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Flu May Catch (Achoo!) You : If you haven't gotten sick yet, you may not be off the hook. A second wave of the illness is expected. So get prepared with some product information.


In September, things looked very bleak for the people who make and sell over-the-counter painkillers, cough syrup and throat lozenges. And things looked good for the rest of us.

All that changed late last month when the flu epidemic--among the worst in the past two decades--struck Southern California and other areas of the nation with a vengeance.

And while we are in a lull in the epidemic right now, with the first wave having peaked in mid-January, we may be in for a second blast soon, according to health officials who track flu outbreaks. Flu usually hits hardest in late January or early February.

It's been a strange flu season, says Scott Emerson, owner of the Emerson Group, a national sales management company that handles a number of cold and flu products and which has offices in Los Angeles and Philadelphia.

"From September through December, this was the best flu season [in terms of fewer people sick]. And then in mid-January we hit the highest peak of flu incidence we've seen in years. In a two-week period, more people got sick than in any other two-week period in the last four years. About 1 million people [nationally] got sick in a two-week period," Emerson says.

What that means is that many drug-store managers, thinking it was going to be a slow year, are suddenly finding themselves running out of some of the most popular products.

"Products are blowing off the shelves," Emerson says. "There are going to be items out of stock all across the country. But for shoppers, what that means is that you may not get your preferred brand, but you will be able to find another brand."

The biggest seller this year is zinc lozenges. A few studies have indicated that sucking on zinc lozenges when the first symptoms of a cold appear may lessen the duration of the illness. The original zinc lozenge, Cold Season Plus, had been the only one available for many years. And zinc lozenge sales were about $1 million in 1994, Emerson says.

"But last year, zinc sales soared to $30 million" as more products came on the market and news of the possible benefits of zinc spread, he says. "This year, we thought we'd see about $80 million in sales. I think it's going to be $160 [million] to $170 million."

But even if zinc can soften the blow of a cold, the ferocity of this winter's flu season has meant that lots of people are still getting very sick. This year's epidemic may be causing additional jitters, says Charles Lacy, director of drug information services at Cedars-Sinai Medical Center.

Stories about cases of "bird flu" in Hong Kong as well as reports that this year's flu outbreak is fueled in part by a strain not covered by the current flu vaccine have caused heightened anxiety, he says.

Moreover, says Lacy, this year's epidemic is striking more young adults and middle-aged people who aren't usually sick and aren't very good at treating their symptoms.

"These are the individuals who are most confused because they are not used to self-treatment," he says. "They respond by going overboard."

That means, for example, loading up on painkillers, several cold or flu products and a few herbal or homeopathic remedies thrown in for good measure.

And that is where some folks get into trouble, Lacy says. He recommends that flu sufferers try to pinpoint the symptoms that are bothering them the most and purchase a product that targets that symptom.

"For the general population, when you buy the combination products, you are buying something you don't need," Lacy says. A combination product may contain an antihistamine, decongestant, cough suppressant and alcohol for a sedating effect.

He has other pearls of wisdom:

* Products containing alcohol: These products can have a sedating effect. But people who become over-sedated and also have nasal congestion can sometimes start to breathe through the mouth instead of the nose, he says. When that happens, it increases the risk that normal bacteria will migrate into the lungs and cause pneumonia. This is a particular risk if a person already has a weakened immune system.

* Acetaminophen overdose: Follow the directions closely when using an acetaminophen product. For example, the infant Tylenol is a different concentration than the product made for older children. Other cold and flu remedies may also contain acetaminophen, Lacy says, and you could ingest too much if you combine products.

* Decongestants and asthma: People with asthma and other chronic pulmonary disorders should be aware that products that dry out the mucosal tissues can sometimes make the chronic condition worse.

* Alternative products containing ephedra: Lacy cautions that products such as decongestants with ephedra are thought by many health experts to carry some dangers. Ephedra triggers a surge of adrenaline that causes increased heart rate and respiration. "We're seeing a lot of homeopathic ingredients with ephedra. So there is also a potential problem for major toxicity," he says.

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