As the H1N1 flu strikes across the country and Carbon County, local doctors and emergency rooms have reported a rise in visits from patients with flu-like symptoms.
For many, this novel flu can be treated at home with rest, fluids, and TLC (tender loving care). But patients with an increased risk of complications from influenza, armed with prescriptions from their doctor or hospital, are now discovering that antiviral medications that can treat the flu are in short supply this year.
"There are people who are having trouble finding these medications locally, and they have been going to pharmacies in Allentown and the Lehigh Valley," said Dr. Clem McGinley, vice-president of Medical Affairs for Blue Mountain Health System. "A lot of people are finding that the drug is not available locally."
Two antiviral drugs are currently available for treatment of the novel flu: Tamiflu, with adult doses in capsule form and children's strength in syrup, and Relenza, an inhaler.
"They are both in shortage. They're having a difficult time keeping up with the production of drugs," said McGinley.
Both Tamiflu and Relenza work by reducing the risk of complications from influenza, and can sometimes shorten the duration of illness. They are recommended for children and adults with chronic health problems, including heart and lung disease, asthma and diabetes.
These drugs must be taken within 48 hours of the onset of symptoms but work best when taken within 24 hours. For many local families, finding the medication within 24 hours has been a difficult, if not impossible task. Patients have been encouraged to continue looking for the drug during the 48-hour window, because supplies are available in some pharmacies.
"There's not much else that has been shown to work," he added. "If you're seriously ill, you need to see a physician."
McGinley stressed that most healthy adults will not need Tamiflu or Relenza this year, and should be able to fight off the flu on their own. Local doctors and the CDC are recommending that adults with a mild case of the flu avoid visiting their doctor or other public areas to prevent spreading the virus further.
"For the average person, they can easily weather this virus without treatment," he said. "If you're healthy, it's a matter of symptomatic treatment," or treating symptoms to make the patient more comfortable. He generally recommends plenty of fluids and rest, and Tylenol or Motrin for aches and fever.
It is important not to take Tamiflu or Relenza if you are not at risk for complications, health officials add. Not only will this lead to further shortages of antiviral medications, but it may cause the medications to become ineffective against treating influenza, a process known as drug resistance.
"If we treat everybody it's going to lead to resistance, and that's going to be a problem in the future," said McGinley. "Most healthy people weather this virus pretty well without this medication."
Because both seasonal and H1N1 flu can cause serious complications and leave people feeling ill for up to a week, area doctors are strongly recommending vaccination and preventive tactics this year.
"The best way of treating the flu is to prevent it. The best way to prevent it is to get immunized, for both the H1N1 and the seasonal flu," said McGinley. Most area residents have already been vaccinated against the seasonal flu, but local H1N1 vaccination programs have been focusing on those most likely to be hit with serious problems from the novel flu children between the age of 6 months to 24 years, and adults with chronic health problems such as heart and lung disease, asthma and diabetes.
Pregnant women are also encouraged to request the vaccine. As more vaccines become available, they will also be offered to healthy adults who wish to be vaccinated.
Adults and children should also exercise caution throughout the flu season. The most effective way to prevent the flu is hand washing, said McGinley. Wash your hands with warm, soapy water for 15-20 seconds, about the time it takes to sing Happy Birthday twice, he said. Alcohol-based hand sanitizers also work well.
"Germs are spread by somebody coughing or sneezing," he said. "Avoid anyone who is sick. If you can, avoid going out in crowded areas or minimize going out in crowded areas." A person sneezing can spread the flu virus up to six feet away from their body, contaminating nearby surfaces. Germs can also spread when a person sneezes or coughs into their hands and then touches a nearby surface.
If you do become ill with the flu this year, use common sense before rushing to the doctor or attempting to work through symptoms.
"If you're a healthy adult, wait it out. You're better off not going out at all, because that's how it spreads," said McGinley. "Avoid work, avoid school, and avoid crowded places. Everyone needs to use their best judgment. If you're not severely ill, there's no need to go to the doctor," he added.
Children under the age of 5, who are most at risk for complications from the flu, should be seen by a physician. Healthy adults who experience symptoms of serious illness and adults with a chronic illness should also contact their doctor. Signs of serious illness include a severe headache or weakness, a temperature above 104, and confusion. People who recover from the flu, but begin to feel worse again, should also contact their doctor because they may have a bacterial infection such as pneumonia.
The CDC estimates that 8 million children and 12 million adults have become ill with the H1N1 virus. About 4,000 people have died from the H1N1 virus in America since April, including 540 children. The seasonal flu kills about 36,000 Americans each year.