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.'"

Comments

Tamiflu

[Anonymous Brave Guy]

Tamiflu was never expected to be a completely effective counter to a mutated strain of bird flu. It might help some people for a short time, which is great of course, but we'll still need a tailored vaccine that currently takes a few months to produce if we're going to beat it on a wide scale. This is why the medical profession is so worried about it, and why so much effort is currently focussed on cutting the time from identifying the mutated strain to availability of a matching vaccine.

Re:Tamiflu

[Anonymous Coward]

My girlfriend is a microbiologist with a specialization in human pathogens, so if anybody would be an expert here it is her.

And she says that in the early stages of a bird flu outbreak, Tamiflu is an effective counter to it. Yes at medically useful doses it has a chance of killing you, but that chance is significantly lower than your chance of dying WIHTOUT it.

The problem comes when it reaches the epidemic stage. You see Tamiflu WILL NOT CURE an infection, it only gives the body enough lead time to build up specialized immunity cells to fight off the infection. During this entire period the virus is still active inside the patient, and still replicating (just at a vastly loweer and non-life-threatening rate). The end result is that it turns patients into incubators for the evolution of resistant strains. The more people that take Tamiflu, the higher a chance for a resistant strain to develop.

The horror story of this is that Tamiflu-using patients are STILL contagious, and this is an airborne disease. With flu-like symptoms, there is almost no chance that an infected person will be quarantined in time to prevent them infecting others. As the resistant strains enter the general population, furhter Tamiflu treatments result in even MORE resistant strains being developed. Eventually the amount of Tamiflu required to recover from the virus will be so high that you have a better chance of survival WITHOUT Tamiflu.

And while edpidemiology resources are being devoted to making the Tamiflu patent holder wealthier, they are not being devoted to the creation and production of a brd-flu VACCINE.

And in the end, thanks to Tamiflu and money-hungry politicians, we end up with a new Smallpox.

A much better viewpoint on a potential bird-flu epidemic is to flatly IGNORE Tamiflu, and nip the potential evloution war we cannot win in the bud. Instead devote all the Tamiflu production resources to producing a vaccine for the non-human bird-flu strain, and begin mass vaccination of domestic bird populations. This will slow down the spread of the virus to the human population, as well as giving us a biological base for a human-usable vaccine.

Then when the human jump ACTUALLY occurs, it is a relatively simple matter of biological cut/paste with the human strain to create a human-usable vaccine. The same manufacturing and distributing capacity used for mass domestic bird vaccination can then be easilly switched to human vaccination.

Poof! Bird-flu scare solved, loss of life minized, and all for FAR CHEAPER than the cash we will have to spend (and lose) taking the Tamiflu route.

This has already

[zegebbers]

affected Roche financially more info here .

Armagedon ready for Christmas

[FishandChips]

My understanding is that one problem here is that Tamiflu is currently the only drug of any use. If there is more than one treatment available, then combination treatments can be used and so cut down the rate at which resistance arises.

I guess the reality is that we can't really be sure what will work and what will not work until after the virus has mutated enough to spread from human to human. And let's hope that never happens. Or, if it has to happen, that the mutation weakens the virus enough to keep things small scale.

I'm a little dubious about Tamiflu. A problem with piling up supplies of Tamiflu at home, for example, is that if you get a bug, how can you know without a test that it is the killer bug? The risk is that you may have a standard bug and then mistakenly use your one and only heavy artillery round on the wrong target. After that, you are foobarred.

Re:In related news...

[Anonymous Coward]

Meanwhile, Rumsfeld sells the world the cure!

the only drug....?

[dsmatthews]

Did you even read all of that BBC story? http://www.biota.com.au/products/relenza.html (The original and still the best.)

Question on immunization

[sphealey]

Here's a question that has been bothering me for a while. The various health agencies have believed for a while that it is possible that the H5N1 virus could mutate into a form that spreads easily among humans. Of course, they cannot know in advance what that mutation will be, and once the mutation appears it will take 18-24 months to develop a vaccine for that specific strain.

So - wouldn't it have made sense to create a vaccine for H5N1 itself, and add that to this year's usual 3-flu cocktail? My understanding is that the human immune system maintains a library of antibodies for viruses that have challenged it in the past. Wouldn't there be a greater liklihood that an H5N1Mutant antibody could be developed if there was already an H5N1 antibody in the library? Again, my understanding is that the difference in surface structure between the primary and the mutant is usually fairly small.

Am I oversimplifing things too much? Or would there be a danger that vaccinating people for H5N1 would actually _increase_ the chance of the mutant developing?

Enlightenment from people who deal with the squishy stuff would be appreciated.

sPh

Re:Question on immunization

[sammyo]

>Am I oversimplifing things too much?

Not at all actually. But consider the timeline.

The flu has not mutated into the form that is highly
contagious to humans yet. When that occurs there will be
a race to cultivate the vaccine. During the period between
the high volume production of the vaccine (months, many months)
the death toll could be significant.

Possible alternative

[fionbio]

Arbidol (in Russian) is virtually unknown outside Russia, while it seems that it was shown to be able to defeat bird flu virus. For some discussions in English, look e.g. here.

I've heard that Tamiflu is preferred for political reasons. Maybe there's actually something wrong with Arbidol, but here in Moscow they claim that Arbidol can cure bird flu in their rather widespread advertisements and aren't driven to court for that.

So?

[hackstraw]

I'm fairly paranoid and all that about things. But a birdie flu is not something that bothers me less than people being bothered by it.

From the bird flu FAQ, around 200 people have died from it, and it was compared to the last plague, SARS, to the 800. How about this silly question? "Can avian flu be passed from person to person? There are indications that it can, although so far not in the form which could fuel a pandemic." Or this? "Does this mean there is likely to be a large outbreak of bird flu? Experts are concerned that this could happen. But in the Thai case, the virus was only passed to close relatives and spread no further." Or this? "What would be the consequence if this did happen? Once the virus gained the ability to pass easily between humans the results could be catastrophic. Worldwide, experts predict anything between two million and 50 million deaths."

So the worst case guestimate is that 0.7% of the population might die. Lets compare that to real data. The population appears to be growing. And, over the past month, on average 6 million people are net gained on this planet. And this growth is estimated to continue at the same rate until July, 2006.

So, if everybody forgets to die and fuck for 8 months its the same thing as the worst case scenario from something that may not be contracted from person to person.

Be scared, very scared.

Wake me up when a good plague comes though. I remember when they would wipe out 1/3 of the population, and we would be grateful, and life went on without laws protecting drug companies from being sued for potentially killing people who make drugs to keep stuff like this from hurting us. Now that, my friends is something to be worried about.

Re:So?

[DigitalRaptor]

I'm not worried at all about getting the bird flu and dying, or losing a family member or friend to it.

What I am very worried about is the economic consequences to the worlds reaction to it.

The current Bush plan calls for the closing of all interstate and air travel, and the closing of all ports, the moment the bird flu is detected on U.S. soil in a human communicable form.

I don't know about you, but that would have serious consequences for me. No gas at the gas station. No food at the grocery store. You can't just order crap off the internet, because there will be no UPS or FedEx to deliver it.

This map shows how fast the 1918 flu epidemic (not a pandemic) spread. So it is very reasonable to try to stop it's spread, and no president, not even one as stupid as Bush, wants to be remembered as the one who killed off 1.9 million voters.

So, travel restrictions are necessary, but we shouldn't think there will be no consequences. A real outbreak of the bird flu in the U.S. will make Katrina look like a FEMA picnic.

Pure political + Big Money

[Poingggg]

I remembered having read somewhere about Rumsfeld being involved as a shareholder of Roche. Did a quick Google and found (amongst others) this: http://www.currentconcerns.ch/archive/2005/06/2005 0602.php . Interesting, isn't it?