What's the Best Treatment for Swine Flu or for Seasonal Flu?

A fellow caregiver asked...

What's the best treatment for swine flu?

Expert Answer

Dr. Leslie Kernisan is the author of a popular blog and podcast at BetterHealthWhileAging.net. She is also a clinical instructor in the University of California, San Francisco, Division of Geriatrics.

For most people, the H1N1 flu (formerly known as swine flu) is like the seasonal flu: It causes a "self-limited" illness, which means that one feels sick but eventually gets better on one's own. In these cases, antiviral medications are not usually given. The mainstay of treatment is to stay home, rest, and drink plenty of fluids to prevent dehydration. Wearing a mask at home may reduce the risk of transmitting the flu to family members. A sick person should try to avoid going out in public, in order to not expose others to influenza.

Some people, however, develop symptoms that are signs of a more serious influenza infection. People at higher risk for severe illness include pregnant women, young children, and adults with chronic illnesses or weak immune systems.

Those with more severe symptoms should definitely seek medical care. For those sick enough to be hospitalized, or who seem at particularly high risk for complications, antiviral medications are available to help fight influenza. The most commonly used drugs are oseltamivir (trade name Tamiflu) and zanamivir (trade name Relenza). In general, these drugs work best if they're started within the first 48 hours of illness.

Although some doctors will prescribe these drugs for people who aren't hospitalized, they're not magic bullets. Among people who aren't hospitalized, most studies have shown that these drugs are moderately beneficial in that they help people recover from symptoms one or two days earlier than usual. They also can help reduce transmission to close contacts. However, since there are concerns about the flu viruses becoming resistant to the drugs, the CDC recommends that antiviral drugs be used for this purpose only in special circumstances.