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Watch Out, Influenza B Is Waiting for You

The good news? Some health care professionals say this isn't a heavy flu season. The bad news? The kind that's going around is accompanied by gastrointestinal complaints.


Pharmacist Neil Badlani's staff at B & B Pharmacy in Bellflower is usually a hale and hearty bunch. But less so this year.

"Sixteen of our 28 employees have been sick at home for at least three or four days this flu season, including me," says Badlani, the pharmacy's co-owner.

Richard Dore, director of corporate communications at Hughes Electronic Corp. in Los Angeles, knows that ghost town feeling too well. "Almost everyone in my department of 19 has been out already," he says.

So how bad is flu season '97, which is expected to peak this month?

It depends on whom you ask.

"We're not having a severe influenza A season this year," says Dr. Shirley Fannin, director of disease control for the Los Angeles County Department of Health Services, "but we do have influenza B this year. It's a heavier B year than we've had in four or five years."

In general, influenza B is accompanied by more gastrointestinal complaints, she says, while influenza A is marked by more respiratory symptoms such as coughing. In Orange County, public health officials say, influenza A and B have also been isolated.

This year's flu vaccine protects against three strains: A / Texas, A / Nanchang and B / Harbin.

"The isolates of B in L.A. County have not been sub-typed," says Dr. Carol Peterson, medical epidemiologist with the county Department of Health Services, "but it is assumed they are the B / Harbin that have been found by the CDC."

Children in Los Angeles Unified School District schools don't appear to be particularly hard hit, if a school policy is any indication. When a particular school has an absenteeism rate of more than 10% for a single cause, the school is requested to call in, says Sue Rue, a registered nurse for the district. So far, she says, "no one has called."

But physicians in private practice say they are seeing much more sickness than usual for this time of year.

"I can't remember a time seeing so many sick people in 10 years," says Dr. Terri Rock, a Santa Monica family practice physician and one of 150 physicians around the country reporting influenza data to the federal Centers for Disease Control and Prevention. She has treated many patients so hard hit, she says, that they can barely get out of bed. Even many of her patients who generally work right through sickness have come in for care.

Rock and other physicians interviewed blame the increase in sickness on both influenza A and B, along with a host of other nasty respiratory viruses making the rounds.

A nurse at a Torrance pediatrician's office says their sick patient visits are up about 70% due to influenza cases.

In his Tarzana practice, internist Joel Lebovitz has seen a 20% or 25% increase over last year at this time in the number of patients coming in for viral respiratory symptoms. Their symptoms range from sore throats and coughs to body aches and fever. Many of his patients, he adds, are coping with the "hang-on" factor--suffering with colds or coughs that linger.

Of course, when you're hanging on by your fingernails, you don't care if the invading bug has a name. (And physicians often don't test to see whether it's influenza A or B, due to the costs and time involved.) What you want is relief.

The standard advice to the flu-stricken is to rest and drink plenty of fluids. (But if symptoms include a sudden high fever, vomiting, intense headache, stiff neck and a spreading pink rash, immediate medical attention is vital to rule out meningitis.)

If patients with influenza contact their physicians within 48 hours of symptoms, antiviral drugs--amantidine (Symmetrel) or ramantidine (Flumadine)--may be prescribed.

"Ramantidine lessens the severity of symptoms by about 50%," says Dr. Russell Klein, an Encino infectious disease specialist and UCLA assistant clinical professor of medicine, who has also noticed an increase in sick patients this season.

The drugs work against only influenza A, but some doctors say the regimen is worth a try even if they are not sure which flu type their patient has.

"Sales of Flumadine [this season] are about 5% or 10% higher than we expected," says a representative for Forest Laboratories in New York, the drug's manufacturer.

Those who have managed to escape winter's scourge so far and who did not get a flu shot might consider doing so. "It's still not too late," says Dr. Peter Katona, a UCLA infectious disease specialist. The ideal time to get a flu shot is October or November, because the vaccine takes about two weeks to become effective. Still, getting one now could help.

Postponing all but vital doctor's appointments might keep you healthy too. When Kaiser subscribers call the appointment line at Kaiser Permanente, Los Angeles, they hear: "There is currently a flu epidemic in the Southern California area and all services are being heavily impacted. Our physician staff is asking us to tell you that visiting the medical center during this time will increase your risk of exposure to the flu."

There may soon be more weapons in the flu fight. Researchers at Gilead Sciences in Foster City, Calif., hope to begin human studies of their anti-flu pill by summer. It works by blocking the enzyme usually essential for replication of the influenza virus. But even if the pill proves spectacularly successful in clinical trials, it probably won't be on the market until at least 2000.


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