Flu Season...


With all the recent responsible (sarcasm) news reports about people dropping dead from the flu, I thought it would be a good time to put some things into perspective.   So far, the CDC reported that 63 children have died from the flu this year.  This is actually on par with previous years.  The patients that we “worry” about with the flu are the very young, the very old and those who have a problem with their immune system (ability to fight off infections).  We also worry about patients taking medications that can decrease your ability to fight off infection and those that develop bacterial infections on top of the flu (like flu and a bacterial pneumonia as an example).


The CDC reports that it’s very difficult to find the actual number of people who die from the flu every year but estimate it to be a range between 12,000 people on the low side (during the 2011-2012) to a high side of 56,000 (like the 2012-2013 flu season). It’s difficult to get an exact number because many people who die from complications related to the flu may never be tested.  To put things in perspective…an estimated 50-100 million people died from the 1918 flu pandemic.  Maybe just write that out…50,000,000 to 100,000,000 people.  Thankfully pandemics do not occur as frequently as the annual flu we see.  The last one was in 2009 with SWINE FLU (H1N1).  This was estimated to have killed close to 300,000 people globally. 


Ok, so now you have the flu.  What do you do?  Unfortunately, it’s usually symptomatic treatment. It involves keeping fevers down with acetaminophen (Tylenol) and ibuprofen (Advil), while simultaneously staying well hydrated.  A lot of people ask about Tamiflu and its effectiveness.  In certain circumstances it should be given, in most cases it’s not affective. 


I’m sure this post will have the Gentec lawyers (part of Roche) after me within the week! Gentec makes Tamiflu the current prescription medication used to treat the flu which is also known as oseltamivir.  All this flu nonsense has been going on since early human existence (please note this is an educated guess), but the use of wide spread treatment of the flu really became popular after the swine flu outbreak in 2009.  Every major health organization recommended treating flu at that time.  So, this became the norm…until the Cochrane collaboration (think of them as the Olympic committee of human research without all the corruption of the Olympic committee) which looks at all the data available from research trials on a drug.


You’ll be shocked to learn that the company withheld almost half of the research trials that showed the treatment actually was not as successful as some of the smaller trials showed. The company trial data that they withheld, help the company make billions of dollars as countries certain of widespread outbreaks stocked the medication.  Shocking.  When they finally got their hands on this data the treatment effect of Tamiflu has only a slight benefit.  Most people get sick with flu for about a week.  If you start this medicine within 2 days of when your symptoms begin, you’re only going to get better a half day sooner.  


At 100$ for the treatment and side effects like upset stomach, to me it doesn’t make sense (with some caveats below).  This treatment DOES NOT decrease your chance of dying or getting admitted to the hospital!  So here is the down low…MOST people who are healthy, don’t require this treatment. There are some people who do require treatment. The CDC (center for disease control) recommends treatment if you’re really sick and need to stay in the hospital, kids less than age 2, adults over 65, people with certain chronic diseases (asthma, chronic kidney disease, sickle cell disease, diabetes, congestive heart failure and certain neuro conditions like muscular dystrophy), patients on immunosuppressant therapy or with HIV, pregnant females, or nursing home residents.  For the rest of us, Tylenol (acetaminophen), Motrin (ibuprofen or advil) and fluids is going to be the best treatment.  That's all for the moment… Dr. Paul