Rhiza Labs FluTracker Forum

H1N1 still around after all, we should all take the shot

Dr. Beaman • February 7, 2010

Dear Readers,

Apparently I gave you some bad information last week when I said "The last time I looked, no reported cases of H1N1 in over a month." I based that on an online article entitled "Swine Flu Now History" with a graph showing the number of reported cases hitting zero in December.

I should have researched that more thoroughly because, according to two experts in epidemiology that both sent detailed information from the CDC, rates are down but definitely not zero. It looks as though the H1N1 virus is still smoldering along at a fairly low level throughout the country. I apologize for that and will try to make sure it never happens again.

Both writers also pointed out official recommendations that everyone, including those older than 60, be inoculated for H1N1. The earlier recommendations exempting the elderly were based on data showing people older than 60 at low risk. At that time, vaccine was scarce and it was being shunted to those thought to benefit most. Now that vaccine is widely available, the CDC recommends everyone have the vaccine except for a few special situations. I am now recommending that all my patients have the shot except those for whom it should specifically be avoided.

One of the writers questioned my statement that I had seen several cases that appeared to be seasonal influenza (rather than H1N1). I'm going to stand my ground on this one. If these folks didn't have winter flu (probably type A) they were certainly doing the best imitations of flu victims I've seen. All their temperatures were in the 103-104 F degree range and they exhibited the classic picture of "aching-all-over-like-I've-been-run-over-by-a-semi" with uncontrollable dry cough and extremely depressed energy levels.

These folks were dramatically sicker than anyone I saw with H1N1 which I described in an earlier column as "Flu Lite." The typical case of swine flu I treated in the office struck me as being about a third as debilitating as seasonal flu.

I treated these recent patients with Tamiflu and they all got better but it took longer than in previous years. I have always told flu victims in the past that, once they started on Tamiflu, they would feel better within 24 hours. Most would tell me they felt brand new the next day. This year that advice didn't work. Most of these unfortunates were in bed for three or four days and didn't feel a bit better until the third day.

It makes me nervous that the influenza virus is about to crack Tamiflu's code and become resistant.

Once that happens, were all in trouble.

Dr. Beaman has written weekly columns in the Hattiesburg American for 26 years. If you have a comment or medical question for him to answer in this column, write to Family Care Clinic, Box 1650, Richton, MS 39476 or e-mail doctorbeaman@bellsouth.net. Questions cannot be answered personally.

Pop an occasional Tamiflu, we'll all be in trouble

Dr. Beaman • January 31, 2010

Q. My husband and I are in our 60s and in good health. We have both had our regular seasonal flu shots last fall. The drug store we use has been trying to sell us Swine Flu shots and we will take them if Dr. Beaman advises us to.

A. The last time I looked, there had been no reported cases of H1N1 influenza in the United States for over a month. It appears for now as if the epidemic is gone. Ironically, about the time Swine Flu died off by itself, millions of doses of vaccine found their way to shelves around the country with absolutely no demand.

There's always a possibility the virus could re-emerge in a slightly different form but there's no reason for you and your husband to consider the vaccine because the swine flu turned out to be a disease primarily of young people.

Speaking of flu, the real seasonal winter flu has arrived in my office. I've seen several dozen miserable feverish achy people with dry coughs in the last week. In past years, I could tell patients with the flu they would feel dramatically better the next day but this year is different. Even with Tamiflu, anti-inflammatory and cough medicine, it's taking 48 hours for these folks to feel significantly better.

It's a bad sign that flu viruses may be evolving resistance to antiviral medications. I worry that this may be related to the fact that lots of people squirreled away some Tamiflu when the bird flu epidemic was being predicted to sweep the globe two years ago.

The worst possible thing you could do when there's one remaining treatment for a serious illness would be to take one dose whenever you feel a cold coming on and yet I hear of people doing that all the time.

If you have Tamiflu, please don't take it until you're sure you have flu, and then take 10 doses and stop.

Dr. Beaman has written weekly columns in the Hattiesburg American for 26 years. If you have a medical question for him to answer in this column, write to Family Care Clinic, Box 1650, Richton, MS 39476 or e-mail doctorbeaman@bellsouth.net. Questions cannot be answered personally.

Speaking of flu, the real seasonal winter flu has arrived in my office. I've seen several dozen miserable feverish achy people with dry coughs in the last week. In past years, I could tell patients with the flu they would feel dramatically better the next day but this year is different. Even with Tamiflu, anti-inflammatory and cough medicine, it's taking 48 hours for these folks to feel significantly better.....


One of the writers questioned my statement that I had seen several cases that appeared to be seasonal influenza (rather than H1N1). I'm going to stand my ground on this one. If these folks didn't have winter flu (probably type A) they were certainly doing the best imitations of flu victims I've seen. All their temperatures were in the 103-104 F degree range and they exhibited the classic picture of "aching-all-over-like-I've-been-run-over-by-a-semi" with uncontrollable dry cough and extremely depressed energy levels.

These folks were dramatically sicker than anyone I saw with H1N1 which I described in an earlier column as "Flu Lite." The typical case of swine flu I treated in the office struck me as being about a third as debilitating as seasonal flu.

I treated these recent patients with Tamiflu and they all got better but it took longer than in previous years. I have always told flu victims in the past that, once they started on Tamiflu, they would feel better within 24 hours. Most would tell me they felt brand new the next day. This year that advice didn't work. Most of these unfortunates were in bed for three or four days and didn't feel a bit better until the third day....

From what I have read, this guy isn't the sharpest knife in the drawer. If nothing else, I understand that swine flu has displaced seasonal flu and so anyone with "flu" now is more than 90% likely to have swine flu.

However, he does say some interesting things, even if he doesn't realise it:



So he is saying that

1. He is seeing a spike in flu cases

2. These cases are "dramatically sicker than earlier"

3. Tamiflu therapy is less effective

So his observations fit with Dr Niman's most recent commentaries NB a new wave starting, but he draws the wrong conclusions.

Glad he's not my doctor.

Yes, he is clearly a fool. He should look at the CDC weekly report which shows that there is no seasonal flu. Influenza A at this time is swine flu.
He assumes that influenza A means seasonal flu because the patients' symptoms are more severe. He apparantly does not believe the lab confirmed swine H1N1 fatalities and apparantly assumes flu can't evolve into a more virulent or lethal strain.

This guy should be reported to the AMA for endangering the health of his patients and readers.

http://www.hattiesburgamerican.com/article/20100207/LIFESTYLE/2070302/1024/H1N1-still-around-after-all-we-should-all-take-the-shot
He's going to stand his ground on his statement that he's seeing seasonal flu, eh?

Among the several examples of misinformation in the following article, notice his use of the word "epidemic"....
http://www.hattiesburgamerican.com/apps ... 0101310302

Since the levels of swine flu have sharplky declined, a strong resurgence would require a chnage in the viral genetics or levels, both of which could lead to more severe cases.

Thus, you are correct. The descriptions of the more severe cases likely reflects a resurgence on a more virulent swine flu, just in time for the tradional flu season.

I have met quite a few doctors worse than him.

I'm sure he means well but as with many GPs . The 'General' stands out. We call them 'General Practitioners' in Austraia not 'Medical Doctors' MDs.

They really should go to H1N1 101 school for a refresher.

One of the writers questioned my statement that I had seen several cases that appeared to be seasonal influenza (rather than H1N1). I'm going to stand my ground on this one. If these folks didn't have winter flu (probably type A) they were certainly doing the best imitations of flu victims I've seen.

All their temperatures were in the 103-104 F degree range and they exhibited the classic picture of "aching-all-over-like-I've-been-run-over-by-a-semi" with uncontrollable dry cough and extremely depressed energy levels.

These folks were dramatically sicker than anyone I saw with H1N1 which I described in an earlier column as "Flu Lite."