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Swine Flu FAQ

Answers to your questions about swine flu.
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How is swine flu treated?

Pandemic H1N1 swine flu virus is sensitive to the antiviral drugs Tamiflu and Relenza. These antiviral drugs are most effective when taken within 48 hours of the start of flu symptoms. It's resistant to older flu drugs.

A third antiviral drug, peramivir, can be used only in hospitalized patients with severe flu. Peramivir is an intravenous drug approved for use under the FDA's Emergency Use Authorization.

Not everyone needs treatment with these anti-flu drugs. Most people who come down with H1N1 swine flu recover fully -- without antiviral treatment.

But the CDC strongly recommends antiviral treatment for people at risk of severe flu complications who come down with flu-like symptoms. Since it's very important to start these drugs soon after symptoms appear, doctors should offer treatment to at-risk patients if they suspect they have the flu. Doctors should not rely on rapid flu tests (they are too unreliable for definitive diagnosis) or wait for results of lab-based tests (because they take too long).

Early treatment is so important that the CDC suggests doctors offer a Tamiflu or Relenza prescription to at-risk patients. If these patients develop flu-like symptoms, they would call their doctor, and based on the doctor's clinical judgment, the patient could then simply fill the prescription.

Many people who have died of H1N1 swine flu had bacterial co-infections, particularly pneumococcal infections. There's a vaccine against pneumococcal infections. It's routine for children and recommended for adults with underlying health conditions, smokers, or people over age 65.  If your flu symptoms get worse after getting better, call your doctor. You may need treatment with antibiotic medications.

Is there enough Tamiflu and Relenza to go around? Federal and state stockpiles are large enough to treat at-risk patients with flu symptoms. But there isn't enough to offer treatment to otherwise healthy people who may have the flu. And health officials have asked people not to hoard Tamiflu or Relenza.

Tamiflu and Relenza can prevent swine flu, but the CDC urges even at-risk people to try to avoid using the drugs in this way. Not only is supply insufficient for preventive use, but preventive use appears to be a major factor in the few cases of drug-resistant H1N1 swine flu that have appeared.

There are situations in which preventive use of Tamiflu or Relenza may be appropriate for an at-risk person who must come into close contact with someone who has the flu. But the CDC suggests that doctors consider a "watchful waiting" approach. In this case, the at-risk person would wait to fill the prescription only if she or he actually developed flu symptoms.

 

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