Flu pandemic: new doubts over key drug

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Thu, 22 Dec 2005 18:25:36 -0800

[Zepps_News] #Flu pandemic: new doubts over key drug

 

 

 

 

http://www.guardian.co.uk/birdflu/story/0,14207,1672430,00.html

 

Flu pandemic: new doubts over key drug

 

Studies show resistance to Tamiflu

 

Sarah Boseley, health editor

Thursday December 22, 2005

The Guardian

 

A packet of the anti-retroviral drug Tamiflu

A packet of the anti-retroviral drug Tamiflu. Photograph: Daniel Maurer/AP

 

 

Serious questions are raised today about the ability to combat an

anticipated bird flu pandemic following the deaths of two people who

were being treated with the drug the world is stockpiling as a safeguard

against the virus.

 

To the dismay of medical experts and concern among those responsible for

the worldwide efforts to fight a pandemic, the H5N1 bird flu virus in

the bloodstream of the two patients in Vietnam rapidly developed

resistance to the drug, Tamiflu. One, a 13 year-old girl, appeared to be

stable at first and then rapidly worsened as the virus mutated, became

more aggressive, and eventually killed her.

 

The deaths are reported today in the respected New England Journal of

Medicine by doctors funded by the British Wellcome Trust working in

Vietnam. They urge changes to the global plans for fighting a flu

pandemic. Other antiviral drugs are needed alongside Tamiflu, they say.

 

An eminent professor at Cornell University in New York calls the report

" frightening " in a commentary in the journal. Anne Moscona, from the

department of paediatrics, microbiology and immunology at Weill medical

college, says Tamiflu-resistant H5N1 " is now a reality " , and calls for

efforts to prevent individuals stockpiling the drug. Its misuse, she

says - by people who, for instance, take too low a dose - will breed

resistance and further undermine its effectiveness if a pandemic sweeps

the world.

 

The British government has ordered 14.6m courses of Tamiflu, enough for

a quarter of the population. Its maker, Roche, cannot keep up with

demand, however, as most countries attempt to stockpile. So far, 3.5m

doses have been delivered, and the rest is due by next September. At a

conference last month, the chief medical officer, Sir Liam Donaldson,

made it clear that Tamiflu was Britain's first line of defence. But he

acknowledged that nobody knew for sure how the drug would work in a

pandemic against a strain of flu yet to be encountered. " It doesn't cure

flu, it simply reduces the severity of the attack, " he said.

 

Last night, a spokeswoman for the department of health said Tamiflu was

selected on the strength of independent advice. " Internationally, this

is agreed as the product of choice, " she said. But she added that the

research would be carefully considered as part of the government's

constant review of its antiviral strategy.

 

Alan Hay, head of the WHO Influenza Centre of the MRC National Institute

of Medical Research, said it was important to remember that four of the

eight Vietnamese patients in the study survived after their treatment

with Tamiflu. But, he said, the report was of " very significant concern

in regard to how we use these drugs to treat people " . It had already

been recognised that resistance could build against Tamiflu. In Japan,

one in six children treated with the drug for ordinary forms of flu

developed resistance. It appeared, he said, that resistance was more

likely in children because they had not been exposed to the prevailing

strains of flu. In the case of bird flu, however, nobody has been exposed.

 

The report in the NEJM by Jeremy Farrar and colleagues from the Oxford

University Clinical Research Unit at the hospital for tropical diseases

in Ho Chi Minh City, Vietnam, reveals that they confirmed a resistant

form of bird flu in two out of eight patients who were being treated

with oseltamivir, of which Tamiflu is the brand name. One was treated at

an early stage of infection, when Tamiflu is supposed to be most

effective.

 

 

 

--

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wiretap, it requires -- a wiretap requires a court order.

Nothing has changed, by the way. When we're talking about chasing down

terrorists, we're talking about getting a court order before we do so "

-George W. Bush, April 20, 2004

 

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