Treating the Flu in People with Health Risks: Get the Facts

Treating Influenza (Flu) in People with Health or Age Factors That Increase Their Risk of Complications

Treating the flu in people with health risks facts*

*Treating the flu in people with health risks facts medical author: Charles Patrick Davis, MD, PhD

• People with chronic diseases like asthma, diabetes and
  chronic heart disease are more frequently hospitalized if they get the
  flu.
• Such individuals get more complications of the flu like pneumonia often due to a depressed immune system.
• The flu can be treated with antiviral drugs.
• People who think they have the flu should check immediately with their doctor if they have high risk health conditions.
• High risk persons should still get the vaccine because it is the best defense against the flu; antivirals are the second line of defense.
• Antiviral drugs may lessen symptoms, shorten the time of illness and may prevent complications of the flu.
• Side effects of antiviral drugs include nausea, vomiting, dizziness, cough, diarrhea, headache and possibly behavioral changes.
• Antiviral drugs work best when started within two days of onset of symptoms; after two days,
  the drugs may be helpful in people with high risk conditions or people very sick with the flu.
• CDC-recommended antivirals are oseltamivir (brand name Tamiflu®) and zanamivir (brand name Relenza®); zanamivir should not be used if the person has a breathing problem.
• Antivirals are usually taken for 5 days, but hospitalized patients may be treated longer.
• Children and pregnant women can take the antivirals.
• Antiviral drugs should be taken by people with high risk conditions and hospitalized patients with the flu.
• Health and age factors that increase flu risk include the following: asthma, blood disorders, heart disease, lung disease, kidney problems,
  liver problems, metabolic disorders, neurological and neurodevelopmental disorders, COPD, Immune system disorders (HIV,
  AIDS, cancers, chronic steroid use),
  Adults aged 65 and older,
  children younger than 2 years, pregnant women, women up to 2 weeks from end of pregnancy, American Indians and Alaska Natives

Do you have Asthma, Diabetes or Chronic Heart Disease?

If so, you are at high risk of serious illness if you get the
flu. In past flu seasons, as many as 80 percent of adults hospitalized from flu complications had a long-term health condition; as did about 50 percent of hospitalized children.
Asthma,
diabetes and
chronic heart disease were the most common of these. This fact sheet provides information about treating influenza in high risk people with prescription influenza antiviral drugs. Treatment with an antiviral drug can mean the difference between having a milder illness versus a very serious illness that could result in a hospital stay.

Why am I at greater risk of serious flu complications?

Your medical condition makes it more likely that you will get complications from the flu, like pneumonia. The flu also can make long-term health problems worse, even if they are well managed. People with asthma or
chronic congestive heart failure may experience worsening of these conditions. Diabetes (type 1 and 2) can make the immune system less able to fight the flu. Also, illness can raise blood sugar levels.

Can the flu be treated?

Yes. There are prescription medications called "antiviral drugs" that can be used to treat influenza illness. Antiviral drugs fight influenza viruses in your body. They are different from antibiotics, which fight against bacterial infections.

What should I do if I think I have the flu?

If you get the flu, antiviral drugs are a treatment option. Check with your doctor promptly if you have a high risk condition and you get flu symptoms. Symptoms can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Your doctor may prescribe antiviral drugs to treat your flu illness.

Should I still get a flu vaccine?

Yes. Antiviral drugs are not a substitute for getting a
flu vaccine. While not 100% effective, a flu vaccine is the first and best way to prevent influenza. Antiviral drugs are a second line of defense to treat the flu if you get sick.

What are the benefits of antiviral drugs?

• When used for treatment, antiviral drugs can lessen symptoms and shorten the time you are sick by
  1 or 2 days.
• Antiviral drugs also can prevent serious flu-related complications (like pneumonia). This is especially important for people with a high-risk health condition like asthma, diabetes or chronic heart disease.

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What are the possible side effects of antiviral drugs?

Some side effects have been associated with the use of influenza antiviral drugs, including nausea, vomiting, dizziness, runny or stuffy nose,
cough,
diarrhea,
headache and some behavioral side effects. These are uncommon. Your doctor can give you more information about these drugs or you can check the Centers for Disease Control and Prevention (CDC) or the Food and Drug
Administration (FDA) websites.

When should antiviral drugs be taken for treatment?

Studies show that flu antiviral drugs work best for treatment when they are started within 2 days of getting
sick. However, starting them later can still be helpful, especially if the sick person has a high-risk health
condition (see list below) or is very sick from the flu. Follow your doctor’s instructions for taking this drug.

What antiviral drugs are recommended?

There are two antiviral drugs recommended by the CDC and approved by the FDA for flu treatment.
These are oseltamivir (brand name Tamiflu®) and zanamivir (brand name Relenza®). Tamiflu® comes as a
pill or liquid, and Relenza® is an inhaled powder. (Relenza should NOT be used in anyone with breathing
problems, like asthma or COPD, for example.) These drugs have been in use since 1999. There are no
generic flu antiviral drugs.

Which illness is known as a viral upper respiratory tract infection?
See Answer

How long should antiviral drugs be taken?

To treat flu, Tamiflu® and Relenza® are usually taken for 5 days, although people hospitalized with the flu
may need the medicine for longer than 5 days.

Can children and pregnant women take antiviral drugs?

Yes. Children and pregnant women can take antiviral drugs.

Who should take antiviral drugs?

It’s very important that antiviral drugs be used early to treat the flu in:

• People who are very sick with the flu (for example, people who are in the hospital).
• People who are sick with the flu and have a high-risk health condition like asthma, diabetes or chronic
  heart disease. (See below for full list of high risk conditions).

What are the health and age factors that are known to increase a person’s risk of getting serious complications from the flu?

• Asthma
• Blood disorders (such as sickle cell disease)
• Chronic lung disease (such as chronic obstructive
  pulmonary disease [COPD] and cystic fibrosis)
  Endocrine disorders (such as diabetes mellitus)
• Heart disease (such as
  congenital heart disease,
  congestive heart failure and coronary artery disease)
• Kidney disorders
• Liver disorders
• Metabolic disorders (such as inherited metabolic
  disorders and mitochondrial disorders)
• Morbid obesity
• Neurological and neurodevelopmental conditions
• People younger than 19 years of age on longterm
  aspirin therapy
• People with chronic obstructive pulmonary
  disease (COPD)
• People with weakened immune systems due
  to disease or medication (such as people with
  HIV or
  AIDS, or
  cancer, or those on chronic
  steroids)

Other people at high risk from the flu:

• Adults 65 years and older
• Children younger than 2 years old
• Pregnant women and women up to 2 weeks
  from end of pregnancy
• American Indians and Alaska Natives