SICKNESS SEASON - Printer Friendly - Muscle & Fitness Hers

SICKNESS SEASON

Jonathan M. Berkowitz, MD

What you need to know about fighting and easing flu symptoms.

No one likes getting the flu: For most people, it means a few days of misery, involuntary bed rest and chicken soup. Things can get pretty bad, yet history has been kind to our generation - we've avoided catastrophes like the 1918 pandemic that killed 500,000 Americans.

Medical science has exploded exponentially since then, of course, but the influenza vaccine, our bulwark of defense, remains potentially flawed. Flawed because influenza's viral coat mutates constantly, creating new strains with altered sites of attack. This mutation forces the scientists responsible for formulating the annual vaccine to predict which strain will dominate. Predicting wrong can spell disaster, yielding an ineffective vaccine that could leave millions unprotected. This guesswork, coupled with potential vaccine shortages, has many experts concerned that another pandemic - a severe, often deadly worldwide outbreak - is lurking on the horizon.

"Unlike 1918, we're better able to treat influenza and its complications," says Keiji Fukuda, MD, chief of epidemiology, influenza section, for the Centers for Disease Control and Prevention in Atlanta. "The downside is we have an older population that tends to get hit hard by flu. The single most important action a person can take to avoid influenza is vaccination."
Easing Symptoms
Even the flu vaccine doesn't come with guarantees - it's just 70%-90% effective against the most common flu strains - but you do have options when it comes to treating the flu. In fact, great strides have been made in just the last few years. The first two flu medications, amantadine and rimantadine, only treat influenza A and cause side effects that severely limit their use. The newer Relenza (zanamivir) and Tamiflu (oseltamivir), designer drugs modeled on computers, are neuraminidase inhibitors that kick the flu in its reproductive heart and inhibit viral proliferation, whether it's influenza A or B. A study published in The Lancet reports that Relenza reduced the severity and duration of the flu by 1.5-2.5 days; Tamiflu demonstrated similar efficacy, cutting duration of symptoms nearly in half, according to the Journal of the American Medical Association.

Two measly days may not sound like much, but remember the last time you had the flu? For two fewer days of feeling like death, you bet these drugs are worth the $55 it costs for a typical five-day course. Tamiflu comes as a pill, and Relenza is inhaled through a UFO-like device that some people find cumbersome. Side effects are rare: bronchospasm with Relenza and nausea with Tamiflu.

Besides reducing misery, Tamiflu and Relenza may save lives by preventing influenza. This is especially important for the elderly and infirm, whose medical problems place them at risk for flu-related complications like pneumonia. The best defense for everyone remains vaccination - it helps prevent infection and limits the duration and severity of symptoms should infection occur.

The only real drawback with neuraminidase inhibitors, which Fukuda calls relatively safe, is that they must be started within the first 36-48 hours after symptoms appear to be effective. That means you must know you have the flu and find a doctor in 48 hours. Yet the common cold can masquerade as influenza, so how do you tell the difference?
Bad-Girl Flu
Colds and flu often share the same miserable tale: fever, chills, cough, body aches and fatigue. What distinguishes the flu from a common cold is that symptoms are severe and sudden, often developing within hours. With the flu, you're miserable right from the get-go; colds gradually build momentum over a few days. Time of year is also important: While influenza tends to strike during winter, a bout of illness in July is probably a cold. For doctors, diagnosing the flu relies on recognizing the typical symptoms in a community where influenza has been documented.

Influenza A and B are spread by inhaling sneezed/coughed virus or by touching a contaminated surface; pandemics occur randomly and are usually caused by major genetic shifts in influenza A. Frequent hand-washing and avoiding close personal contact with people who are ill go a long way toward prevention. If your significant other is sick as a dog, it may not be a bad idea to sleep on the couch for a week, which is how long it takes most people to stop shedding the virus.

The Sickening Truth
Let's say you did everything right but still got sick. First, call your doctor. Time is of the essence, and many doctors will prescribe Relenza and Tamiflu over the phone. Call in sick to work, too; you'll soon be too ill to think straight, and no one wants your germs.

Second, consider tried-and-true favorites like chicken soup and liberal hydration - they can be lifesavers. You'll probably become dehydrated from the fever, and liquids will minimize that crummy, washed-out feeling you get when you're sick. Try running a humidifier in your bedroom to open up your clogged nose.

For all you exercise nuts out there, read my lips: Do not exercise when ill. Rhabdomyolysis, a potentially fatal inflammation and destruction of muscle, is a rare but real flu complication made all the more likely by exercise. Take at least a couple of days off! You will get better, you will get back to the gym, and you'll return to your high level of fitness sooner than you think.