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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.'"
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.
If you disagree, post your argument. (-1, Overrated) isn't your personal censorship tool for views you don't like.
affected Roche financially more info here .
Unpretentious Sydney reviews by unqualified Sydney reviewers
at this time of year...
... President Bush decides to bomb the Canary Islands in a bid to stop a global flu outbreak...
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.
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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.
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.
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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.
Having just written two term papers analyzing the social construction of the bird flu, I'm loaded with more H5N1 knowledge than I ever thought possible. Part of the problem is that Tamiflu isn't designed to fight the bird flu, it's not a vaccine, it's an anti-viral (and, up until the end of 2004, it was one of Roche's least successful drugs). It operates by reducing the spread of a virus within the body, alleviating the severity of the effects of normal flu strains in humans by up to 38%, and reducing the time of infection by up to two days. It does NOT cure/prevent bird flu, but it is believed that it might be effective in lesseing the communicability of the disease. There are other anti-virals, such as GlaxoSmithKline's Relenza, that should have roughly equal effectiveness. BUT, guess what? The creator/patent-holder of Tamiflu is Gilead Sciences Inc; a company whose CEO from 1997-2001 was none other than Donald Rumsfeld. The wife of former California Gov. Pete Wilson is on the board, as well as George Schultz (US Sec of State from '82 - '89). These political connections might be a key reason why the Bush Administration hasn't invoked the WHO's TRIPS Agreement, which allows for compulsory licensing (in which, in the face of a potential health crisis, the patent on a drug is broken, allowing other companies to produce the drug, while a modest licensing fee is paid to the patent holder), and would actually allow the US to stockpile enough of the drug to make a serious impact (WHO recommends that a country have enough anti-virals to treat 25% of its population, given the current productive capacities of Roche, the US won't have that amount until around 2011). In light of the recent discovery that the 1918 flu outbreak was, in fact, a strain of the bird flu that had mutated amongst bird populations until developing in a strain that was capable of human-to-human transmission, scientists DO have a genome sequence of one such iteration of the virus, which could be used to develop vaccines (that may or may not work). Most health officials agree, however, that spending money on drug stockpiling is an empty gesture, and that available treatments should be sent instead to the poor East Asian countries where an outbreak is most likely to occur (and who can least afford to pay for the drugs). Even then, the drugs are not recommended as a primary means of prevention, rather, improvement in monitoring/reporting infrastructures, as well as new medical technology, is the suggested course of action. I could go on, but suffice it to say, it's not surprising to hear about Tamiflu's lack of effectiveness, and were it not for the fact that the "BIRD FLU PANDEMICPALOOZA" were just a big political opportunity for the Bush Administration to assert themselves as competent and forward-thinking after the Katrina tragedy and the recent drop in US public support for the Iraqi War, that is, if the Bushies REALLY wanted to fight the flu and not just use it as a means of gaining some good PR while lining the pockets of their friends, then Tamiflu would almost never be mentioned in the press. End Rant.
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.
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...