Flu season seems to be heating up, with spikes in the number of cases throughout the whole country, and very high activity in 16 states

If you're curious about where you live, check out Google's Flu Tracker

The thing that seems to have health officials worried and scratching their heads this time around isn't the spike in influenza activity--that usually happens sometime during February.  The problem this year is that the drug most commonly used to ward off influenza if you get it --called Tamiflu--is ineffective.  The CDC reported in January that influenza A (as opposed to influenza B, which isn't as severe as the A strain) wasn't responding to Tamiflu,  but the most recent news is that Flu A is about 100% resistant to the drug.

The most useless drug ever?

In my pediatric practice, I almost never prescribe Tamiflu, for the following reasons:

1) For it be effective, you have to take it within 48 hours of being of developing symptoms.  Many times, that's impractical because many kids don't show up in the office for fevers until 2 to 3 days out.  Also, I prefer to test my patients to see if they have influenza--that result doesn't come back for about a day where I work.  So the window of opportunity for Tamiflu to make a difference is pretty small. 

2) Even when it's used effectively, Tamiflu only seems to reduce the symptoms of the flu by about 1 to 2 days at best.  To me, that's not a lot of bang for the buck--which leads me to reason #3

3)  Tamiflu is $$$$-it runs about a $100 for a course, a lot of money for parents who may have high deductible insurance plans for at best 24-48 hours of return. 

4) most of my patients are vaccinated against the flu, which gives me great reassurance that when they show up with fevers, it won't be influenza causing it (although, again, some strains of the virus aren't responsive to the vaccine--but that's par for the course since it happens just about every year)

It turns out the biggest buyer of Tamiflu is Uncle Sam--the Government has been stockpiling it for years in anticipation that we may all need some if there's a flu pandemic:  Basically, we all get caught flatfooted because the virus mutates into a very dangerous strain that the vaccine can't prevent.  There have been several pandemics over the past century, but the most notorious was in 1918--50 million people died worldwide as a result of the "Spanish Flu."  Some literally got sick in the morning and were dead by the time the sunset, bleeding out of every orifice in their body.   Here's an interesting picture from that era with a scary caption:

Back to 2009, we've got crates of Tamiflu that, frankly, may be completely useless should Flu A mutate into something virulent.  At the time that the stockpiling began, some experts suggested that we stockpile another flu drug, Relenza, as well.  While some Relenza was purchased, the vast majority of our stockpile is Tamiflu.  Not a wise use of our tax dollars.

Regardless, for now Tamiflu still seems to work for that nasty Avian flu we heard about for the first time in 2005, though we haven't seen much of that in North America. 

Raise you hand if you need a flu shot:  Ok, for those of you who did, go back to the Google Flu Tracker link, where you'll find a "flu shot locator" by zip code.  Good stuff. 

www.rahulkparikh.com

Twitter: docrkp

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ADDENDUM: teendoc sent me a link reporting the death of 2 kids from influenza--very sad:

http://www.momlogic.com/2009/02/when_the_flu_turns_deadly.php