Medical Forum / Diseases and Disorders / Asthma / February 2006
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.''
 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 - 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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