What's the treatment for influenza?

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For most people influenza is an upper respiratory tract infection that lasts several days and requires symptomatic treatment only. Within days, the person’s body will eliminate the virus. Antibiotics, such as penicillin, which are designed to kill bacteria, cannot attack the virus. Therefore antibiotics have no role in treating influenza in otherwise healthy people although they are used to treat complications. Antiviral drugs for influenza are an important adjunct to influenza vaccine for the treatment and prevention of influenza. However, they are not a substitute for vaccination. For several years, four antiviral drugs that act by preventing influenza virus replication have been available. They differ in terms of their pharmacokinetics, side effects, routes of administration, target age groups, dosages, and costs. When taken before infection or during early stage of the disease (within two days of illness onset), antivirals may help prevent infection, and if infection has already taken hold, their early administration may reduce the duration of symptoms by one to two days.

Neuraminidase inhibitors, which treat both influenza A and B, work by inactivating an enzyme the virus needs to grow and spread. Zanamivir (Relenza) may shorten the amount of time you have the flu by a day or two and may also cut the risk of flu within a family when one family member is infected. Relenza is inhaled through a device similar to an asthma inhaler every 12 hours for five days. It's not for use by anyone with respiratory conditions such as asthma and lung disease. Side effects may include nose and throat discomfort, headache and cough. Another drug, oseltamivir (Tamiflu) is available in pill form. It may also shorten the duration of the flu by a day or so. Oral antiviral medications such as amantadine (Symmetrel) and rimantadine (Flumadine) may reduce the severity and duration of type A - but not type B - influenza if you take them within 48 hours after symptoms begin. But these medications may have serious side effects, including nausea, nightmares and convulsions. Taking lower doses of the drugs may reduce side effects.

For several years, amantadine and rimantadine were the only antiviral drugs. However, whilst relatively inexpensive, these drugs are effective only against type A influenza, and may be associated with severe adverse effects (including delirium and seizures that occur mostly in elderly persons on higher doses). When used for prophylaxis of pandemic influenza at lower doses, such adverse events are far less likely. In addition, the virus tends to develop resistance to these drugs.

In severe influenza, admission to hospital, intensive care, antibiotic therapy to prevent secondary infection and breathing support may be required. Children who are suspected of having influenza, and who have high fevers, should never be given aspirin to treat the fever. This can cause the disease called Reye's syndrome. Instead, acetaminophen (Tylenol) should be used.

More information on influenza (flu)