While the European Center for Disease Prevention and Control reports that influenza activity so far this season is at a low level in Europe, the U.S. Center for Disease Control (CDC) reports that flu indicators are higher than usual for this time of the year. The indicators include: number of doctor visits for flu symptoms, number of lab specimens testing positive for strains of the flu, and number of hospitalizations for influenza.
How to best prevent getting the flu this winter? For the second flu season in a row, the CDC is recommending injectable vaccinations (flu shots) and NOT the nasal spray vaccine (live attenuated influenza vaccine) called FluMist®. A CDC study found that FluMist® is only about 5% effective for preventing flu, while the shot can be close to 65% effective. Some countries (including Canada and the UK) continue to recommend use of FluMist® as an option. These countries base their recommendations on different studies that support the vaccine's use.
The CDC recommends these options* for vaccination for the 2017-2018 flu season:
- Standard dose flu shot given into the muscle (usually with a needle, but two doses can be given to some people with a jet injector).
- Standard dose flu shot given into the skin.
- A high-dose shot for people 65 and older.
- A shot made with adjuvant for people 65 and older.
- A shot made with virus grown in cell culture.
- A shot made using a vaccine production technology (recombinant vaccine) that does not require the use of flu virus or eggs.
*Source: www.flu.gov (U.S. Center for Disease Control)
If you do get the flu, there is no magic cure, unfortunately. Most people do not need medical care or antiviral drugs. Your doctor will probably tell you that resting at home and avoiding contact with others will be the best thing to do. However, if the patient is in a high risk patient category (such as under age 5 or over age 65), the health care provider may prescribe an antiviral medication like oseltamivir (Tamiflu), which may reduce the symptoms and/or reduce the time that you experience symptoms by about one day.
Earlier this year, the World Health Organization's Committee on the Selection and Use of Essential Medicines changed the status of oseltamivir from an "essential medication" to a "complementary medication." Oseltamivir was added to the WHO's medication list in 2009 in response to the swine flu pandemic that year. Evidence from outcomes in the years since then have "reduced the previously estimated magnitude of the effect of the drug on clinical outcomes." As a "complementary" medication, WHO recommends its use be restricted to confirmed or suspected influenza in critically ill hospitalized patients. In addition, unless new information emerges that supports its use for seasonal flu outbreaks and pandemics, the Committee noted in their 2017 report that the drug may be deleted entirely from the next list.
Check out reviews of Tamiflu on AskaPatient. Also, an analysis of H1N1 flu drugs from 2011 has charts showing common side effects reported on AskaPatient.com and links to some of the research from that time period that questioned the effectiveness and safety of Tamiflu. This includes BMJ and Cochrane research that contributed to the body of data about the drug that emerged in the years since 2009.