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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.'"
... President Bush decides to bomb the Canary Islands in a bid to stop a global flu outbreak...
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.
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.