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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.
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.