A shot in the arm for flu season

The time for getting a flu shot is now. Antiviral drugs also may provide relief.

By Richard Harkness, Sun Herald (Biloxi, Miss.)

Last update: November 12, 2007 - 3:53 PM

It's that time of year again: flu season. (Minnesota confirmed its first case last week.) Here are some things to keep in mind about what you can do to protect yourself.

Q Who should get a flu shot?

A Anyone who wants to reduce the chances of getting the flu. The government recommends flu shots for all adults older than 50; children ages 6 months to 5 years; anyone in between with underlying conditions, such as pregnancy or chronic illness, that make them more vulnerable to complications, and others such as caregivers.

Q When is the best time to get a flu shot?

A According to the Centers for Disease Control and Prevention, the U.S. flu season peaks between December and March. It's recommended that you get your shot during October and November, so now is the time. Even if you delay, you're likely to benefit if you get the shot any time during the season.

Q There are drugs that are effective against the flu. Can they be taken instead of getting a flu vaccination?

A You're referring to the antiviral drugs, amantadine and rimantadine (older agents) and Tamiflu and Relenza (newer agents). They prevent flu viruses from replicating once they get inside the body.

Although these drugs are not intended to replace a vaccination, they fill an important niche during the flu season.

Q If I've had a flu shot, can I use an antiviral drug?

A An antiviral drug can be used to supplement the flu vaccination in certain situations. For example, suppose you get vaccinated after a flu outbreak has been reported in your area. Once you receive a flu shot, it takes about two weeks for your immune system to gear up enough protective antibodies. During this "lag time" you can still get the flu. An antiviral drug can be taken to gird you through this vulnerable period.

Q Which antiviral drugs should I take?

A The older agents, amantadine and rimantadine, work only against influenza A, the most common type of flu.

Tamiflu and Relenza are effective against both influenza A and B.

Tamiflu comes in oral capsule and liquid form. Relenza is a powder designed to be inhaled through the mouth like some asthma medications.

Unless cost is the primary factor, prescribers should probably choose Tamiflu or Relenza. The CDC advises that flu virus strains may have become too resistant to the older agents.

Q When should I take the antiviral drugs?

A To be effective, the antiviral drug must get an early crack at the flu virus.

For treatment, the drug should be started within two days after symptoms begin, and the sooner the better. For prevention, the drug should be started within two days of contact with an infected person.

When started promptly to treat the flu, these agents have been reported to cut the duration of illness dramatically, by up to three days.

Q Are there precautions?

A Clinicians should avoid pairing an antiviral drug with FluMist, the nasal spray form of the flu vaccine. That's because FluMist uses a weakened but live flu virus. The drug could stall the intended replication of the virus, thus interfering with the body's production of flu antibodies.

Speaking of FluMist, it's now approved for kids as young as 2 years old instead of 5.

Consider FluMist a mercury-free alternative to the flu shot for healthy children and adults 2 to 49 years old, except pregnant women.

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