The drumbeat has started to get your flu shot. As influenza starts showing up around the country you will no doubt be urged to get vaccinated. But last year’s vaccine produced dismal results. Even though it was a surprisingly good match for the circulating viruses, the CDC found that the vaccine was only about 27 percent effective for those over 65, the very people who are most vulnerable to complications of influenza.
The most virulent form of flu last year was H3N2. Only 9 percent of senior citizens who were vaccinated got protection against that strain according to the CDC.
What are people to do if they come down with the flu this year despite a flu shot? Even though there are antiviral medications like Tamiflu (oseltamivir) and Relenza (zanamivir), many doctors don’t believe they are very effective. For reasons that are not obvious, many health professionals have not embraced antiviral medications against influenza.
A new study in the journal Pediatrics suggests this attitude might be deadly. Investigators from the CDC and the California Department of Public Health analyzed data from 800 children who had been hospitalized because of the flu. These were very sick kids who ended up in intensive care units (ICUs). The researchers found that children who received antivirals within 48 hours of coming down with symptoms were more likely to survive than children who went untreated. In their own words, the authors state that:
“There is strong evidence that NAI [neuraminidase inhibitors, aka antiviral drugs] treatment of hospitalized adults is beneficial when initiated early in the clinical course of influenza, although evidence from randomized placebo-controlled trails is lacking…A recent meta-analysis reviewing data from 90 studies of adults and children with H1N1 found NAI treatment within 48 hours of symptom onset reduced the likelihood of severe outcomes such as death and ICU admission…Our results suggest that prompt NAI therapy in children with influenza virus infection who are hospitalized in an ICU may improve survival, including in those more severely ill who require mechanical ventilation.”
Sadly, doctors have been reducing their prescribing of antivirals during flu season. During the last pandemic between 2009 and 2010 roughly 90% of the patients reviewed in this study received antivirals. Two yeas later that had dropped to 63%.
The researchers’ conclusion:
“These results and our findings suggest that further efforts are needed to educate clinicians to increase antiviral treatment in hospitalized patients with seasonal influenza, including those who are critically ill.”
Peggy Weintraub, MD, chief of pediatric infectious diseases at UCSF (University of California, San Francisco) did not participate in the study but commented:
“Antivirals matter and they decrease mortality, and the sooner you give them the more effectively they do that.”
There is now solid evidence that antiviral drugs make a difference in the course of influenza. For those most vulnerable, a prompt prescription can shorten the duration and severity of an infection.