Influenza makes you feel miserable. Fever, muscle aches, chills, headache, cough and fatigue add up to an unpleasant five or six days. As a parent, it’s just as difficult to watch your child suffer through the discomfort of “the flu.” That’s why so many moms or dads ask their pediatrician to prescribe the antiviral drug Tamiflu (oseltamivir) when a child develops influenza-like symptoms. Unfortunately, there seems to be a lot of confusion about Tamiflu—how it works, what it does, and when it should be prescribed. Randy Sterkel, MD, community pediatrician and medical director of the St. Louis Children’s Hospital Answer Line and Doug Carlson, MD, director of the CARES unit and hospitalist medicine at St. Louis Children’s Hospital weigh in on the latest findings and recommendations about Tamiflu.
What is Tamiflu?
“Tamiflu is an antiviral medication that blocks the actions of the influenza virus in the body,” says Dr. Sterkel. “If it is given within the first 48 hours of onset of symptoms, it can help decrease the length of time the patient feels ill—but only by about one to one and one half days. And it only works on true influenza—not on colds or other viral illnesses that may seem like flu. If a child has been sick for more than 48 hours, current data from the Centers for Disease Control suggests that there is virtually no benefit from Tamiflu.”
How Does Tamiflu Work?
“It is important for parents to understand that Tamiflu is not like an antibiotic used to cure strep throat or urinary tract infection,” says Dr. Carlson. “Tamiflu does not cure the flu—instead it helps by potentially shortening the duration of the symptoms. Viral illnesses such as influenza are self-limiting and will resolve themselves without treatment. With plenty of rest, fluids, and extra attention from a caregiver, most children will start to feel better and be on the road to recovery within four to five days.”
Who Should Get Tamiflu?
“Tamiflu should be considered for children who are at high-risk for developing complications of the flu or for those children exhibiting severe symptoms,” says Dr. Sterkel.
Who is Considered High Risk?
Children with underlying medical conditions:
- Lung disease
- Heart disease
- Neuromuscular disorders
- Weakened immune system
- Children with diabetes, sickle cell disease, kidney or liver disease
Does Tamiflu Have Any Side Effects?
“Influenza does not typically cause gastrointestinal symptoms such as diarrhea, nausea or vomiting,” says Dr. Carlson. “Parents need to know that patients who take Tamiflu may develop gastrointestinal side effects from the medication. At this point we have to consider whether or not a child is better off by simply managing his or her symptoms with fever reducers, rest, and plenty of fluids rather than introducing the potential for nausea, diarrhea or vomiting. Minor side effects from Tamiflu are common, but there are also rare but more serious side effects to consider when deciding to treat.”
Will Tamiflu Prevent the Flu?
“Tamiflu is not routinely given to prevent a person from getting the flu,” says Dr. Sterkel. “In some cases, if a child with flu-like symptoms lives in the same household as an adult or child at high risk for influenza complications, a physician may prescribe Tamiflu. However, the CDC does not recommend widespread use of antiviral medications for prevention because of the potential for antiviral resistant viruses to emerge. The best way to prevent influenza is with an annual vaccination. We recommend that everyone ages six months and older get an annual flu shot or nasal spray vaccination as soon as they are available in the fall. It is not 100 percent effective but is an excellent defense to help spare you and your child from the discomfort and potential complications of influenza.”