In Tough Flu Year, CDC Touts Prompt Tamiflu Prescriptions

Note: We've also posted a follow-up to this news story: Quick, Take Tamiflu? Maybe Not A Slamdunk If You're Young and Healthy.

Flu seasons are never good, but this year's is shaping up as a notably nasty one. It's dominated by a strain of virus — known as H3N2 — that tends to cause more severe symptoms and is a poor match for this year's vaccine. And we're still right in the middle of it.

So today, CDC director Dr. Tom Frieden issued this new, Tamiflu-touting message to reporters and the public: "Anti-viral flu medications are greatly under-utilized. But if you get the flu, and if you get medicines early, they could keep you out of the hospital; they could keep you from having to go into the intensive care unit; and they might even save your life."

If I or one of the members of my family got flu or a flu-like illness, I would get them or me treated with Tamiflu as quickly as possible.

CDC director Dr. Tom Frieden

That message is especially important, he says, for people at high risk for complications of flu, including elders over 65, pregnant women, very young children and people with underlying health issues such as asthma or diabetes. The anti-virals work best if taken within the first 48 hours of flu onset.

In case you're now feeling an urge to run out and stock up on Tamiflu, well, first of all, you can't. Tamiflu and its ilk are available only by prescription.

And second, you shouldn't. It would make you a bad citizen. Frieden reports that though manufacturers have a big enough supply overall, there are spot shortages of Tamiflu around the country, and it may already take some calling around to find a pharmacy with a supply. Stockpiling could deprive patients who need the drug more than you do.

Dr. Alfred DeMaria, medical director for the Bureau of Infectious Disease at the Massachusetts Department of Public Health, says a local pediatrician recently told him about prescribing an antiviral drug for a Cystic Fibrosis patient at high risk for flu complications. The family had to go to several pharmacies before they could fill the prescription.

"Why was that? The pharmacies have just-in-time inventory for expected sales," Dr. DeMaria says, "and if those expected sales go up because people say, 'Oh, it's going to be a bad flu season; they're recommending Tamiflu; I'm going to get some and keep it just in case,'" then supplies run short.

The new CDC recommendations encouraging health care staffers to write more antiviral prescriptions may surprise those familiar with less-than-exciting reports on how effective the drugs can be. In general, if taken early, they appear to cut the flu's duration by 20 percent, from an average of five days to four.

But Frieden of the CDC emphasized findings that they can reduce "how long people are sick and how sick they get," saying they can reduce hospitalizations, ICU stays and deaths.

Most people don't know there are prescription drugs to fight flu, he says, and many physicians don't prescribe them nearly as much as they could. He urged doctors to have a high degree of suspicion on flu and prescribe antivirals even without waiting for a positive flu test.

At today's news conference, reporters noted that this push for prescriptions even without a positive diagnosis contrasts sharply with health authorities' stance on antibiotics: that they should be used sparingly to avoid the development of drug-resistant infections.

Frieden responded:

"In terms of a medication like Tamiflu, the key thing, as with antibiotics, is if you're prescribed it, take the full course: It's one pill, twice a day for five days. That course of antivirals will have a benefit, and we have not seen the widespread emergence of resistance to Tamiflu."

Yes, health authorities are concerned about antibiotic resistance, he said. But "for influenza, in this season, we would like to see more antivirals used. The risk here is of progressive illness, hospitalization and death. The risk here is not of widespread emergence of resistance at this point."

His ultimate bottom line:

"To put it very simply, if I or one of the members of my family got flu or a flu-like illness, I would get them or me treated with Tamiflu as quickly as possible."

Emphatic, huh? Readers, thoughts? Experiences? Have you tried Tamiflu? How did it work for you? The latest CDC flu map:
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Carey Goldberg Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.



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