In this article: Are cold and flu preparations dangerous? Health links for the flu

Health

A shot of good news about colds, flu

By Tamar Asedo Sherman

It's been a bad year for cold and flu routines. First, millions had to delay flu shots because of a shortage of vaccine. Then, many favorite remedies were jerked from drugstore shelves after an ingredient was linked to strokes.

Luckily, it's not too late to get your shot, and your drugstore has plenty of other remedies, some of them improved. Best of all, researchers are working on non-needle flu vaccines and a cure for the common cold.

Catch up on the latest developments here.

The vaccine vacuum

All this fall, old and infirm people have waited in line for flu shots during chain-store promotions, going there because many physicians had no vaccine. Some are still waiting.

The unusual shortage was due to manufacturing problems in growing one strain of the flu virus. As new vaccine became available, it was distributed to doctors, clinics and corporations on a first-ordered-first-shipped basis.

Production is now perking along, and the federal Centers for Disease Control and Prevention says vaccine will be available for everyone -- 75 million shots -- before the flu season truly gets under way in January and peaks in February and March.

Because of that timing, Gregory A. Poland, M.D., chairman of the Mayo Clinic Vaccine Research Group in Rochester, Minn., says there's no cause for alarm if you still have not gotten a shot. After getting a vaccination, "you need [only] a good 14 days for maximum protection."

Still, the CDC ordered 9 million more doses for this month as a safety cushion for high-risk patients: those with diabetes, anemia or chronic heart, lung and kidney disease; pregnant women; and people undergoing chemotherapy.

This year, the CDC added two groups to its list of people who should get shots -- but says broader recommendations have not worsened the vaccine shortage. The added groups:

Those over 50. Before, those over 65 were urged to get shots; the new guideline recognizes that many people ages 50-65 are chronically ill and at high risk if they catch the flu.

Young children. Vaccinating children helps families, according to a CDC study in October's Journal of the American Medical Association. Because 70% of children under age 5 are in day care, they are at high risk of contracting the flu. When kids were vaccinated, their families had 80% fewer potential flu cases. More significant: economic savings in absences from work to care for sick kids, and decreases in doctor visits, earaches and antibiotic use. New drugs -- minus the needles -- are on the way A no-needle inoculation is on the horizon: A nasal-spray flu vaccine using live viruses is up for approval by the federal Food and Drug Administration. Preliminary tests show FluMist to be highly effective and easy to administer to children. Its developer, Aviron Inc. of Mountain View, Calif., says that if all goes well the spray might be available for next flu season. For the time being, if you catch the flu your best hope is to take one of four new antiviral agents within 24-48 hours of the onset of symptoms. The drugs, called neuraminidase inhibitors, ease the flu symptoms and reduce the spread among family, friends and co-workers. The drugs:

Zanamivir (Relenza) is inhaled twice a day for five days. It shortens type A and type B flu by a day or two.

Oseltamivir (Tamiflu) capsules reduce the severity of the symptoms and complications. Taken every day for six weeks, the drug could help people avoid the flu.

Amantadine (Symmetrel) and rimantadine (Flumadine) pills work best if you've had a flu shot. They fight type A influenza but have unpleasant side effects.

In the search for a cure for the common cold, there's new hope. Pleconaril, a drug already used to treat meningitis and polio, is a promising treatment for viral respiratory infection, a severe form of the common cold. "I'm extremely impressed," says lead researcher John Irvin, M.D. "I've seen dramatic resolution of symptoms in some people, literally within hours of taking the medicine." The drug is now in double-blind studies at the Center for Pharmaceutical Research in Kansas City, Mo.

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What's left on your drugstore's shelves

You've heard that about half of the 800 over-the-counter cold and flu preparations -- including Alka-Seltzer, Dimetapp, Robitussin and Triaminic -- were withdrawn from chains such as Rite-Aid, CVS and Wal-Mart early last month. At the same time, manufacturers suspended production of many popular remedies and started reformulating their cold medicines.

The reason: Those remedies contained phenylpropanolamine (PPA), a common antihistamine that has been in use for 50 years but was recently linked to several hundred cases of stroke in young women.

Losing remedies with PPA is "no big deal," says Peter J. Casano, M.D., an ear, nose and throat specialist at the University of Mississippi Medical Center in Jackson. "It's one less decision to make."

Many other antihistamines do not contain PPA; check with your pharmacist or health practitioner if your favorite is gone.

Besides, Casano says, antihistamines are useless in treating colds. Here's why: Antihistamines block allergies; decongestants are more suitable for colds. When people with colds use antihistamines, they are seeking the side effect of drying runny noses. The most effective alternative to antihistamines, he says, is a prescription nasal spray called Atrovent.

Casano is convinced of the efficacy of zinc lozenges, available at drugstores and supermarkets, judging by extensive studies and personal experience. Even better, he says, is a new zinc gel nasal spray called Zicam, which cuts the length of a cold from nine days to two days.

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Health links to help you through flu season

Flu basics from the CDC
How widespread was the flu last week? A state-by-state map
Advice for travelers
NIH fact sheet on the common cold
You and Your Stuffy Nose (click on "Info Brochures")
Pills help in vaccine shortage
Priorities and patience