ASK THE DOCTOR: The new flu remedies are of little help
By DR. JIM MITTERANDO
The Patriot Ledger

People often - and incorrectly - call any viral cold the flu. Being a virus, influenza is not affected by antibiotics, which only kill bacteria.

The several antiviral flu medications now available have limitations, one being they must be taken within 48 hours of the start of the flu. Furthermore, the medications merely decrease the duration of symptoms by one day.

Most doctors have avoided these medications because of their limited benefit, high cost, side effects and because even during a flu epidemic, half the people with flu symptoms actually have a flu-like virus that does not respond to the medications.

Most doctors' offices do not have the new, expensive rapid flu tests that use a nasal or throat swab. Rather, most doctors (including myself) diagnose The Flu by the incidence of patients complaining of typical cold symptoms (runny nose, cough and sore throat) and flu signs (fever, chills, achiness, malaise).

Usually, I prescribe rest. I feel the antiviral pills would be useful only with elderly patients or an unvaccinated, high-risk person (people with asthma or suppressed immune systems) with flu symptoms.

The newer antiviral flu medications, which have been advertising quite a bit lately, include Tamiflu (Oseltamivir) and Relenza (Zanamivir).

Tamiflu, a pill, can trigger nausea and vomiting. Relenza, an inhaler, can cause wheezing.
Older medications, such as Amantadine and Rimantidine (brand name Flumadine), are just as effective as their newer competitors, but not as heavily marketed. Amantadine, though, can cause confusion in the elderly.

Currently, research is under way on a nasal-inhaler form of a flu vaccine, which would be easier to administer and may prevent future epidemics if given to children, who often spread the disease.

Ultimately, there is no substitute for flu vaccination. It is never too late, even during this month and next.

If you do get the flu, stay at home, sleep, drink lots of fluids and follow up with your doctor if you develop shortness of breath (which could be a sign of pneumonia) or if you do not improve after four or five days.

Dr. Jim Mitterando is a family doctor at Health Care South/Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.

Readers should send questions to: Ask the Doctor, The Patriot Ledger, P.O. Box 699159, Quincy, MA 02269-9159, or by E-mail to his attention at features@ledger.com.

Questions of general interest will be answered in this column. The information in this column is not intended to diagnose individual conditions, and individual replies are not possible. Readers should see their own doctors about specific problems.

Copyright 2001 The Patriot Ledger