Influenza, a primer – Part II

By Dr M. S. Ramya and Dr. Abhijeeth Chandrasekaran

[Continued from part I. This article is the second of a 2-part series. The previous part (part I) described the illness; this part (part II) describes the management]

What is the treatment for flu?

Antiviral medications

Antiviral drugs form the mainstay of treatment. Given the potentially serious nature of the illness, treatment is started immediately.

Your doctor will decide the best treatment for you.

The most common medication used is oseltamivir, a medication that is given orally. This drug can be given from 2 weeks of age. Treatment course usually lasts for 5 days for flu cases without any complications.

Another medication for treatment is zanamivir. This is given through nasal (nose) delivery. Other drugs that were used in the past but are not commonly used now include amantadine and rimantadine.

Ideally, drugs should be started within 48 hours of illness for efficacy.

Supportive care

Patients need to take adequate liquids and bed rest.

In uncomplicated influenza, you will usually start feeling better after treatment, after approximately 3 days of onset of symptoms.

If influenza gets complicated, then your doctor may use appropriate medications to treat the complications. Typically, complications are suspected if there is recurrence of fever, prolonged fever or worsening of clinical status.

Can we prevent influenza?

Yes.  Through Vaccines and Drugs

Vaccines

Vaccines are the preferred mode of prevention for many people. Vaccines can reduce flu illness and attendant illness-related issues. Similar to some vaccines like polio, if a higher number of people get vaccinated, the chances of the flu virus to infect and thereby spread the virus to other uninfected people decreases. All in all, society at large, benefits.

Vaccination is routine in some western countries since the flu season has a typical seasonal onset. In the Indian context, infection is generally present throughout the year (though there may be higher rates of flu during winter). In addition, as the types of influenza virus keep changing every year, this requires corresponding changes in the vaccine. Given these limitations, it is more difficult to use vaccination for flu prevention in India.

However, some vaccines are also available in India. Please consult your doctor for details regarding flu vaccines. Typically, vaccination should be given as soon as vaccines (for the virus types common in that influenza season) are available. This is preferably done before the onset of influenza circulation in the community, so that there is time for antibodies to reach protective levels

Medications

Though less common, anti-viral medication may also be used for prevention of influenza. The same antivirals used for treatment, i.e. oseltamivir and zanamivir, are also used for prevention. The course of treatment is however different for prevention (as compared to treatment). Generally, drugs are used (in place of vaccines) in situations where vaccination is impracticable or risky (e.g. unvaccinated persons who are at high risk for complications) or impracticable (e.g. people in care facilities during institutional influenza outbreaks). Drug-based prevention lasts only as long as the effect of the drug lasts.

In addition to the above, maintaining general hygiene individually and collectively is necessary to prevent flu

 

Dr. M. S. Ramya is a pediatrician, and is currently practicing in Chennai.

Dr Abhijeeth Chandrasekaran is a pathologist, and is currently working in the pharmaceutical industry.

Corresponding author: Dr. M. S. Ramya, email: ramya_dr2000@outlook.com

Disclaimer: The views expressed in this article are solely those of the authors in their private capacity. 

References

Nelson textbook of Pediatrics, Twentieth edition. Kliegman R. M, Stanton BF, St. Geme JW, Schor NF, Behrman RE. Elsevier 2016

Influenza (Flu). As provided in the Centers for Disease Control and Prevention (CDC) website accessed at http://www.cdc.gov/flu/index.htm on 7 December 2016.

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