Flu-stricken Texas teacher’s death puts focus on antivirals

A Texas elementary school teacher who died almost a week after getting sick from the flu became a talking point online after her husband said she didn’t immediately fill her prescription for an antiviral drug after deeming the $116 insurance co-pay too high.

While her husband told the Wall Street Journal that he picked up the prescription the day after she refused it and she then started taking the medication, Heather Holland, 38, died three days later on Feb. 4.

Doctors told The Associated Press that while it’s ideal to start taking antiviral medication as quickly as possible, it’s no guarantee that one’s condition will not drastically worsen.

Antivirals make it “not zero, but less likely” that complications will develop, said Dr. William Schaffner, infectious diseases specialist at the Vanderbilt University Medical Center in Nashville, Tennessee, who added, “antivirals are not a magic potion.”

Frank Holland of Willow Park, just west of Fort Worth, told the newspaper that his wife, a second-grade teacher, came home feeling a bit sick Jan. 29. The mother of two went to work in nearby Weatherford on Jan. 30 but by evening had a fever.

She went to the doctor on Jan. 31. Frank Holland said a rapid flu test was positive for influenza B. The doctor wrote her a prescription for oseltamivir phosphate, a generic form of the antiviral medication Tamiflu.

Frank Holland told the Wall Street Journal that they had the money, but she was frugal and didn’t want to fill it.

She went to a Fort Worth hospital on Feb. 2. The following day, blood tests showed she had sepsis, a complication of infections, he said.

Antiviral drugs – when taken within 48 hours after becoming sick – can lessen symptoms, shorten the time one is sick by about one day and reduce complications.

“There are people who are going to do very well, regardless of getting Tamiflu or not. There are people that are going to do very poorly, regardless of getting Tamiflu or not. And then there’s kind of the middle segment of the population where Tamiflu really may push them to the right outcome,” said Dr. Luis Ostrosky, an infectious disease expert with McGovern Medical School at UTHealth and Memorial Hermann-Texas Medical Center in Houston.

Dr. Trish Perl, chief of infectious diseases at UT Southwestern Medical Center in Dallas, said that “in some cases it may be useful” to give patients an antiviral even after the 48-hour onset.

The Centers for Disease Control and Prevention said the flu shot is the best way to prevent seasonal flu. Frank Holland said he couldn’t remember whether she got a flu shot this season. Generally, he said, they’ve both been “pretty healthy.”