PHARMACISTS REPORT HUGE DEMAND FOR NEW FLU DRUGS

The local flu outbreak that has been filling emergency rooms is also increasing demand for two new influenza drugs.

While the number of people seeking treatment for flu-like symptoms at local emergency rooms has leveled off from its peak last week, the demand for the prescription influenza medications Relenza and Tamiflu continues to be high. Demand is so great it has been difficult to keep the drugs in stock, said Ben Tally, a pharmacist at Medicap Pharmacy, 1020 N. Kingshighway.

John McMullin at John's Pharmacy, 2001 Independence, said demand has been increasing for all kinds of medications used to treat flu-like symptoms and their complications, from antibiotics to cough medications. But he said it is the flu medicines, both new to the market this winter, that he has been selling out of in the last two weeks.

The local demand reflects national figures. The Associated Press reported more than 51,000 prescriptions for Relenza, which must be inhaled, were written in the week ending Dec. 24 more than four times the level in the first week of December, according to IMS Health, a market research firm. Tamiflu, a pill, sold nearly 45,000 prescriptions the same week, or nearly 10 times more than in the first week of December.

Both medications diminish the severity of symptoms from influenza A or B by about half and the time of infection, typically five to 10 days without treatment, by about one-third, said Paul Mackey, a nurse practitioner at St. Francis Medical Center emergency department's Convenient Care.

"They don't get quite as sick for quite as long, but as sick as people have been with this, that's quite a bit of relief," Mackey said.

That relief comes with a price tag: The five-day course of treatment for either Relenza or Tamiflu is $45 to $65, pharmacists say. Not all insurers cover the new drugs.

There also is a time limit. Patients need to start taking an influenza drug within 48 hours after symptoms appear, said Dr. Frederick A. Rawlins, a physician in the emergency room at Southeast Missouri Hospital. But most people wait at least three days before seeking medical attention, he said.

Both hospital emergency rooms use a nasal swab test to confirm an illness is true influenza rather than one of the many other types of viruses and infections that produce flu-like symptoms.

People with influenza who want to shorten the time they are sick because they don't want to miss school or work need to be treated early on, Rawlins said.

Whether to miss work poses a dilemma for many people: Should they go to work feeling badly and risk getting worse and spreading germs, or stay home and miss work and get behind?

It also is a dilemma for employers who need their employees on the job but don't want sick workers spreading germs, said Karen Green, an officer at Mercantile Bank. She said Mercantile has been hard hit with absences caused by flu and bronchitis.

"Generally when you know people are sick, you don't want them coming in and giving it to you," Green said.

Human-resource managers at Thorngate Ltd. and Procter & Gamble Co. said employees who call in sick aren't asked about the type of illness they have, so it is difficult to say what effect the flu has had on their work forces. But both recognize that employees sick with contagious illnesses like influenza are better off at home.

Jane Wernsman, assistant director of the Cape Girardeau County Health Department, said influenza is most contagious in the 24 hours before the onset of symptoms and during the peak of severity of symptoms. Those symptoms start with sudden onset of fever, frequently with chills, headache and fatigue, itchy, watery eyes; and a dry cough, Wernsman said. As the infection goes on, symptoms generally include sore throat, nasal congestion and a worsening cough.

Influenza is spread through contact with large droplets such as would be emitted from someone sneezing or coughing and through articles recently contaminated such as when an infected person coughs into his hand, then shakes hands with someone else.

To avoid the flu or at least lessen its severity, Wernsman said authorities recommend boosting the immune system by eating a healthy diet, drinking plenty of fluids, getting adequate rest, avoiding large crowds and washing hands frequently.

The latter, she said, could be the most important. "You can avoid all kinds of bad stuff if you wash your hands often and thoroughly," Wernsman said.

The emergency rooms at St. Francis and Southeast hospitals aren't as crowded this week. Both were seeing 30 percent to 40 percent more patients last week with the increase due to those seeking treatment for flu-like symptoms. The number of patients being seen is closer to normal this week, although both emergency rooms are still seeing a considerable number of patients with flu-like illnesses, those who work in the emergency rooms say.

St. Francis' Mackey said this could just be a brief lull.