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October 01, 2005

Avian Flu: Tamiflu Resistance?

A disturbing report in The Times:

A CONSIGNMENT of antiviral drugs bought by the Government for £186 million to protect the public against a bird flu pandemic could be rendered useless after the emergence of a resistant strain of the virus.

Experts in Hong Kong gave warning yesterday that the human H5N1 virus which surfaced in northern Vietnam this year was showing resistance to Tamiflu, the drug widely considered the best chance of protecting the population.

Describing the case of Tamiflu-resistance, William Chui, of the Department of Pharmacology at the Queen Mary Hospital in Hong Kong, yesterday urged drug manufacturers to make more effective versions of Relenza, another antiviral also known to be effective in battling H5N1.

“There are now resistant H5N1 strains appearing, and we can’t totally rely on one drug [Tamiflu],” Professor Chui said, adding that general viral resistance to Tamiflu, known generically as oseltamivir, was also thought to be growing in Japan.

Now as we know, and this report confirms, an influenza pandemic is a certainty at some point, next year, five, ten years away. Whether it is avian flu is as yet unknown, of course, but some form of flu is going to sweep round the world at some point, as it has done in the past.

And to find that one of the candidate strains is already showing resistance  to one of the only two drugs we have to treat the symptoms (it’s worth noting that we still have not cured anyone anywhere of a viral disease. We can, as long as they don’t mutate too quickly, like AIDs or flu, vaccinate against them, we can treat and alleviate symptoms, but we do not have a cure for any viral disease at all and never have had.)

Looks like it might be worth adding a few packs of Relenza to that Tamiflu you have stockpiled. And, please, don’t use it until such a pandemic does occur, for that will just encourage the evolution of strains resistant to that drug as well.


October 1, 2005 in Health Care | Permalink


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» http://maggiesfarm.anotherdotcom.com/archives/1499-.html from Maggie's Farm
Bad NewsAs I suspected, Tamiflu is losing its effectiveness. I doubt it ever was very effective. My post last week remains the word on the subject, here. [Read More]

Tracked on Oct 1, 2005 11:18:19 PM

» Stock up on that Tamiflu from Zacht Ei
There's 10 caps already in my fridge. I bought them in March after a particularly nasty bout of flu, so I'd be able to deal with a future flu virus somewhat more easily. Of course, if that future virus should... [Read More]

Tracked on Oct 15, 2005 11:41:02 AM

» Avian flu: the kimchi option from New Economist
With reports of growing Tamiflu resistance**, readily available alternatives become more attractive. One possibility is kimchi; Mark Thoma cites a Washington Post story that more people are buying it after reports it may help cure avian flu. Blame it o... [Read More]

Tracked on Dec 31, 2005 10:17:00 PM


But surely one has to take a vaccine well before a real infection. How long do you suggest, Dr. Tim?

Tim adds: Dr. Tim? No idea at all.

Posted by: Rub-a-dub | Oct 1, 2005 11:48:30 AM

Dear Dr. Tim,

If we're considering viruses living organisms, Acyclovir will stop replicating Herpes Simplex Virus 1, we can't "cure" humans because it sits, dormant non-replicating and one needs to get at the activated viral thymidine kinase, but the symptoms can be amelieorated so it just lies dormant in the trigerminal ganglia, or wherever.

Rub-a-Dub: Depends on which virus of course. See Rabies as an example of post-infective immunisation, although whether this actually counts as a cure depends upon whether you consider infection to be the time of being bitten or after encephalitic symptoms have begun, when you're a bit buggered, really.

Posted by: inactualfact | Oct 1, 2005 4:52:29 PM

I'm a pulmonary doc at a university. It's my understanding that for either Relenza or Tamiflu, a patient must start therapy in the first day of symptoms for the drugs to be effective.

For my patients with severe lung disease, I write a prescription for Tamiflu in the fall, have the patient fill it and keep it on hand. They are instructed to start taking the drug when they have two of the following three symptoms: 1) high fever 2) severe muscle aches and weakness 3) worsening shortness of breath. They are to call my office the same day. This fits with published guidelines, but there's no study to show that such a program is better than any other.

Both drugs shorten the time of viral shedding and time that patients are symptomatic. Importantly, both lower the risk of complications from influenza (pneumonitis and super-infection with bacterial organization, like pneumococcus).

I have already planned to have Relenza on hand for me and my family. Just in case.

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