As the 2009/2010 influenza season progresses, there is cause for worry. Flu activity is already widespread in 46 states, according to the Center for Disease Control (CDC), and the 2009 novel H1N1 flu virus, popularly known as the “swine flu,” is on the rise. Meanwhile, the swine flu [...]]]>

As the 2009/2010 influenza season progresses, there is cause for worry. Flu activity is already widespread in 46 states, according to the Center for Disease Control (CDC), and the 2009 novel H1N1 flu virus, popularly known as the “swine flu,” is on the rise. Meanwhile, the swine flu vaccine is difficult to obtain, leaving many unprotected from this new strain. Fortunately, the antiviral treatments Tamiflu and Relenza are still largely effective against the swine flu.

Why is there so much worry about pandemic flu this year? Regular flu kills 36,000 people in the US each year, but the swine flu variation has the potential to kill many more. The latest update from the CDC shows that swine flu has caused at least 95 children’s deaths since April. Why is this strain so dangerous?

• It is a new combination (made of human, swine, and avian elements) and virtually no one has natural immunity to it
• The vaccine is not yet widely available
• This strain attacks the young and healthy population in disproportionate numbers

There is some hopeful news from the CDC in terms of protecting yourself:

Almost all of the influenza viruses identified so far are 2009 H1N1 influenza A viruses. These viruses remain similar to the virus chosen for the 2009 H1N1 vaccine, and remain susceptible to the antiviral drugs oseltamivir and zanamivir with rare exception.

Influenza antiviral drugs are prescription drugs (pills, liquid, or inhaler) that decrease the ability of flu viruses to reproduce. It is advised that you begin them within two days of getting influenza. Many people ask about taking anti-viral drugs before they show symptoms, but according to the CDC, pre-exposure antiviral chemoprophylaxis should only be used in limited circumstances, and in consultation with your doctor.

The drug oseltamivir (trade name Tamiflu, from Roche) is one of two drugs that is approved for treatment of swine flu. It is taken orally, in a pill form or a suspension. Common side effects include: nausea, vomiting, diarrhea, abdominal pain, and headache. Less frequently, delirium, hallucinations, rash, hepatitis, and allergic reactions including anaphylaxis can occur. There is some concern that oseltamivir can cause the desire to self-harm, and this seems more pronounced in children. People with the flu, particularly children, may be at an increased risk of self-injury and confusion shortly after taking Tamiflu and should be closely monitored for signs of unusual behavior. However, oseltamivir is approved by the FDA for use in children 1 year of age or older. In addition, in July 2009, the FDA issued an Emergency Use Authorization for the use of Tamiflu in pediatric patients younger than 1 year of age.

The drug zanamivir (trade name Relenza, from GlaxoSmithKline) is the other medication approved to treat swine flu. It is an inhaled powder that comes with a disk inhaler. It can cause side effects, especially in those with asthma or other chronic lung disease. Decreased respiratory function and bronchospasm have been reported with use of zanamivir. Zanamivir is generally not recommended for use in persons with underlying lung disease such as asthma and chronic obstructive pulmonary disease. Other side effects reported by less than 5% of those who have used this drug are diarrhea, nausea, sinusitis, nasal infections, bronchitis, cough, headache, and dizziness. Relenza is approved for treatment in children 7 years and older, but only those without underlying respiratory or heart disease, including asthma.

One final caution as you navigate flu season is to beware of some unscrupulous online vendors selling fake flu drugs to capitalize on the public’s fear. The Food and Drug Administration recently issued a warning to consumers to be careful not to purchase counterfeit medications. You may rest assured that eDrugSearch.com deals only with reputable, licensed pharmaceutical suppliers in the U.S. and Canada. Our advanced search features enable members to identify pharmacies with specific licensing requirements, third-party accreditations, Better Business Bureau memberships, and more. We offer a feedback system so consumers can share their ratings of the pharmacies they deal with. Browse the ratings, and enjoy peace of mind as you choose among our consumer-tested pharmacy partners for your flu season needs.

The answer is that, yes, you can use these drugs as a precautionary measure against swine flu. Government health officials and [...]]]> After our post yesterday on five ways to protect yourself from swine flu, we received a number of e-mails inquiring about the use of Tamiflu and/or Relenza as a flu preventative.

The answer is that, yes, you can use these drugs as a precautionary measure against swine flu. Government health officials and physicians, however, are hesitant to endorse this because the overuse of antiviral drugs can help germs become resistant to them.

However, some physicians have been providing prescriptions for Tamiflu and Relenza as a precaution. As pharmacist Steve Tigrett reports:

It hasn’t gotten out of hand yet. Some doctors are writing it as a precaution, just to have in case they do start showing symptoms. It needs to be taken pretty quickly after you contract the flu.

The best course of action is to see your physician immediately at the onset of symptoms and to begin taking the medications at that time.

Antiviral drugs are about 70 to 90 percent effective in preventing flu following an exposure. If Tamiflu (oseltamivir) or Relenza (zanamivir) is taken when flu symptoms first appear, they can dramatically reduce the duration of illness and the severity of symptoms. These drugs inhibit the flu viruses’ ability to reproduce, helping to treat existing flu infections and to prevent future ones.

Is one of these two medications better than the other? There is no consensus on this. According to Dr. Marcus Gitterle, a New Braunfels emergency medicine physician: “If I had to choose, I would take Relenza, as I think it gets more drug to the affected tissue than Tamiflu.”

The most important thing is to begin taking these medications within 48 hours of the onset of symptoms. If you wait beyond this period, it may be too late to prevent a full-blown case of the flu.

Read more at Organized Wisdom.

Since we are headquartered in San Antonio, eDrugSearch.com is located relatively close to ground zero in the current swine flu outbreak. The first H1N1 death in the United States was here in Texas, and today, Dr. Marcus Gitterle, a New Braunfels emergency medicine physician, is attracting significant attention after sending out a frightening internal [...]]]>

Since we are headquartered in San Antonio, eDrugSearch.com is located relatively close to ground zero in the current swine flu outbreak. The first H1N1 death in the United States was here in Texas, and today, Dr. Marcus Gitterle, a New Braunfels emergency medicine physician, is attracting significant attention after sending out a frightening internal e-mail that has spread across the Web like wildfire.

Based on privately communicated information from the Centers for Disease Control and other sources, Dr. Gitterle said that the virus is far worse than the media is telling the public.

Here’s an excerpt from Dr. Gitterle’s e-mail:

Since it is such a novel (new) virus, there is no “herd immunity,” so the “attack rate” is very high … Almost everyone who is exposed to this virus will become infected … The “clinical attack rate” may be around 40-50%. This is the number of people who show symptoms. This is a huge number. It is hard to convey the seriousness of this.

The virulence (deadliness) of this virus is as bad here as in Mexico, and there are folks on ventilators here in the US, right now … Here in the US, folks are getting Tamiflu or Relenza quickly, and we have ready access to ventilators. What this means is that within a couple of weeks, regional hospitals will likely become overwhelmed.

There are 10-25 times more actual cases (not “possible” cases — actual), than what is being reported in the media.

During the night, we crossed the threshold for the definition of a WHO, Phase 6 global pandemic. This has not happened in any of our lifetimes so far. We are in uncharted territory…

Dr. Gitterle subsequently has pointed out that, even if the swine flu does not prove more severe than the typical flu, the fact that the “attack rate” is three times higher could mean more than 100,000 people in the United States could die before the outbreak has ended.

Whether or not things are as serious as Dr. Gitterle suggests, this is clearly a situation where it’s better to be safe than sorry.

Here are five things you should do to protect yourself and your family from the H1N1 virus:

1. Avoid indoor gatherings, or entering any enclosed space with someone who has signs of a respiratory illness. Try to stay at least six feet from anyone with a cough, sneeze, runny nose, or other symptoms; the droplets can travel further than you might think.

2. Avoid handshakes and wash your hands frequently. Washing your hands prevents the transfer of virus particles from the hands to the eyes, nose and mouth. If you do shake hands, use a hand sanitizer immediately afterward.

3. Don’t rely on masks. Snug-fitting medical masks, such as surgical or dental masks, might be better than nothing — but not much better. Too often, they simply give us a false sense of security about being in group settings. The better course is simply to avoid groups whenever possible.

4. Treat swine flu with Tamiflu or Relenza. Doctors says this swine flu strain is treatable with two antiviral drugs: Tamiflu (oseltamivir) and Relenza (zanamivir). Roche, which makes Tamiflu, and GlaxoSmithKline, which makes Relenza, have already begun increasing production.

U.S. government officials say they have stockpiled enough of these medications to treat up to 50 million people. If the virus spreads widely enough to exhaust this stockpile, Roche says it has an annual production capacity of 400 million treatment courses.

Is one of these two medications better than the other? According to Dr. Gitterle: “If I had to choose, I would take Relenza, as I think it gets more drug to the affected tissue than Tamiflu.”

5. Consider alternative remedies and immunity boosters. N-Acetyl-Cysteine, a nutritional supplement, has been shown to prevent or lessen the severity of influenza. Dr. Gitterle recommends 1200mg twice a day for adults, and 600mg twice a day for children over 12. Additionally, Oscillococinum, a homeopathic remedy, has been shown to be effective in a clinical trial with an H1N1 variant. Taking vitamins C and D is also a good idea.

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