Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
This week I am sick with the flu, so it's a good opportunity
to discuss this condition.
Flu is known by physicians as influenza, although there are
still some old-timers who refer to it as the "grippe." It is
a virus that has a long history.
Back in 1906, San Francisco was hit with an epidemic of the
flu just a few months after its famous fire. It killed
thousands of people. World War I also had many casualties due
to this disease. Today, it's rarer to be so serious due to
better hygiene, but in the elderly it can still be dangerous.
As with most viruses, it used to be that the flu had little
that could be done for it other than fluids, plenty of rest,
and acetaminophen (acamol). In truth, we aren't even so sure
that rest and fluids help, but fluids will help if there is a
fever to lessen the chance of dehydration, and a person
should probably not overexert himself. He should listen to
his body.
Two medications appeared on the scene in the late 60s, but
they were only good against Influenza A and not B, and we
didn't have the technology to know which was which. These
drugs, amatadine and ramatadine also made those who take them
very jittery.
Today, meaning this year, we do have the technology to tell
which type you have, as well as two new medications that
cover all types of the virus. They were just recently
approved by the FDA, so they are still expensive. The experts
insist that the yearly vaccine is a better idea.
The vaccine must be taken yearly, as this virus changes
itself so easily. The experts predict what form it will take
each year, and the vaccine is designed accordingly. This year
I did not take the vaccine, since in Israel they don't use
the acellular vaccine but live attenuated vaccine. The
acellular works well with few side effects but is more
expensive than the live attenuated, which is the virus which
is still alive, only rendered harmless. The problem is that
it is still a virus, so the body ends up giving you flu
symptoms anyhow for three days. This doesn't happen with the
acellular vaccine, which is just a piece of the virus's
proteins.
The flu seems to be a winter virus, and I must repeat that
antibiotics are not a treatment for viruses. Antihistamines
are also not a good idea unless you need to sleep. We prefer
decongestants. Cough can be a tough problem. I most often
prescribe dexomethropan but it doesn't always work.
If you are sneezing and coughing, please realize that
sometimes it only takes five individual viruses to infect
another person so, at least for other people's benefit,
consider staying home. There is mild evidence that chicken
soup may help, as well as Vitamin C in doses of 3 grams a
day.
I have to rest. I feel horrible. Write me (and send your
chicken soup) to me in care of the Yated.
