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Fighting the flu

Dr. Drew Werner

EAGLE COUNTY – Since 400 B.C., when Hippocrates described an illness characterized by cough and pneumonia, we have battled the flu. In 1918, the most severe influenza (flu) outbreak ever recorded killed 20 million people. More people died in that pandemic than in all of World War I. Guess what? Here we go again.Dear Doc: I feel like a truck ran me over, but I never got the license plate. One of my co-workers has the flu. What can I do? Is there anything to keep my family healthy?- Sick in AvonDear Sick: All is not lost. While it certainly sounds like the flu, it is important to get in to your doctor for several reasons. Most importantly is to get an accurate diagnosis of what you have. It could be something more serious like a bacterial pneumonia. That would require prompt treatment with antibiotics. Even the flu can lead to a viral pneumonia, a serious illness. Nevertheless, we now have anti-flu medications, which can lessen the severity of the illness and shorten its course if taken in the first two days of the illness. More serious symptoms of the flu may include:– Shortness of breath.– Dehydration.– Exacerbations of other medical conditions including asthma, emphysema, heart disease and diabetes.There are four prescription medications, which have been well shown to decrease both the duration and severity of the illness. These include the older medications amantadine (brand name Symmetrel) and rimantadine (brand name Flumadine) as well as the recently introduced zanamivir (brand name Relenza) and oseltamivir (brand name Tamiflu). The key to the use of any of these medications is early treatment. Starting treatment in the first 24 hours is preferred and the benefit rapidly decreases after 48 hours. While all four medications work against Influenza type A, only zanamivir and oseltamivir work against Influenza type B. It is important to talk to your doctor about which type of flu is in the community before choosing a medication. Zanamivir is the only medication of the four, which is inhaled and shouldn’t be used if you have asthma or emphysema.The best medicine is still prevention. Exercise, eat right, drink plenty of fluids and get plenty of sleep. Careful, frequent hand washing is essential. The waterless hand sanitizers are very effective in killing both bacteria and viruses on your contaminated hands. I recommend keeping some in the car, diaper bag and lockers at school or at the gym. The handier (no pun intended!) it is to use, the more you will use it.Over-the-counter supplements may be helpful as well. In the mid-1970s, Linus Pauling studied vitamin C extensively. His work suggested that it is effective in moderate doses of 500mg to 1,000 mg per day in preventing the flu while higher doses might decrease the symptoms and duration of the illness. Overall, about 50 percent of individuals seem to benefit from vitamin C supplements and diets rich in foods containing vitamin C such as tomatoes, broccoli, and citrus fruits. Several small scientific studies have evaluated Echinacea as well in the treatment and prevention of upper respiratory infections including the flu. While little benefit was found in preventing the flu, it offered some benefit in decreasing the severity and duration of the typically 10- to 14-day illness. Both Vitamin C and Echinacea are considered safe.Aspirin, Tylenol and anti-inflammatory medicines may decrease some of the flu symptoms once they have struck. It is important to remember, however, that you should not take aspirin under the age of 18 for flu symptoms due to the risk of developing Reye syndrome, a serious complication of aspirin use with viral illnesses. Finally, the flu will be with us till the spring, so it is not too late to get your flu shot. Additional supplies of vaccine have been made available. Although still in limited supply, the extra doses available have led to a broadening of the criteria for those who may receive the flu shot. Check with your doctor to see if it is right for you.Please keep your questions coming in! The only bad question is the unanswered one!Dr. Drew Werner of the Eagle Valley Medical Center writes a weekly column for the Daily. He encourages health questions. Write him by e-mail to editor@vaildaily.com or c/o Editor, Vail Daily, P.O. Box 81, Vail, 81658.Vail, colorado


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