Influenza and Tamiflu
Hilliard Pediatrics, Inc. - Dr. Tricia Lucin, MD
The flu is caused by the Influenza family of viruses, typically Flu A or B. Although some people will occasionally refer to vomiting and diarrhea as “the flu”, Influenza is actually a respiratory illness. The flu occurs yearly, typically during winter months and is spread by contact with respiratory germs (coughing, sneezing, etc) and contaminated objects (dirty surfaces, unwashed hands). This virus causes symptoms typically within 1-4 days of contact, and can be contagious before symptoms begin, making Influenza highly contagious.
How to Prevent the Flu
There are several ways to prevent yourself and your family from the misery of the flu. First, and always applicable, is good handwashing. Avoidance of people with illness, staying home if you are sick, and mask-wearing can all be helpful, but as noted above, the virus is contagious before symptoms strike, thus these are not foolproof methods to stay well. Last, but likely the best, is the yearly flu vaccine. Vaccine efficacy changes from year to year because the strains of flu in the community are always changing, but typically yield somewhere between 30-70% immunity for the season (ie, you need to get it yearly!). Personally, I’ll take even a 50% reduction in my chances of getting the flu! (Plus, in most studies, people with the worst symptoms and bad outcomes tend to be those who weren’t vaccinated. That means that if you do get the flu after vaccination, your symptoms probably won’t be quite so bad.)
What happens if you or your loved ones get the flu? Well, buckle up for a few rough days. Fevers can be up to 105 degrees, body aches, chills, extra fatigue, deep cough, sneezing, sore throat, and vomiting can all be common for 4-6 days. You are going to need to drink lots of extra fluids, and probably take acetaminophen and ibuprofen to relieve your symptoms just a little. And you will likely sleep a lot, otherwise feeling like you were hit by a truck. Not fun. You definitely need an office visit if fevers last longer than 5-6 days, you have trouble breathing, or symptoms get worse after they start to get better.
- So what about Tamiflu? Well, Tamiflu (Oseltamivir) is an antiviral medication that can be used to treat Influenza. It is most effective in the first 48 hours of symptoms, but it is not a perfect medication, so let’s discuss the pros and cons. Tamiflu can shorten the duration and severity of flu symptoms. Studies vary in their results, but typically this is somewhere between 8-24 hours. Also, in patients who are hospitalized for the flu, Tamiflu can help them get out of the hospital quicker with fewer complications. On the other hand, Tamiflu has frequent side effects, with vomiting and headaches at the top of the list. Overuse of antivirals (just like antibiotics), can also lead to resistance, meaning that the flu gets harder to treat the more we use medications like this because the viruses get better at avoiding the antimicrobial properties. There are specific recommendations for who should be offered Tamiflu.
- Tamiflu should be offered as early as possible for patients who are hospitalized or at high risk of severe illness. This would include children younger than 2 years of age, people with chronic disease (including asthma, diabetes, kidney disease or heart disease), those with weak immune systems (or close family members), and women who are pregnant or just had a baby. A physical exam and conversation with your provider is necessary before starting this medication. Additional consideration can be given to those with severe onset of symptoms (difficulty breathing, dehydration, etc). Antiviral treatment can also be considered in healthy individuals before 24-48 hours of symptoms based on your provider’s clinical judgement, but we at Hilliard Peds think the modest improvement of symptoms is not a great trade off for the high likelihood of side effects in most healthy kids. Every kid and family is different though, so if you have questions or concerns, let’s discuss your particular situation.
Last Updated: 03/2019