HEALTH MATTERS: INFLUENZA
Influenza: A neighborhood nemesis By Dr. Melissa Black email@example.com Various scourges come and go in our neighborhood, but none have prompted more dread than the influenza epidemic of 2017. More deadly than Ebola, which killed an estimated 11,000 homo sapiens in 2014, the 1918 influenza epidemic killed 50 million. Down Under the flu season runs from April to October, where the majority of 2017cases were Type A H3N2 and the vaccine was estimated as 10% effective. The CDC predicted based on last year's statistics that the flu vaccine would be around 32% effective. Not great, but still, if it were the lottery with 1/3 odds, I'd buy a ticket. Vaccination is no guarantee your house will evade influenza. The vaccine is more effective against influenza Type B and Type A H1N1. It provides the weakest defense against H3N2, this year's predominant in-
vader, and thus the vaccine often gets a bad rap. However, a 2017 well-designed study by Arriloa et al. in the journal Clinical Infectious Diseases found that having vaccination reduced death rates and hospital length of stay. I don't know how much time you've spent in a hospital bed, but I've been there and if Fluzone gets me out a few days sooner and alive, I'm all for it. Current CDC guidelines state that for outpatients with acute uncomplicated influenza, oseltamivir, zanamivir or peramivir "may be used" if treatment can be initiated within 48 hours of onset. Treatment is recommended for others who are high risk, such as elders, children or people with certain chronic illnesses regardless of time frame. Government issued guidelines and expert opinions are actually weak foundations for medical decision-making. Dr. Google sometimes adds insight, especially if your online search takes you to the Cochrane Library. During World War I, Dr. Archie
Cochrane observed that at times soldiers treated on the battlefield fared better than those in the best hospitals. His legacy, the Cochrane Collaboration, is an army of scientists who independently analyze the hard research data behind treatments. A Cochrane review of all the available evidence for antivirals found that they shorten duration of influenza symptoms by one half-day on average. Compare that to one Norwegian study that found 15 ML of elderberry extract given four times a day relieved symptoms 4 days earlier that placebo. Potential side effects of antivirals include headache, vomiting, delirium and seizure. The influenza virus has already outsmarted two former antiviral drugs with complete resistance. With its high rate of use, Tamiflu will likely be next. The good news is that there is still hand washing, mask wearing, quarantine, elderberry extract, good hospital care if needed, and a neighbor's chicken soup on your side.
Village Magazine 15
Oakhurst Magazine serving the south area of the City of Decatur. Winter issue 2018.