Slashdot Mirror
Bird Flu May Be Developing Drug Resistance
Pingular writes "The virus currently causing bird flu in humans may be developing resistance to the only drug that can so far combat the infection. From the article: 'A previous paper in the journal Nature described a single case of drug resistance in a patient being treated for avian flu. However, in this case the patient had been given low doses of Tamiflu before becoming infected, as a family member had been stricken. Lead researcher Dr Jeremy Farrar described the latest findings as "very worrying" - but said they were not surprising.'"
Yes, there was a second drug mentioned in one of the earlier articles which was expected to be much more effective. So no news here.
My wife's sketchblog Blob[p]: Gastrono-me
It is also good that the bird flu is not tranfered from human to human...
There are too many instances where people will not finish the prescribed antibiotics and/or then share the remainder with someone who has 'similar' symptoms. Unfortunately, this allows/encourages microbes to alter their structure and become resistant.
After reading the article, it sounds possible in this instance that - because the individual had recently been previously given Tamiflu for a different reason - the virus was given the opportunity to develop resistance. There is also the possibility that the Tamiflu did not work because its mechanism (inhibition of influenza virus neuraminidase, with the possibility of alteration of virus particle aggregation and release) has specific peak/load times based upon exposure or prophylaxis - and again, the individual had already been dosed.
But what that means is that the virus undergoes mutations at a certain rate. And eventually one of those mutations might lead to resistance to the drug. All the other variants will be destroyed but that very small population which has the resistance will spread very rapidly.
That is why some say that not taking the full dose of antibiotics and using antibiotic soaps in homes can lead to the breeding of super-bacteria. A problem bigger than bird flu at this moment is antibiotic resistant staph bacteria (methicillin-resistant S. aureus aka MRSA). When you hear about people getting sicker just by being in the hospital - they probably caught MRSA. The deadliness and the number of cases from such infections have gone up even though it would make sense for them to go down with all the advances in medicine and hygiene. Some speculate that soon there will be another strain of staph bacteria (VRSA) vancomycin resistant S. aureus which would pretty much be resistant to all the known anti-biotics. All that has to happen is for microorganisms to mutate and spread faster than it takes for us to find new antibiotics.
No need to worry, unless you eat uncooked chicken or live on a chicken farm. That pretty much stands even if you live in the affected area of Asia.
Computers allow humans to make mistakes at the fastest speeds known, with the possible exception of tequila and handguns
>wouldn't it have made sense to create a vaccine for H5N1 itself
One of the only ways to create a vaccine is to use bird eggs and then use the resulting "stuff" (I can't recall if it is the the developed antibodies or weak/dead viruses) and inject that into humans.
The problem with H5N1 is that since its an avian flu, it kills the bird embryo before you can develop/grow anything useful for humans.
The surprise isn't how often we make bad choices; the surprise is how seldom they defeat us.
oseltamivir (the real name of TamiFlu) is a viral inhibitor which helps protect cells. It does not work like some antibiotics which (often) actually kill the harmful agent. It may reduce the severity of symptoms, but we know that most of the time it doesn't make a lot of difference. The liklihood of it working in H5N1 has probably not been helped by the Chinese spraying their flocks of chicken with these types of drugs, which will tend to select resistant strains.
If there is one lesson you learn from this, it should be this: only vaccination of large numbers of people will prevent significant disease. If your government is telling you that you will be fine because they are stockpiling oseltamivir, the experts in virology/ infectious disease/ emergency planning/ public health suggest otherwise.
The problem is we don't know what the pandemic will be. Current H1N5 'Bird Flu' is only one candidate virus for combination with a 'traditional' influenza virus to make a new mutant strain to which most of the population has no resistance.
[IAAD, am involved with pandemic influenza planning]
Humorous signatures are over-rated.
My understanding is that one problem here is that Tamiflu is currently the only drug of any use.
7 25
Tamiflu is a generic antiviral/antflu agent which has not been effective against avian flu in any practical tests.
http://www.wnd.com/news/article.asp?ARTICLE_ID=47
Relenza is the other main antiviral drug which may be an effective palliative. It's worth remembering though, these drugs will not prevent the spread of a pandemic.
They may at best alleviate the illness of some of the victims, but that's it. In other words, they're a pharmecutical companies' ideal medicine - vital to save the patient, but won't stuff up the market.
"I've got more toys than Teruhisa Kitahara."
In my almost professional (not quite finished with med school) opinion, the answer would be no. Think of all the vaccinations we have to date, and how few (if any) mutations there have been that have evaded vaccinations.
The immune system is different from antibiotics because it will kill all of the critters. There is also a systemic response, fever, sequestering copper and iron, lowering blood glucose levels etc...ABs do this (not in entirety)...and AB have the side effect of killing your natural flora as well, which can predispose you to secondary infections (see C. difficile in people on broad spectrum AB)
Vaccinations contain attenuated/dead/non-virulent organisms, with their full complement (not an immuno joke...though it could be) of surface proteins, glycoproteins, etc... Your body will recognize several of these sites as foreign and produce antibodies to them. This aids their destruction through phagocytosis, and other nasty things like membrane attack complexes.
It would take something tantamount to a complex change of presentation for some organism to avoid a vaccination.
Argh. The laws of science be a harsh mistress.
I would not be surprised to find out that pretty much all the virus and infectious bacterial agents in nature tend to build up resistance to the various drugs that are used to combat them.
I haven't read through all the comments, so someone's likely to have already said this but,
The best thing for people to do with regards to their health is build up their immune system without drugs. Eat more foods with anti-viral, and anti-bacterial properties.
Garlic's a good one, all round. Peppers - capsicum, chili - are good too, and can add a nice little kick to an otherwise mild tasting meal. Having fish? Add lemon juice, or orange for a slightly sweeter taste. Salad? Add some shallots or onions.
I think the biggest problem though with the enhanced diet approach is that too many people cook their food too much.
I will happily nibble on raw onion, raw garlic, shallots, a capsicum, chili. I may not be very approachable if I'm breathing in your direction, but I wouldn't be approachable if I was sick either.
Boost your immune system, don't rely on the drugs. What happens when you catch a new strain of something that there is no drug to combat it with? Don't just eat healthy, eat health-enhancing foods, and your body will still catch things, but it'll be a lot more ready to fight them.
I don't get very sick these days, but when I do - even if it's a really bad cold or flu that's knocking people about here and there, and there's warnings about it on the news, fairly common around here during the winter months - I tend to get better within fourty-eight hours.
I've caught things that have had friends and family in bed for days, taking drugs prescribed by a doctor and complaining about how crap they feel, and while they do that, I'm seriously chowing down on various strong foods, making myself sweat and do a lot of physical exertion, and keeping myself hot and active, flushing myself through with lots of water and hot soups.
It's simple, but it tends to work. The strongest drugs I take these days are aspirin if I get a migraine, and no, I'm not one of these anti-drug guys. I smoke, which I know doesn't help normally, and I like to drink alcohol, I just don't like to try and combat every little ailment I have with drugs, and my body tends to resist communicable illnesses that people around me have got.
Eat healthy, and you'll be healthy. Eat health-boosting foods, and you'll tend to gain resistance to little nasties.
His name is Robert Paulsen...
Arbidol is actually recommended by Russian Ministry of Health as profylaxys of flu. Its manufactures don't try to hide themselves from general public. They also do provide rather detailed information concerning its biochemical principles. The drug did undergo clinical testing. It isn't advertised as a panacea. So there seems to be no 'mystery' or 'wonder' about it.
From my understanding the "girlfriend" poster's proposal is two stages, and other than the lack of a profit angle I can't see anything wrong with it.
;)
The first stage would invovle developing a vaccine for the domestic bird population. Relatively easy to do since they have simpler biologies than us, and there are several hundred (easy) surviving bird-flu avians that can be pooled for an immunology database. Then it is a relatively simple matter of finding the particular marker sequence that is responsible for the immunity (hence the requirement of several hundred subject making it easy: process of elimination within a larger pool results in fewer possible candidates). Use of this accine for mass domestic bird populations (chicken farms and so on) reduces the number of "incubators" for human/bird species jump of the bird-flu. This would give us TIME for stage 2.
Stage 2 invovles the construction of several SMALL (at lest that is my impression) facilities for the production of the human/bird-flu vaccine, using the methods discovered for the regular avian version of the bird-flu. Once an full-on outbreak occurs it really IS a simple matter of biological cut/paste like was described. The same procedure happens every year for the asiatic flu. You take the new virus and compare it to the old virus, the difference in cell protien attachments is the difference that makes it human-compatible. Then you take your existing vaccine, and alter it to have the same protien attachment. The result is a vaccine that is effective agaisnt the new version of the old bug. The HARD part come in manufacture and distribution, but with a lab capable of cranking out a few million doses in a couple days located next to every major urban population center...
If anything, given this plan, I would think that construction worker's unions would be SCREAMING for it. After all, it entails one of the largest contruction projects in the USA since the interstate highway system... so maybe there IS a profit angle after all