Tuesday, January 11, 2000

Aggressive drugs
keep flu virus
in check

The B strain of the virus is
hitting isle residents particularly
hard this season; two new drugs
attack it and dramatically
cut recovery time

Flu shots can help

By Lori Tighe


Her voice sounded like a man's. Her headache made her toss and turn all night. Her eyelids were like burning coals, and her body hurt especially around the rib cage.

"I felt really beaten up," said Dr. Kanthi von Guenthner, first deputy medical examiner for the city. "I haven't been this sick in a long time."

Like hundreds of others in Hawaii, she caught the flu. She missed work all last week, but returned yesterday. Von Guenthner would still be home if not for the newest anti-viral drug on the market, Tamiflu.

If taken in the first few days, it attacks the virus and prevents it from spreading.

Unsure if she had a lousy cold or the flu, von Guenthner called her doctor, Ben Tamura, at Kaiser Clinic. She described her symptoms, which included a fever and severe body aches. He declared it the flu because of her bodywide symptoms and prescribed Tamiflu, just two months on the market.

Now she sounds like a commercial: "I couldn't believe it. Sure enough, it definitely helped me," von Guenthner said.

Not only did it shorten the course of her illness by several days, but after a day and a half of taking the medication, her symptoms faded.

"After the third dose there was a big improvement. It was a very pronounced difference. It was helping me," von Guenthner said.

Tamiflu and another similar drug inhalant, Relenza, have provided doctors with a new arsenal to fight the flu, said Dr. Ramsey Hasan, who works in the emergency room at Castle Hospital.

"The feedback so far has been very good," Hasan said. "Healing a few days faster makes a world of difference to many people."

Kaiser Permanente has filled several hundred prescriptions for Tamiflu so far, said Barbara Kashiwabara, director of Kaiser's pharmaceutical services.

With Tamiflu and Relenza, complete recovery takes five to seven days. Without the drug, recovery takes 10 to 14 days, she said.

But the new medications have not been tested on children yet.

The catch with these new medications is they must be taken within the first few days of symptoms to work. Many people either don't know for sure they have the flu, or hold out hoping they don't have it, Hasan said.

If people suffer with more than the flu, such as ear infections or pneumonia, they may need additional antibiotics, Hasan said.

"If someone suspects they have the flu, they should contact their doctor or go in and let the doctor evaluate them," Hasan said.

What seemed to start as a normal flu season in Hawaii is becoming one of the worst flu seasons Hasan has ever seen, he said.

"We're seeing mainly older folks, dehydrated, with generalized weakness and respiratory problems. It's totally justified for them to come to the ER," he said.

Two elderly people died from the flu outside the hospital, according to city officials. Hospital death tolls from the flu weren't available yesterday.

All ages, including adolescents, have entered Castle Hospital suffering from the flu as well, Hasan said.

Kaiser has added Tamiflu to its formulary, which means the HMO's members can get it with their pharmaceutical benefits.

But Kaiser didn't add Relenza to its formulary, Kashiwabara said. Although the drugs are similar, Relenza is more difficult to take. Patients found the powder inhalant hard to use, she said.

The older medications already on the market for years that attack the flu virus are amantadine and rimantadine. But they only work on the A strain of influenza. The strain going around now is mostly the B strain, which the new drugs do work on, she said.

"It makes it nice for physicians to have something more to use," Hasan said, "beyond Tylenol and bed rest."

You still have time to get
a flu shot, and they
really work

Star-Bulletin staff


The flu shot remains the best line of defense for people who haven't caught the flu yet, said Barbara Kashiwabara, director of pharmaceutical services for Kaiser Permanente.

"Hawaii tends to see a late flu season into April, so it's not too late to get the shot," she said. "It's good for the next few months."

Unfortunately the long-standing myth of catching the flu from the flu shot still lives, Kashiwabara said, laughing.

The problem may be with the fact that the vaccine doesn't take effect for two weeks. So people can get the flu the day after the shot, although it is unrelated to the vaccine.

This season's flu shot appears to be doing its job, she said. Specially designed for the season's particular influenza strain, the vaccine doesn't prevent all strains of the flu.

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