Tamiflu

updated October 29, 2022

This post was originally written and posted 2 years before we had even heard of SARS-CoV-2, aka COVID-19. Four years later, “flu” symptoms are just as likely to be due to COVID as influenza, maybe more so. Still, we need to be vigilant because neither has disappeared. This post focuses on influenza.

To many people “the flu” is any respiratory illness characterized by some combination of fever, cough, congestion, headache, fatigue, and body aches. That term has become so nonspecific even we doctors use it that way. But it more correctly refers to influenza, which is one of many viruses that cause illness. The illnesses caused by the other viruses are usually called “colds”, upper respiratory infections, aka URIs, bronchitis, pharyngitis, sinusitis and pneumonia.

I recommend this resource from the Centers for Disease Control and Prevention to understand

Flu Symptoms & Complications

The human respiratory system — The respiratory tract including the nose, sinuses, mouth, throat, trachea, bronchi in blue and the lungs (pink). Infections can involve the breathing organs from the nose all the way down to the lungs. (photo complimentary from Pixabay)

Prior to the availability of the rapid flu test, using a nasal swab we doctors diagnosed influenza by the characteristic symptoms, confirmatory findings on exam, and knowing there was an outbreak in the community. The test is not absolutely necessary but is helpful for confirmation in the event the illness doesn’t progress as expected or to differentiate it from other illnesses especially COVID.

Vaccination-key to prevention

The World Health Organization (WHO), Centers for Disease Control and Prevention(CDC) , the National Foundation for Infectious Disease and every other reputable medical organization recommends vaccination against influenza.

My family and I always get vaccinations which have successfully protected us without side effects or adverse reactions. There are risks, as is the case for any medical procedure, or other things we do in life. In this case we have decided the benefit outweighs the risk.

Other tips to stay well and protect others

Stay home if you are sick, and ask your family, co-workers and employees to do the same.
If you absolutely must go out among other people, put an effective mask over your nose and mouth.
Cover your nose and mouth when coughing or sneezing
Wash your hands frequently.
Clean frequently touched surfaces.

Hand hygiene saves lives. — a common sight now in public restrooms

Antiviral (influenza) medications

The antiviral drug Tamiflu, generic oseltamivir, will “shorten the duration and severity of symptoms” by 1-2 days, if started early (within 24-48 hours). There is some evidence that it will also lessen the risk of serious complications , especially in higher risk people (see below ).

I warn people that even with Tamiflu they will still feel miserable for a few days. But if it gets you back to school or work a day earlier, it may be worth the cost.

Oseltamivir can also be prescribed for prevention, if you know you have had close contact with someone with confirmed influenza, such as a household member. It’s only effective though for that episode, a 10 day course taken as soon as possible after exposure.

Xofluza

Xofluza, generic baloxavir, is for treatment of uncomplicated influenza for children and adults 12 years and older, who have been sick for no more than 48 hours. Patients take 2 tablets as a single dose. It can also be used post exposure .

Relenza

Relenza, generic zanamivir, is a dry powder that is inhaled twice daily for 5 days or daily for prevention

Home care of influenza

Rest; eat and drink as normally as possible; extra fluids if running a fever
Non-prescription cough/congestion /pain/fever meds

Don’t confuse Tamiflu (generic oseltamivir) a prescription anti-viral drug with Theraflu, an over the counter drug that treats symptoms.Theraflu does not affect the course of the illness.

Here are more general guidelines on what to do if you get a respiratory illness from FamilyDoctor.org.

Flu complications

Influenza causes uncomfortable disabling symptoms but most people recover fairly quickly and fully. In some cases influenza can progress rapidly and overwhelm the respiratory and/or nervous systems, leading to death.

People also die from complications of influenza, and infants, young children and the elderly have greatest risk.The most common fatal complication is bacterial pneumonia, infection in the lung. Influenza can also attack the nervous system causing brain inflammation (encephalitis and/or meningitis) and paralysis in the form of Guillain Barre syndrome .

an xray of healthy lungs with no signs of pneumonia. — Healthy lungs with no signs of pneumonia.

High risk persons-take influenza seriously

Persons with chronic illnesses like diabetes, lung disorders, chronic liver or kidney disease, depressed immune systems and cancer , as well as infants and persons of advanced age are at greater risk of complications and should always consult a physician if feeling ill. If you are not sure if you fall into that category, ask your doctor.