Posted on: Monday, October 18, 2004
Getting yourself through flu season
By Robbie Dingeman
Advertiser Health Writer
With flu shots harder to find this year, health professionals say other tools — tests, antiviral drugs and even common-sense advice that we ignore in other years — can help fight the seasonal illness.
The last decade has seen advances in testing and drugs that allow patients to get test swabs in a doctor's office and learn quickly if they have the flu, officials at the Centers for Disease Control and Prevention say.
Then doctors can prescribe antiviral drugs — known by their trade names of Symmetrel, Flumadine, Relenza and Tamiflu — to ease the illness and shorten its duration.
State epidemiologist Dr. Paul Effler said that three of those four antiviral drugs (all but Relenza) can also be used to prevent the flu, so he sees promise in using them to treat patients most at risk for flu this season. If you get the flu, your doctor could prescribe the antiviral drug to your family members so you wouldn't drag them down with you.
"The benefit would be in preventing a new infection," Effler said. He also sees potential in using the drugs for treatment of outbreaks in certain groups or institutions such as long-term-care facilities.
Effler cautioned that the drugs aren't a cure-all, and usually just ease the severity of the illness if people wait to take them until after they have symptoms.
With the vaccine shortage, Effler figures that more people will consider all their options. "They aren't inexpensive," he said. "We anticipate that there will be increased demand across the country."
The nationwide vaccine shortage resulted when British officials, concerned about possibly tainted vaccine, halted plans for manufacturer Chiron Corp. to distribute some 46 million doses.
Dr. Robert Sussman, medical director of The Medical Corner, which operates urgent-care clinics in Kailua, Kapolei and Waikiki and at the airport, normally runs a series of community clinics at Times Super Market locations. But Sussman called off the clinics and worked with state officials to determine the best way to distribute the limited supply of vaccine to those most vulnerable.
He sees promise in using the rapid tests to convince patients that they really do need to stay home when they get the flu.
Sussman said people can help themselves with lots of hand-washing and healthy habits. "Don't work too hard, get exercise, all the usual healthy habits that nobody does." Relatively healthy individuals can play a big part in staying that way, he said.
"It's hygiene, it's good awareness, it's the antiviral drugs," Sussman said.
He said part of the sudden high demand for flu shots comes from people who worry because of the shortage, in the same way that word of a possible shipping strike routinely sends Hawai'i shoppers to the store to stock up on rice and toilet paper. "Everybody wants one because there's a shortage."
Those at highest risk should still get flu shots, officials said. Those are: babies ages 6 months to 23 months; people 65 and older; those with a chronic condition such as diabetes, asthma, or heart or lung disease; pregnant women; residents of nursing homes and long-term-care facilities; healthcare workers who tend to high-risk groups; those who care for infants.
Richard M. Sasaki, 75, of Waipahu, found himself calling around to try to find a flu shot. He gets flu shots annually because he has a heart condition and takes blood thinner. "I'm kind of worried," Sasaki said. "I don't know where else I can go."
But he's listening to advice to "try to just take care of yourself" this year, not only for himself but to stay well to babysit his granddaughter, who is a toddler.
Jodi Leslie, a registered dietitian with the state Department of Health, said people can help their families with diet, rest and exercise.
"The most important thing is stay hydrated," she said, which helps to fight any bug. Drink water, fruit juices high in vitamin C, and some hot liquids such as chicken soup and herbal tea.
Avoid dairy products such as ice cream, milk or pudding because they increase phlegm or mucus production, she said. And get plenty of rest.
If you're too sick to wash dishes, consider using paper plates and disposable utensils to get rid of the germs, Leslie said. And get a new toothbrush, because your old one could be the source of contamination, she said.
Leslie cautions against relying on herbal remedies, because they are not tested or regulated by the government.
She said studies have shown that zinc and vitamin C can help boost immunity and reduce the severity of an illness. But she said studies also indicate that it's best to get most vitamins and minerals from foods. "Eating it in its natural state is preferred. So it's better to eat an orange than to take it in a pill," she said.
She recommends yellow and orange fruits and vegetables such as papaya, pineapple, mango, squash, pumpkin, yellow bell pepper, orange sweet potato and carrots.
Dr. Inam Rahman, president of the Hawai'i Medical Association, said the organization is sending a letter to physicians asking them to prioritize their patients and if they have extra flu vaccine to send it to the state health department or call colleagues.
Rahman puts more faith in better awareness of flu symptoms than he does in the diagnostic rapid tests that have become more available in the past five years. "If somebody has the flu, they need to come and get treated within the first 24 hours to get the most benefit from the antiviral treatment."
He said the tests are somewhat expensive and not that easy to use. Rahman believes that most of the very young have received their vaccine but is less certain about the medically fragile and the frail elderly.
"I am concerned," Rahman said. "I don't want people to panic."
Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 535-2429.
