Tuesday, December 2, 2008

What is Flu Trends and When should I give Tamiflu?

I have already mentioned reasons to get the influenza vaccination. Don't forget about trying to avoid areas where influenza is active. Google has recently released a very helpful tool called Flu Trends which "uses aggregated Google search data to estimate flu activity in your state up to two weeks faster than traditional systems." Note the number of cases of influenza increased from December through March. So the season is really right here! The number peaks around Christmas and again in early February.

I try to ask all of my patients to get a flu vaccination, but often the $25 cost, which is usually not covered by insurance, puts them off. Think of it as the price of prevention. Freedom is not free.

What if you suspect you have the flu? I would see your doctor quickly. I'll explain why. First, he or she may decide to do a
diagnostic test. In my office, as in most outpatient offices, that test is a rapid diagnostic test. This is most accurate when done within 4-5 days of the onset of symptoms. The answer is available within 30 minutes. Second, suppose you'd like to take an antiviral medication. There are two approved medications for prevention and treatment of influenza infections: oseltamivir (Tamiflu®) and zanamivir (Relenza®). The guidelines for both recommend starting the medication as soon as possible after the onset of symptoms and NO LATER than 48 hours after the onset of symptoms, because no clinical benefit has been shown. I am not trying to make people neurotic or drum up business. These are the published guidelines, based on scientifically validated data. If you do need an antiviral, I am much more likely to prescribe Tamiflu for two reasons. First, Tamiflu is approved from age 1 year old on up as compared to 7 years on up for Relenza. Both should be taken for 5 days. Second and more importantly, Relenza is not recommended for use in people with underlying airways diseases, like asthma. Many of my patients have asthma, so that makes my decision pretty easy. Note, I can't comment on the relative costs right now.

If you have questions, ask your doctor...
Edited 12/8/08

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