPD (chronic obstructive pulmonary disease), diabetes, heart disease or cancer, though they are certainly at high risk. Young people in the prime of life are being affected. Baby boomers who have no pre-existing medical conditions are also being felled.

It is still a mystery why this year’s H3N2 flu virus is wreaking such havoc. Traditionally, the flu kills because of the body’s own immune reaction. That seems counterintuitive. Don’t we want our immune system to fight off the viral infection? The answer is yes…but. The but refers to an overreaction.

If the immune system goes into hyperdrive, it can lead to something called a cytokine storm. Inflammatory compounds made by the body can damage tissue throughout the respiratory tract. Other cells and organs can also be affected. When too many healthy cells die suddenly, the flu kills.

Secondary infections are another reason the flu kills people. Strep and staph infections can develop and also threaten the lungs. If such bacterial infections get out of hand, a blood infection can quickly overwhelm the body. Septic shock is a killer and is very hard to treat.

Heart Attacks from the Flu Kill People:

We suspect that most deaths from influenza are related to complications of respiratory infections. But others could be due to heart attacks. A study published in the New England Journal of Medicine (Jan. 24, 2018) has shown that people are six times more likely to suffer a heart attack during the first week after coming down with influenza.

Infection with flu viruses increases inflammation throughout the body. Platelets, the sticky part of blood that can form clots, are also activated. This seems to increase the possibility of a heart attack. Older patients may be especially vulnerable. Anyone who experiences symptoms such as chest pain while they are sick with flu should seek immediate medical care.

Will the Vaccine Lessen Flu Severity?

Almost every news report about this year’s flu epidemic is followed by a message to get vaccinated. The media doctors and news anchors repeat the mantra that even if the flu shot is not perfect, it will lessen the severity of the infection. Is that true?

We have tried to find solid scientific support for this idea. We were astonished to discover that there is surprisingly little good research to back up this belief. A French study published in the journal Vaccine (April 11, 2017) concluded:

Our results are consistent with previous studies reporting limited or no efficacy of the influenza vaccine in reducing illness severity at onset of symptoms.”

We recently wrote about this in much more detail. Here is a link to that article:

Will The Influenza Vaccine Protect You from Flu’s Complications?

What About Tamiflu?

We were saddened to read in the New Hampshire Union Leader (January, 28, 2018) that an otherwise healthy 38-year-old woman, Amanda Franks, died of the flu, leaving behind four children. The newspaper described the situation from the perspective of her sister, Jolene King:

“Franks went to the doctor on Sunday, Jan. 14, when she didn’t get better and was running a fever, King said.

“The mother of four tested positive for the flu and was given a prescription. 

’She said they prescribed her Tamiflu, but the doctor said the side effects were a lot of times worse than the flu, so she decided not to take it,’ King said. 

So Franks returned home and told her sister she would continue drinking lots of liquids and resting.

“’Her words exactly were, she was just going to keep fighting it on her own,’ she said.”

Tragically, Amanda Franks developed septic shock and died a few days later.

No one can say whether oseltamivir (Tamiflu) would have prevented this flu-related death. We disagree with the doctor who suggested that the side effects of Tamiflu are a lot times worse than the flu. Although many physicians do not seem to think the drug works, the CDC supports the use of the drug and states this on the website:

When treatment is started within two days of becoming sick with flu symptoms, antiviral drugs can lessen symptoms and shorten the time you are sick by about one day. They may reduce the risk of complications such as ear infections in children, and pneumonia and hospitalizations in adults.  For people at high risk of serious flu complications, early treatment with an antiviral drug can mean the difference between having milder illness instead of more severe illness that might require a hospital stay.  For adults hospitalized with flu illness, early antiviral treatment can reduce their risk of death.”

Learn more about the pros and cons of Tamiflu at this link:

The Inside Story of Tamiflu: Side Effects & Benefits

The Reader Experience with Oseltamivir (Tamiflu):

Here are just a few comments from visitors to this website:

Rosalie in Utah had a good experience:

I coughed all night, ached all over, had a fever, and as soon as I could the next morning visited Instacare and was given a prescription for Tamiflu. Cough and aching went away rapidly, and over the next day my fever subsided. I got better and better and was over it in a few days. I’d certainly take Tamiflu right away if I got the flu again. I always get a flu shot because the flu is miserable.”

Carole in Washington wasn’t sure Tamiflu worked:

I went right in to get Tamiflu within 48 hours of coming down with the flu after I saw the positive remarks about it on your website. I tested positive for influenza A. I was pretty sick for about 4 days and had the cough for a month where I then came down with post nasal drip. I am not sure it helped or not. I have only had the flu once before many years ago.”

Val in Florida had a bad experience with side effects:

I took Tamiflu as a preventive the day after being exposed to the flu. I did not come down with the flu, but the side effects were just as bad. It increased my blood pressure unacceptably and gave me nausea, headache, and horrible vertigo for several days (and even now, two and a half weeks later, I’m still having slight instances of vertigo).”

Lisa in Raleigh shared a positive story:

Our 19 year-old-son got the flu on the day before Christmas. We got him to Minute Clinic before they closed. He was prescribed Tamiflu and his fever went from 103 to 99 in two days. He felt almost fine on the fifth. He didn’t have any side effects other than it slashed the number of days he was ill.”

Share your own experience with influenza in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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