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Medical Forum / Diseases and Disorders / Asthma / February 2006

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Tamiflu-resistant bird flu

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Alison Chaiken - 15 Oct 2005 18:33 GMT
http://www.mercurynews.com/mld/mercurynews/news/world/12910470.htm

Posted on Sat, Oct. 15, 2005
Drug-resistant bird flu found in Vietnam girl
VIRUS'S INABILITY TO SPREAD REASSURES DOCTORS
By David Brown
Washington Post

WASHINGTON - A strain of H5N1 bird-flu virus found in an infected
Vietnamese girl is resistant to the drug being stockpiled by more than
a dozen countries, including the United States, as a defense against a
possible global pandemic, researchers reported Friday.

The new finding, while not unexpected, raises the possibility that
oseltamivir, sold as Tamiflu, might be less useful than anticipated if
resistant-strains of the H5N1 avian-flu virus become more prevalent
and the virus gains the ability to pass easily from person to person
-- a trait it does not possess now.

Friday's report is the first indication that tests have detected a
drug-resistant strain of H5N1 since the virus began circulating among
birds in Asia. It was found in a 14-year-old Vietnamese girl who
became ill in February while caring for her brother, who was also
infected. She had initially received a low preventive dose of Tamiflu,
and then a higher dose when she became ill. She recovered fully.

The report, by Q. Mai Le of Vietnam's National Institute of Hygiene
and Epidemiology, in Hanoi, and 15 international collaborators, will
appear in next week's issue of Nature. The journal released it early
``owing to its relevance to current public debates,'' a representative
said.

The H5N1 strain has infected 117 people in Southeast Asia and killed
60 since December 2003.

Although resistant to Tamiflu, the strain reported Friday remained
susceptible to zanamivir, sold as Relenza, another member of the same
class of anti-viral drugs. Japanese researchers reported last year
that in a small group of children treated with Tamiflu, 18 percent
developed resistant viruses.

A major unanswered question is whether a Tamiflu-resistant virus can
pass from person to person.

``Tamiflu is going to work,'' said Anne Moscona, an
infectious-diseases specialist at Weill Medical College of Cornell
University, who wrote a review of the drugs in the New England Journal
of Medicine last month. ``We have reason to hope that resistant
strains will not be transmissible and will not be the ones spreading
in a pandemic.''

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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 - 15 Oct 2005 19:09 GMT
>http://www.mercurynews.com/mld/mercurynews/news/world/12910470.htm
>
[quoted text clipped - 21 lines]
>infected. She had initially received a low preventive dose of Tamiflu,
>and then a higher dose when she became ill. She recovered fully.

Yes but  theTamiflu-resistant virus was just found in one person who had been
taking preventive Tamiflu.  Also it looks weakened and might not be a candidate
to furtger mutate and spread.  Also she did recover!  

So there are grounds for hope!

However, prudent stockpilers might want to order a supply of Relenza  and
amantadine also.   We will not know until the pandemic hits (if it occurs)
whcih one will still work.

By the way, we might have a different pandemic than bird flu.   The complete
formula for the Spanish flu virus of 1918 has just been published (a very naive
decision), and terrorists may be working even as we speak to recreate it.  One
expert described that as inevitable, sad to say.  That flu killed many people
within a day and immunity to it in the general population is rapidly declining
to zero.
Cousin Jack Newquay - 18 Oct 2005 20:21 GMT
We asthmatics need to be very worried about avian 'flu.. Sorry to be a
harbinger of doom but with my impaired lung function I am afraid of dying.
H5N1 is not a problem as I see it but it is if it is 'modified' by a
'regular' 'flu virus and is transmittable between humans then it poses a
very real threat.
I am formulating a policy of staying away from work ( where I am in daily
contact with the public) and laying up a store of food and drink so that I
need not venture out in public.
Sorry folks to sound so despondent but at 59 years old I am taking no
chances.
Am I wrong?
Roger (UK)

>>http://www.mercurynews.com/mld/mercurynews/news/world/12910470.htm
>>
[quoted text clipped - 45 lines]
> declining
> to zero.
Merlin - 19 Oct 2005 03:30 GMT
G'day all, Quite obviously most fowl throughout Europe will now be
affected, Greece is the latest.
The united Kingdom and other countries will logically follow.
The "flu" season is present, poorly aerated conditions in buildings
exists as energy is conserved, this is especially exacerbated by the
current oil costs.
The main interest is in the H5N1 varietal strain which curently rapidly
kills these birds, usually in a couple of days, but in it's present
form does not present a problem as far as a human pandemic is
concerned.
The Vietnamese girl's story (as mentioned) was from a family that had
eaten "Duck-blood soup" which apparently has an element of poorly
cooked material.
Most of that family tested positive to H5N1, the older brother did
recover and the elders of the family don't seem to have suffered ill
effects. The family was apparently used to consuming less than healthy
fowl. Many families in this region consume their sick or dead animals
as a matter of course.
I would imagine these peoples blood would now auction off at good
prices.

We have just had a post covering and reccommending the use of feather
pillows, this is ironic!
I have finally noted that someone has had the sense to stop poultry
products being exported and imported as the case might be with some of
the problem areas.
Someone has just "twinked" to the "egg" situation, in some places these
things used to be called "bacteria bombs", this in itself has massive
implications with products made using eggs and their source.
The poorer places may accept that the fowl need to be destroyed, but
imagine some clever poor farmer trying to save feathers or eggs, as far
as I know the current method is simple destruction of animals.
Quite obviously irradiation of products may have some assistive effect,
but the ladder exists.
It is most likely that a person that has a normal influenza infection
of some description that comes into contact with the H5N1 thing has the
possibility of generating a potent weapon, the terrorist mentality
would be well aware of this and probably be already trying to develop
it and most likely "would" have.
Looking at the overall odds of this happening in the current areas
where both bugs exist, things would appear to be somewhat grim. A bit
like some rash person being in a gunpowder magazine in the dark and
having a box of matches in their pocket!

With the 1918 version, the main area for infection was between the ages
of twenty to fifty as far as I know, but that was a civilisation which
were not associated with immune system depleting drugs, so if this
pattern were followed we would likely be looking at something somewhat
different!
Of course if a complete isolation and quarantine principle were
involved it may slow down the infection spread, but if the bug is
transmitted as an airborne particle, any place with recirculating
airconditioning could be one of the main infection mechanisms.
This could well be worth considering. Shutting down aircon in buildings
has no improvment effect because the ventilation systems remain
essentially as recirc.
We have a society where windows do not open, trains, buses, planes,
buildings, some homes even have non-opening windows.
So it may not be best for your family to run out and buy "feather
pillows" then purchase overseas imported products with "egg or chicken
content", come home with the "flu" and if you are between twenty and
fifty living in a total recirc "air-conditioned" home expect zero
problem!

The other side of this, is that the persons less likely to be affected
are those living in remote places with little contact to outside world
with complete aeration, which is not us!

Of course the world could just "shut down" and no one move, but this is
not an option.

Air scrubbing systems would be a step in the right direction, these
would have to be high volume and probably require to be high intensity
ozone devices with charcoal filtering, this technology is the only one
I know of that would be suitable. These would have to be immediately
installed in most cases.

Some people may adopt the principle of remaining in their homes, this
is a good idea if you are well off, but most couldn't possibly do it.
I would imagine credit companies are already considering credit
limiting.

Airlines and passenger ship companies already have contingency plans as
do many governments.

One thing that might be worth considering is dumping the "Colonel's"
shares and placing that money into "Internet Grocery" and "Online
Shopping" organisations, these will suddenly have vital qualities for
many people.

Would it be best to prioritise younger people for medical assistance if
it comes to that?
I know if I am involved with any triage situation what I will be
doing!!

It most certainly is food for thought for us old expendables!

Cousin Jack's idea is pretty sound, but the need for getting booze
would preclude the isolation.
Usually those that try hardest to avoid getting problems get them! And
those that are teetollers usually get them worst. What period of
isolation time starting "when" and finishing "when", were you planning
Jack?
Don't forget mutation may happen with other animals apart from humans,
so your best bet is probably going to be just to use commonsense,
breathe less (Like Buteyko breathing) and maybe wear a surgical type
mask to avoid breathing aiborne particles as much as possible in those
areas of concern.
Here in Australia there is movement toward vaccine ideas, there are
supplies of Tamiflu and Relenza, but it would be expected that any
breakout would most likely be resistant as, when and if it may happen.


This is really Cay sera sera stuff!

Cheers, Merlin.
Spicer - 24 Feb 2006 13:34 GMT
> We asthmatics need to be very worried about avian 'flu.. Sorry to be a
> harbinger of doom but with my impaired lung function I am afraid of
[quoted text clipped - 58 lines]
>> declining
>> to zero.

Please visit http://ge-e.com. We have launched a product across Europe,
Middle East and Africe that 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.

Great for Asthma, Hay Fever and anyone whose systems are Immuno-compromised
or suppressed.

Expert Reviews:

http://www.airsupply.ca/lantos.php was on the SARs commission in 2003
outbreak in Canada.
http://www.airsupply.ca/vadas.php
 
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