Medical Forum / Diseases and Disorders / Asthma / February 2006
Be prepared for Flu
|
|
Thread rating:  |
Don Brady - 18 Sep 2005 04:41 GMT There could be a Bird Flu pandemic if it leaps to the human species, as many epidemiologists are predicting (Or it could be some other kind of flu).
It may have a 40% death rate.
If you start to come down with any kind of flu, take Tamiflu immediately. It is almost the only drug that can be used. It can also prevent flu (in many cases) if you start taking it when and if a pandemic hits. (Don't take it until then though).
Many countries are now ordering large stockpiles of Tamiflu. Odds are that if there is a pandemic, you will not be able to get it unless you are in a priority category.
So many people are getting a stock in advance now. That includes me. I just ordered some from http://www.pharmaenergy.com/drugs/influenza/ . That may be technically illegal for U.S. residents but small personal imports are tolerated. That company will arrange for a German doctor to write you a prescription, included in the price. That is almost the only (so far) reliable company that will still do that for Tamiflu - I have searched far and wide and read discussion groups that share experiences on this topic).
Other alternatives include your local doctor and pharmacy (at a higher price probably), or the Canadian Internet
You have been warned......
(I have no connection to these products or companies - I just dread the effect that a flu epidemic would have on sinus and asthma sufferers).
Merlin - 18 Sep 2005 08:06 GMT G'day Don, yes this raises another really interesting situation where there are so many bogus laboratories producing packaged drugs which are in fact completely counterfeit and commonly have no active ingredients at all. One interesting case was where a yank medical surgical team were involved in a South African country as volunteer doctors, the surgical operations went well but the patients started dying. When it was discovered the drugs used in the hospital were counterfiet the team packed up and went home. So things may not be as they seem with these bogus drugs. My advice was that there was no known effective drug available at this time for this kind of flu. Are you quite sure your information is correct. Cheers, qldit.
mcs - 18 Sep 2005 13:30 GMT > G'day Don, yes this raises another really interesting situation where > there are so many bogus laboratories producing packaged drugs which are [quoted text clipped - 10 lines] > Are you quite sure your information is correct. > Cheers, qldit.
> Good Question but maybe one too many . Steven L. - 18 Sep 2005 16:25 GMT > G'day Don, yes this raises another really interesting situation where > there are so many bogus laboratories producing packaged drugs which are > in fact completely counterfeit and commonly have no active ingredients > at all. "Frontline" did an episode on Chinese counterfeits. The Chinese are counterfeiting just about everything manufactured in the West, from designer-name golf clubs to pharmaceuticals, and that stuff has spread onto international websites. And of course, the Chinese counterfeit drugs are often worthless, containing no active ingredients.
 Signature Steven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net
Remove the NOSPAM before replying to me.
Don Brady - 18 Sep 2005 19:35 GMT >G'day Don, yes this raises another really interesting situation where >there are so many bogus laboratories producing packaged drugs which are [quoted text clipped - 6 lines] >packed up and went home. >So things may not be as they seem with these bogus drugs. It is indeed a possibility in general but I believe that the source I mentioned is ok at this time.
See the discussions at http://www.curevents.com/vb/showthread.php?t=20275 .
>My advice was that there was no known effective drug available at this >time for this kind of flu. >Are you quite sure your information is correct. Yes, see http://www.recombinomics.com/News/09160501/Tamiflu_Primetime.html and the ABC News article at http://abcnews.go.com/Primetime/Investigation/story?id=1130392&page=1 and many other news stories.
Steven L. - 18 Sep 2005 16:29 GMT > There could be a Bird Flu pandemic if it leaps to the human species, as many > epidemiologists are predicting (Or it could be some other kind of flu). [quoted text clipped - 12 lines] > (I have no connection to these products or companies - I just dread the effect > that a flu epidemic would have on sinus and asthma sufferers). But it's precisely because I have asthma that I am in a priority category.
Remember the flu shot shortage last fall? When I told The Powers That Be that I had asthma (and showed them a confirming note from my asthma specialist), they fast-tracked me right to the top of the flu shot list and I got my shot immediately. In fact, I got my flu shot ahead of 80 year old men and women.
 Signature Steven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net
Remove the NOSPAM before replying to me.
Don Brady - 18 Sep 2005 19:31 GMT >But it's precisely because I have asthma that I am in a priority category. > [quoted text clipped - 3 lines] >and I got my shot immediately. In fact, I got my flu shot ahead of 80 >year old men and women. Yes asthma sufferers were in the priority category for flu shots last year, and are again this year.
(People who do not have asthma, such as myself, are not).
But if there is a flu pandemic, there may or may not be enough Tamiflu at that time to include them all. http://abcnews.go.com/Primetime/Investigation/story?id=1130392&page=3
>While there is no vaccine to stop the flu, there is one medicine to treat it. Called Tamiflu, it is made by the Roche pharmaceutical company in Switzerland. Roche has been selling Tamiflu for years. > [quoted text clipped - 5 lines] > >He later admitted that only 2 million are currently on hand, but asserted that no other country is in a better position. The government calculationa are also way over-optimistic - see http://www.recombinomics.com/News/09160501/Tamiflu_Primetime.html
Also for prophylactic use (to prevent or mitigate the severity of the flu before you get it) after a pandemic starts, you are not going to be able to get it once a shortage develops (which cold be imminent).
SJF - 19 Sep 2005 00:28 GMT > There could be a Bird Flu pandemic if it leaps to the human species, as > many [quoted text clipped - 35 lines] > effect > that a flu epidemic would have on sinus and asthma sufferers). My layman's reading, Google and a product information slip which accompanied an old prescription, is that there are several other antivirals on the market which have similar effects on influenza A viruses. None have actually been demonstrated effective on bird flu but perhaps they may be presumed to be effective against that influenza A virus.
Checking Drugstore.com, I note that the price for Tamiflu is about $600 for 100, for Amantadine (patent has long since expired) it is about $30 for 100. There may be some differences in dosage and effectiveness (the latter apparently not established) but it makes one wonder if there has been some drug industry inspired hype to promote another me-to product. It wouldn't be the first time.
SJF
Don Brady - 19 Sep 2005 00:48 GMT >My layman's reading, Google and a product information slip which accompanied >an old prescription, is that there are several other antivirals on the [quoted text clipped - 10 lines] > >SJF Amantadine and Relenza are promising against Bird flu too. Amantadine is indeed much cheaper.
According to http://www.recombinomics.com/News/09170502/Tamiflu_Amantadine_Prevention.html
> The emphasis on Tamiflu is due to the fact that the H5N1 isolated > from patients in Vietnam and Thailand was amantadine resistant, > so the only class of antivirals available was the neuramindase > inhibitors, and only Tamiflu was readily available. Amantadine may have more side effects. Someone said that but I am not sure if it is true.
Many people are ordering Anantadine too. I will do that also,
The best thing may be a combo of the two, in the event someone does come down with bird flu (at which point odds of living are only 50-50). They work on different principle and so can complement each other.
Merlin - 19 Sep 2005 01:53 GMT What might you gentlemen all consider best, maybe the Titanic revisited, mothers and children first, younger able bodied people say up to 30 next, and the rest might be most interesting. Noah calls the shots! And the Tamiflu stuff still remains in the maybe category! What is the bet the political boys would get a boat!! What is the bet the Tamiflu stuff is really being counterfeited with great gusto! I was under the impression that India was one of the major sources for bogus drugs. Merlin.
Alison Chaiken - 19 Sep 2005 03:51 GMT > Checking Drugstore.com, I note that the price for Tamiflu is about $600 for > 100, Roche's website (www.rocheusa.com/programs/TamifluChain2002.pdf) says that the shelf life of Tamiflu is 3 years. I'm not sure how many doses a patient might take per day, but 100 sounds like a lot given that the maximum extent of flu is 2 weeks in my experience.
 Signature Alison Chaiken "From:" address above is valid. (650) 236-2231 [daytime] http://www.wsrcc.com/alison/ Predators fail often; prey fail only once. -- Tom Evslin
Don Brady - 19 Sep 2005 05:10 GMT >Roche's website (www.rocheusa.com/programs/TamifluChain2002.pdf) says >that the shelf life of Tamiflu is 3 years. I'm not sure how many >doses a patient might take per day, but 100 sounds like a lot given >that the maximum extent of flu is 2 weeks in my experience. The recommended dose to treat flu in general is 2 per day for 5 days, for a total of 10.
It seems from experimental data that longer (and maybe a higher dose) would be better for bird flu.
But you can also take it during the "flu season" to prevent flu. It is approved also for that purpose. For that purpose, the recommended dose is one per day.. Some authors have advised planning on taking it throughout each of the posited 3 waves of a possible pandemic. That could take you to about 100.
mcs - 19 Sep 2005 12:42 GMT so without going to drugstore.com, , is that a reliable vendor? Is paying 600 dollars something people are doing? Will they get good product as opposed to counterfeit?
>>Roche's website (www.rocheusa.com/programs/TamifluChain2002.pdf) says >>that the shelf life of Tamiflu is 3 years. I'm not sure how many [quoted text clipped - 16 lines] > the posited 3 waves of a possible pandemic. That could take you to about > 100. Don Brady - 19 Sep 2005 22:31 GMT >so without going to drugstore.com, , is that a reliable vendor? I tihnk they are reliable. Ther are others that are a bit cheaper but they are mostly Canadian etc.
> Is paying >600 dollars something people are doing? Most people probably just o rder one ($66) but soem are ordering several at least.,
>Will they get good product as >opposed to counterfeit? No counterfeiting of Tamiflu has been reported to date. It comes in a blister pack and packaging that wouldot be easy to counterfeit. Really if you buy from a pharmacist in the U.S, or Canada or Germany your exposure to counterfeiting is minimal.
Don Brady - 19 Sep 2005 23:13 GMT >>so without going to drugstore.com, , is that a reliable vendor? > >I tihnk they are reliable. Ther are others that are a bit cheaper but they are >mostly Canadian etc. Actually the others are *much* cheaper for larger quantities.
Alison Chaiken - 22 Sep 2005 02:49 GMT http://news.bbc.co.uk/1/hi/health/4268964.stm
 Signature Alison Chaiken "From:" address above is valid. (650) 236-2231 [daytime] http://www.wsrcc.com/alison/ Predators fail often; prey fail only once. -- Tom Evslin
Alison Chaiken - 22 Sep 2005 02:56 GMT http://www.nytimes.com/2005/09/21/health/21cnd-bird.html?ex=1284955200&en=b7ec20 1d9fd32466&ei=5088&partner=rssnyt&emc=rss
 Signature Alison Chaiken "From:" address above is valid. (650) 236-2231 [daytime] http://www.wsrcc.com/alison/ Predators fail often; prey fail only once. -- Tom Evslin
Don Brady - 22 Sep 2005 03:23 GMT >http://www.nytimes.com/2005/09/21/health/21cnd-bird.html?ex=1284955200&en=b7ec20 1d9fd32466&ei=5088&partner=rssnyt&emc=rss Thanks for the blog-safe link. I was just working on creating one but you beat me to it.
I found the following excerpt interesting:
>..... researchers from the Centers for Disease Control and Prevention in Atlanta found that influenza viruses, particularly those from the dreaded bird flu strain, had developed high rates of resistance to the only class of cheap antiviral drugs available - drugs mainly used to treat flu once patients have caught it. These resistance rates have increased rapidly since 2003, particularly in Asia. > [quoted text clipped - 3 lines] > >The immediate implications of these finding are most ominous for the developing world, because wealthier nations have been stockpiling newer and vastly more expensive antiviral medicines, like Tamiflu, which are effective against the disease but still under patent. 00doc - 19 Sep 2005 16:26 GMT There are two broad types of influenza (with many subtypes each - hence the reformulated vaccine every year) A and B. All the available meds are active against type A flu's but most flu medications do not cover type B; which is not so bad because almost all flu that goes around each year is type A. The Avian flu's that have been detected are type A. The vaccine usually contains three strains - two A's and one B.
The fear of a pandemic is because the avian flu has the "H5" subtype which is similar to the pandemic strain if 1918 and has had a high fatality rate in the few humans who have gotten it. The good news is that there has been little to no human to human transmission so far. The bad news is that that capability may just be a mutation or two away. The estimates I have seen usually suggets more like a 20% mortality rate (which could still be a disaster of Biblical proportions) but I think at this point they are all just guessing.
To answer Alison's question: Presumably if a pandemic hit the people who are stockpiling the meds would want to use it prophylactally - taking one pill daily to keep the flu away - rather than just keep it around for treatment. In that case 100 pills may not be enough.
To my knowledge none of the agents has been shown to be more effective than any of the others. I can't imagine there has been enough human disease for anyone to be experienced enough to really know. The main advantage of Tamiflu is that it covers type B, which is not an issue in this case. It is much more expensive that the other pills which makes me wonder about the motivation of these people selling it.
Amantidine does have more side effects, particularly in the elderly (mostly neuropsychiatric). Rimatidine would be a good compromise on effectiveness, cost, and side effects. One should keep in mind that while the vaccine is a biological that must be grown in culture and so production cannot easily be started or increased this is not true of the meds we are discussing. Considering that there are four different meds available (in the US), that two of them are out as generics and so have several manufacturers, and that as non-biological agents production can be increased relatively easily I think the risk of not having enough meds to treat the high risk groups at least is small. The bigger risk is that there will not be a vaccine and the meds will not be as effective as we would like.
Don Brady - 19 Sep 2005 23:11 GMT That was an excellent post.
However, just to comment broiefly on one point:
>To my knowledge none of the agents has been shown to be more effective >than any of the others. I can't imagine there has been enough human >disease for anyone to be experienced enough to really know. The main >advantage of Tamiflu is that it covers type B, which is not an issue in >this case. It is much more expensive that the other pills which makes >me wonder about the motivation of these people selling it. News accounts do say:
"Oseltamivir, known commercially as Tamiflu, is the only treatment proven to be effective against bird flu in humans."
(AP 8/27/05)
and the U.S. governmenti is reported today to be placing a one billion dollar order for a stockpile of the drug. I have to think that they would buy one of the cheaper anivirals if they thought that they were as effective and safe..
00doc - 20 Sep 2005 04:12 GMT > That was an excellent post. > [quoted text clipped - 12 lines] > to be > effective against bird flu in humans." You do have a point but the above is not true either. Nothing has been proved effective in humans. There have simply not been enough cases and most of the cases that have been detected have been in farmers in rural asia who did not recieve effective antivirals of any kind early enough to expect to make a real difference.
In laboratory experiments Tamiflu has been shown to be effective in mice while some of the strains tested have been resistant to amantadine and rimantadine. BTW - there is another neuraminidase inhibitor on the market (Relenza) but it is even more expensive, is inhaled, and has been known to cause bronchospasm so it is relatively contraindicated in people with lung disease (like asthma).
> and the U.S. governmenti is reported today to be placing a one billion > dollar > order for a stockpile of the drug. I have to think that they would buy > one of > the cheaper anivirals if they thought that they were as effective and > safe.. I'm sure the lab data has a lot to do with it - although like I said, no one really knows what effect the drugs will have. Parital effectiveness may be enough to slow down the spread and turn a fatal disease into a severe but survivable one.
On a related note(s):
The government says it is planning to stockpile 20 million doses of Tamiflu and 20 million doses of the newly developed vaccine. The reality is that they have only ordered 450,000 doses of vaccine so there seems to be some kind of disconnect there. Strong antibody responses have been obtained in humans but since no vaccinated person has ever been exposed to the virus no one knows how effective it might be. The problem is that stockpiled vaccine will not likely be an exact match for whatever strian emerges so the immunity will likely only be partial.
Many models of spread suggest that 120,000 courses of treatment will probably be enough to quell an outbreak. Of course, this assumes the assumptions regarding the behavior of the virus are correct, that the governments respond apprpriately within 2-3 weeks of detection, and that it occurs in relatively rural south east asia and not Kuala Lampur, Bangkok, or Los Angeles. Since the virus has been found in migratory waterfowl that may not show symptoms I'm especially not optomistic about the last assumption.
 Signature 00doc
Spicer - 24 Feb 2006 14:18 GMT >> "Oseltamivir, known commercially as Tamiflu, is the only treatment >> proven to be >> effective against bird flu in humans." > disease into a severe but survivable one. There is no vaccine yet and even if one comes along it may only reduce exposure & symptoms.
You may want to visit http://ge-e.com
The product (Mini-Mate) creates a pure air breathing zone for the wearer, repelling, incinerating, or oxidizing any particulates prior to it entering the mouth, nose & eyes. The size and type of particulate is immaterial, it can be the most lethal pathogen known to man and as long as it measures between 3 microns 0.04 microns and is affected by diffusion, turbulence, gravity and electrostatics the Mini-Mate will offer an effective barrier.
Two respected experts in their fields who have offered their medical opinion upon the product. http://www.airsupply.ca/lantos.php was on the SARs commission in 2003 outbreak in Canada. http://www.airsupply.ca/vadas.php
Please note the Influenza A+B claims. H5N1 is Influenza A.
The product has featured on Oprah Winfrey, Dateline NBC and other TV shows, (see clips on our website). It has had extensive research but as it's not a "mainstream" vaccine based solution the medical profession are not talking about it, probably because a no large drug co will touch it as it could ruin their drug sales in all sorts of areas. I'll leave you to decide.
|
|
|