--- In FairfieldLife@yahoogroups.com, "Rick Archer" <r...@...> wrote:
>
> I don't even know if I'd be eligible for a flu shot. There's a
shortage, and
> I don't think I'm in a high risk category. 59 yrs. old. Not pregnant.
>


******

Probably only the most at-risk people should get the flu vaccine, based
on recent experiences with flu vaccination:

http://www.latimes.com/features/health/la-he-tamiflu24-2009aug24,0,46646\
54.story
<http://www.latimes.com/features/health/la-he-tamiflu24-2009aug24,0,4664\
654.story>

"Indiscriminate use of antiviral medications to prevent and treat
influenza could ease the way for drug-resistant strains of the novel
H1N1 virus, or swine flu, to emerge, public health officials warn --
making the fight against a pandemic that much harder.

Already, a handful of cases of Tamiflu-resistant H1N1 have been reported
this summer, and there is no shortage of examples of misuse of the
antiviral medications, experts say.

People often fail to complete a full course of the drug, according to a
recent British report -- a scenario also likely to be occurring in the
U.S. and one that encourages resistance. Stockpiling is rife, and some
U.S. summer camps have given Tamiflu prophylactically to healthy kids
and staff, and have even told campers to bring the drug to camp. Experts
anticipate more problems in the fall as children return to school and
normal flu season draws nearer.

"Influenza viruses mutate frequently and any viral resistance could be
acquired easily," said Dr. Anne Schuchat, director of the National
Center on Immunization and Respiratory Disease at the Centers for
Disease Control and Prevention in Atlanta. "It won't surprise us if we
see resistance emerge as a bigger problem in the fall or in the years
ahead."

Prescribed in pill form, Tamiflu (oseltamivir) works by preventing the
flu virus from leaving infected cells and spreading to new ones. Because
a vaccine against pandemic H1N1 influenza will not be widely available
for several months, Tamiflu and to a lesser extent Relenza (zanamivir),
an antiviral that acts similarly, are key medical tools for fighting the
pandemic in the meantime.

On Friday, however, the World Health Organization advised doctors that
even those who are sickened with swine flu do not need to be given
Tamiflu or Relenza if they are only mildly or moderately sick and are
not in a high-risk group (such as children under 5, pregnant women and
those with an underlying health condition).

Both drugs can help prevent illness in people exposed to the virus and
reduce illness severity in people already sickened with it. On Aug. 14,
after U.S. national soccer team forward Landon Donovan was diagnosed
with H1N1 flu, players, coaches and support staff of the U.S. and Galaxy
teams were advised to take Tamiflu as a preventive measure.

Tamiflu was chosen a few years ago for stockpiling by the federal
government to deal with future pandemics.

Health authorities in the United States and elsewhere are keeping a
sharp eye on prescriptions of the drug as they prepare for a surge of
H1N1 cases in the fall. The U.S. government has issued detailed
guidelines <http://www.cdc.gov/h1n1flu/recommendations.htm>  on
prescribing antivirals. But health professionals may not follow the
recommendations or may give in to patients who pester them for
prescriptions that are ill-advised, said Dr. Robert Schechter, acting
chief of the immunization branch of the California Department of Public
Health.

"These medicines can be very helpful to those who could get very sick,"
Schechter said. "But excessive use will accelerate the development of
resistance and lead to the lack of a medication for everybody."

Anxiety over indiscriminate use is growing, and taking the medications
cavalierly is not without consequence. British health authorities
reported Aug. 2 that cases of side effects from Tamiflu had doubled in
the prior week, coinciding with the July 24 launch of a program in
England to provide antivirals to anyone with H1N1 influenza who requests
it over the phone or online.

In the first three days of the program, 150,000 packets of Tamiflu were
dispensed and 293 cases of side effects were reported. Tamiflu can cause
vomiting, diarrhea and mild neuropsychiatric effects.

Some U.S. health authorities have also expressed concern over misuse of
the medications. Last month, the CDC urged directors of summer camps to
stop handing out Tamiflu to healthy campers.

Americans are known to hoard antivirals: A 2006 study showed that
heightened anxiety over a possible avian flu pandemic caused Tamiflu
prescriptions to soar 300% in 2004 and 2005.

Just as with antibiotics, of central importance to antivirals' success
is taking them properly, including completing the recommended course.

However, a study published in late July found poor adherence among
children in London who took Tamiflu for prevention of pandemic H1N1 in
the spring.

Less than half of the grade-school-age children and only 76% of the 13-
and 14-year-old students completed a full course of medication.

More than half of the children reported side effects, such as nausea,
stomach cramps and trouble sleeping. Almost one in five reported a
neuropsychiatric side effect, such as poor concentration, confusion or
bad dreams, even though the U.S. Food and Drug Administration says
neuropsychiatric side effects are rare.

Moreover, a study published this week found that Tamiflu and Relenza are
unlikely to prevent complications, such as asthma flare-ups or ear
infections, in children who have seasonal influenza. But they do
increase the risk of vomiting.

The authors of the study, published in the British Medical Journal, said
they don't know if their findings can be generalized to the pandemic flu
strain.







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