Nov 5, 2012

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

I watch way too much Discovery Channel. I saw a documentary about people with a fascinating condition called face blindness. These people had normal memories in every way except they couldnt recognize faces. Of anyone. They couldnt pick out their mothers face or their sons face out of a photo line up. This made social situations very awkward. People they knew for years would come up to them and have a conversation and the person with face blindness would either have to admit they didnt know who the person was or try to fake their way through the conversation and hope the person would drop other identification clues. Imagine how difficult life would be if you couldnt recognize anyone. Now imagine there was an infectious disease that killed thousands of Canadians every year, but every year Canadians seemed to forget what it was. Im going to call this condition flu blindness.


A few weeks ago, Barret told you to get the flu shot. A flu shot will protect you from about 2 weeks after you get it and the protection will last about 6 months. This years flu vaccine contains the H1N1 strain that scared us last year, plus two other new strains. You should get the flu shot because in Canada, an estimated 10% to 25% of people will get the flu each year. Between 2000 and 8000 Canadians could die of influenza and its complications this year, depending on the severity of the flu season. However, some of you will choose to get the flu instead of the shot. Also, although much less likely, some of you will get the shot and will still get the flu. So now what?


There are three different prescription medications in Canada that can be used to treat the influenza virus. Tamiflu or oseltamivir is available as an oral capsule and a liquid. It is called a neuraminidase inhibitor which means it stops an enzyme in both the influenza A and B virus which stops them from replicating. This stops the spread of the virus to uninfected cells. So now the immune system can come in and kill off the virus. Relenza or zanamivir is inhaled through the mouth and is also a neuraminidase inhibitor. The third medication is called amantadine. Amantadine was originally used to treat Parkinsons disease. It is called a M2 ion channel blocker which means it interferes with the replication of influenza A. It does not effect influenza B. Because amantadine doesnt work against influenza B, it isnt used very often in flu treatment anymore.


Both oseltamivir and zanamivir are used twice a day for 5 days to treat the flu. Both should be started within 48 hours of the onset of flu symptoms and both will reduce your illness by about 1 day. They are both quite expensive, costing about $60 each. At the time of writing this article oseltamivir or tamiflu was available and zanamivir or relenza was on back order. Most people arent going to go to their doctor within 48 hours of the first sign of flu and spend $60 to possibly reduce their flu by 1 day. If you have the flu already what should you do?


If you are a healthy person under 65, rest as much as you can and drink lots of fluids. The flu will last a week to 10 days, and you may very well have to miss work or school for a few days. (Or you can be like me, I always seem to get sick on my holidays.) Here are some warning signs for when to go see the doctor. If you have a high fever (>40.50C), a stiff neck, or seizures go see a doctor. If the fluy person in your house is difficult to arouse, confused, delirious, or has a fever lasting more than 72 hours take them to see the doctor. If the fluy person is very young, or very old or has a serious underlying disease, a doctor visit may be in order. Finally, if the flu lasts longer that 10 days and the sputum (the stuff you cough up, or comes out of your nose) changes color (other than clear, white, or very light yellow), go to the doctor. You may have caught a second, bacterial infection while you were fighting the flu, and this is how pneumonia can start.


So besides rest, and fluids, what can you take for the flu? Talk to your pharmacist about what symptoms you are having, and the two of you can pick out what over the counter medications will help you the most. For fever, headache, and muscle aches acetaminophen is the most common choice. ASA should be avoided because of a rare but serious condition called Reye's syndrome that can happen to children if their fever caused by a viral infection is treated with ASA. Cough is usually treated with a cough suppressant like Dextromethorphan (DM). Any number of cough drops can help a sore throat. Many cough drops act the same way as a sour, sugarless candy and bring relief by increasing salvia production. There are cough drops that have a local anesthetic in them. They work great, but you have to be careful you don't drink anything hot right after taking them. If you do, you can burn your throat without realizing it. Finally for the runny nose, look for a product with a decongestant in it.


To stop the spread of the flu virus, wash your hands often with soap and warm water for at least 20 seconds. Wash before and after eating, after you have been in a public place, after using the washroom, after coughing and sneezing and after touching surfaces that may have been contaminated. An alcohol-based hand sanitizer is also effective in killing viruses. Keep your hands away from your face. In most cases, the flu virus enters the body through the eyes, nose or mouth. Cough and sneeze into your elbow, not your hand. If you use a tissue, dispose of it as soon as possible and wash your hands. Finally, if you have the flu, stay home so you dont infect the rest of us.


The opposite of face blindness also exists. The Discovery channel documentary introduced a woman with face hyper responsiveness. She remembered every face she every saw. I want you to be a flu fight hyper responder. With simple steps like getting a flu shot and washing your hands, seasonal flu doesnt have to wipe you out for a week every year.


As always if you have any questions or concerns about these or other products, ask your pharmacist.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.


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