Lou Romig, MD
Flu season is in full swing and our area is already being hit hard. Read these important points about proper medical care for your family amid the flu outbreak:
1) If someone has flu-like symptoms (fever that’s hard to control, body aches, sore throat, runny nose, cough, headache, vomiting, diarrhea), there’s an excellent chance they have the flu, even if a flu test comes back negative. The flu test can miss 30-50% of those who really do have the flu. CDC is encouraging providers not to do flu tests on every patient with flu symptoms, but to assume they have it based on history and examination alone.
2) Most people who have the flu or flu-like symptoms don’t need any treatment aside from rest, hydration and symptomatic treatment with nonprescription medications, such as acetaminophen or ibuprofen.
3) Tamiflu is NOT a miracle cure for the flu. Studies show that, at best, treatment with Tamiflu within the first 48 hours of symptoms may decrease the period of illness by 12 -24 hours. So, instead of being sick for 5 days, a patient might be sick for 4 days. It may or may not decrease the intensity of the symptoms. Tamiflu tends to give kids stomach pain and vomiting, which may only make them feel worse than if they didn’t take it at all.
4) There are certain types of people who are at greater risk of complications of the flu and who should be treated with Tamiflu in the hope of lessening their illness. These people include: children less than one year of age, the elderly and anyone with chronic illnesses such as asthma, epilepsy, heart disease or a compromised immune system.
5) Treatment with Tamiflu may also be considered to help cut down on transmission of the disease to other household members who are at increased risk if they get the flu. For example, Tamiflu should be considered for a healthy 5-year-old child with the flu whose frail grandmother lives with the family. That grandmother should also see her primary care provider as she might also benefit from taking Tamiflu as a prevention measure.
6) Otherwise healthy children with symptoms of the flu don’t absolutely have to be seen by a doctor unless they have symptoms like severe pain anywhere, the inability to stay hydrated or difficulty breathing. It’s always better to be conservative in seeking medical care, but parents may find themselves waiting for a long time in busy doctors’ offices, urgent care centers or ERs, only to find the provider may or may not test the child for the flu and may or may not prescribe Tamiflu. Antibiotics should not be prescribed unless there are signs of a bacterial infection. All the Amoxicillin in the world will not cure the flu, because antibiotics don’t work on viruses. Children with chronic illnesses, and especially those with immune system compromise, should be seen if they get flu-like symptoms because they may benefit from Tamiflu more than children who have no long-term medical problems.
7) Anyone with flu-like symptoms should stay home until they have had no fever for at least 24 hours. Kids should stay out of school and daycare. Adults should stay home from work or school. One of the reasons the flu spreads so easily and quickly is that people don’t stay home while they’re sick. There are many good reasons why a family might need to a send a sick child to school or daycare, or a sick adult might have to go to work, but it’s in everyone’s best interests for people who are sick to stay home.