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OK. Tamiflu. Let's talk about some facts.

At Cook Children's, 921 kids were tested for the flu the week before Christmas and 353 kids were positive (314 Flu A, 39 Flu B). So the flu has arrived in our area.

Every year our office gets inundated with phone calls about Tamiflu. Who can take it? Will it help my kiddo? Will it help me? Will it prevent contraction of the flu?

Let me try to spell a few things out so it makes some simple sense:

1. If you got your kiddo the flu vaccine this year, I want you to give yourself a big old fat kiss in the mirror because congrats on making a great decision for your child! While we aren't sure how good of a match it is until the season is over, way to give your child a fighting chance! The kids in the office that I've seen with the flu who have been vaccinated have typically been less sick than those who haven't.

2. Tamiflu (oseltamivir) is a medication anyone can take within 48 hours of starting the symptoms of the flu to REDUCE THE NUMBER OF DAYS ILL BY 1-1.5 DAYS. Notice how I didn’t say "make the symptoms go away" or "make it less severe." It mostly just reduces the number of days sick....by about a day.

3. Notice how I didn't say it cures the flu. Nothing cures the flu. It is a virus, and thus has no cure.

4. These are the reasons the AAP and CDC think a person should take Tamiflu if diagnosed with influenza (and are at "high risk of complications"):

• If under 2
• If over age 65
• Anyone with a chronic illness (diabetes, asthma, chronic heart disease, epilepsy, amongst others)
• Anyone who is immunosuppressed (cancer treatment, immune system deficiency)
• Women who are pregnant or postpartum
• Anyone hospitalized with influenza
• Healthy kids who have documented influenza and have a baby sibling under age 6 months

5. TAMIFLU DOES NOT WORK FOR VIRUSES THAT ARE NOT THE FLU. Meaning - if you or your kiddo has a "flu-like illness," and there are only about 400 circulating our area right now, Tamiflu will do nothing for you.

6. Tamiflu DOES NOT work much at all if taken more than 48 hours after the first symptom of influenza. Studies have proven this time and again.

7. Tamiflu sometimes causes more problems than it helps. It is infamous for making kids puke, be nauseous, have diarrhea, and have stomach cramps. (I personally took one dose of it a few years ago and swore I'd never do it again)

8. Tamiflu can help prevent a child from catching influenza, but given its cost and side effects, and chance for failure, we usually mostly recommend this for children who are at "high risk of complications" or have a very young or chronically ill sibling (see that list above).

9. Any provider can prescribe Tamiflu for any child they deem to be experiencing severe symptoms. If your child is really sick, and they have a positive flu test, and it's been less than 48 hours, we will write the prescription. But remember that clinicians also always have resistance in the back of our minds. The flu virus will LEARN and REMEMBER Tamiflu. And someday, maybe soon, it will no longer work. So if we seem "stingy" with this medication - that's why.

If you want to get jiggy with the beautiful science of all of this, a good stop for you would be this VERY informative page by the AAP: https://redbook.solutions.aap.org/selfserve/ssPage.aspx….

(Have fun with the 8,000 links on that page. SCIENCE! YAY!). If you don't want to read all of this information, please talk to your pediatrician if you have questions.

People are always asking my opinion of it, and I think I'm very "meh" about Tamiflu. It is costly and it can cause a lot of side effects. I do think it benefits the very young, the very old, and those with chronic illness, and I think it's worth it in those cases. Your best protection against the flu every year is to get the vaccine and wash your hands.

The flu virus can live on some surfaces for up to 24 hours. Isn't that astounding? Think about that. A guy sneezes in his hand, touches a door handle, and someone 12 hours later could touch it, wipe an eye or nose....and boom. Flu.

Again - WASH YOUR HANDS!

Hugs, everyone! Hang in there!

Dr. Diane

At Willow Park, we are getting tons of calls for it if a child has been exposed, a parent has been exposed, a neighbor has it, your dog sniffed someone's bum who had the flu two weeks ago, etc.... 

Ask most physicians about Tamiflu and we'll tell you...."Meh." Tamiflu is helpful, but is not vital to getting over the flu.

1. It is not a "cure" for the flu. It allows for recovery one day faster than if you did not take anything.
2. It is expensive.
3. It does not come without side effects (especially tummy side effects) - sometimes worse than the symptoms of the flu!
4. It works best only if started within 48 hours of symptoms appearing.

Tamiflu is important to use and prophylax in children who have underlying medical issues - think asthma, diabetes, immune system deficiency. It is also indicated for use in children under age 5 if the child has the flu, or has a close contact with the flu.

It is NOT needed for healthy older children who are not symptomatic.

The best way to not catch the flu/get a milder version of the flu is to get the flu vaccine yearly! 

Hugs, 

Dr. Diane

About the Author

Dr. Diane Arnaout joined the Cook Children's Willow Park practice in 2011. Dr. Arnaout was born and raised in the Dallas-Fort Worth area. She served as a leader on the medical education committees during her internship and residency in pediatrics at the University of Texas Health Science Center in the Texas Medical Center at Houston, Texas.

Flu Myth #1

The flu shot can give you the flu.

Nope. Not true.

http://www.usatoday.com/story/news/health/2013/01/14/can-flu-vaccine-cause-the-flu/1833793/

Flu Myth #2

The only time I got the flu was the year I got the flu shot.

This may be true, but it’s completely coincidental. There’s no mechanism where the shot would make you more susceptible to getting the flu.

Flu Myth #3

The flu is annoying, but harmless.

This is true for many children, but we should watch for dehydration and difficulty breathing. Kids with asthma and other chronic medical conditions should be monitored closely.

Flu Myth #4

I had the “stomach flu.”

If you had vomiting and diarrhea only, you probably had another virus. Flu symptoms are fever, cough, congestion and body aches but rarely stomach problems.

Flu Myth #5

Because the flu shot is only covering 2 strains, you should skip it.

Getting coverage for 2 strains is better than 0.

http://www.checkupnewsroom.com/does-my-child-still-need-a-flu-shot/

Flu Myth #6

Over the counter cough and cold medicines help kids with the flu.

Cough and cold medicines do not work very well for anyone and can be harmful in kids. Just skip them. Run a humidifier and if over one year, give them some honey at bedtime.

Flu Myth #7

If you suspect your child has the flu, they need to see the doctor right away.

If they are drinking OK and staying hydrated, home care can be appropriate. Certainly call your doctor before going to the emergency room unless they have symptoms other than fever, cough and congestion.

http://www.checkupnewsroom.com/more-flu-longer-waits-in-the-ed/

Flu Myth #8

Every child who has the flu needs Tamiflu.

If your child is healthy (no asthma), the benefits of Tamiflu are minimal if anything, it is expensive and there are possible side effects. Consider these factors when and have a conversation with your doctor.

About the author

 is a Cook Children's pediatrician in Lewisville . He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.