INFLUENZA INFO FOR 2005 - 2006                                                                       Dankers  10/05

INFLUENZA  SYMPTOMS

· Usually sudden onset of aching and fever. (Within a few hours you know you are really sick.)

· Fever usually above 101.                                                           

· Headache, body ache and often eye ache.  (As if you have been  “run over by truck”)

· Usually within a day, you get a dry cough that can keep you awake.  The cough often persists.

· Often sore throat and hoarseness which are aggravated by the cough.

TREATMENT

These symptoms can be caused by influenza type A or type B.  Both types can be prevented by getting a flu shot at least two weeks before exposure. The flu shot is the best guess for what’s

to come, so it is not 100% effective. Protection from the shot only lasts 4-5 months so best to

get in early November.

Type A causes 85% of outbreaks and can be dramatically lessened by taking Amantadine, which prevents the spread of the virus through your body.  The earlier you start the better.  It is usually not effective after 48 hours of symptoms, because then the virus has already spread.

Amantadine comes as a 100mg capsule.  The adult dose is one capsule as soon as possible when

symptoms start, and then 1 twice daily for 5 to 7 days (at least two days beyond improvement).

Generic Amantadine costs less than $15 for thirty.  (I usually prescribe two courses at a time for

family members who may benefit by being able to start Amantadine earlier in their course.) 

Taking one Amantadine per day can also prevent influenza A, therefore another strategy during an epidemic is to give a flu shot and then one Amantadine daily for two weeks.Amantadine is usually well tolerated.  Possible side effects are fatigue, nausea or dizziness, and these occur more in the elderly.  Rimantadine has fewer side effects but is twice as expensive. They only work against type A.  There are newer medications that may be effective against A and B.

Fluids and rest help.   The dry cough afterwards can be very bothersome. Dextromethorphan (DM) is the best non-narcotic for cough. The night cough often requires prescription narcotic cough suppressants otherwise people can be awake all night and have sore throat and chest pain from the cough.  I prefer hydrocodone which is stronger than codeine but generally better tolerated.