• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

Tamiflu Drug 'Oversold' As Pandemic Flu Fix

Posted on: Monday, 7 November 2005, 12:01 CST

By JACKIE JADRNAK Journal Staff Writer

Don't think Tamiflu will stop an influenza pandemic. That's the message from some local experts who express frustration that publicity over efforts to stockpile the anti-viral drug may raise public expectation that it's a magic bullet. The U.S. government has announced plans to squirrel away enough to treat 20 million people.

No one even knows for sure if the drug will have any effect on a new, virulent influenza strain, such as some people fear may develop from the current H5N1 "bird flu" virus.

"Virtually everyone I know in general medicine has been inundated by people wanting to supply themselves" with Tamiflu, said one medical professional at a conference in late October in Albuquerque on pandemic influenza planning.

"There is a lot of hype around the drug," said Dr. Gary Overturf, professor of pediatrics and pathology at the University of New Mexico. "I agree that it's being oversold."

"It's the concept of a quick fix," said Dr. Bernadette Albanese, UNM assistant professor of pediatrics and medical epidemiologist with the state Department of Health. "It's a mentality the public has and is being fed by a media frenzy. We need to shift the mentality away from the 'quick fix' to things people really can do."

Some of those things are those your grandmother probably advised: Cover your mouth when you cough or sneeze, and wash your hands frequently. "It's not sexy to talk about washing your hands," Albanese said.

Both nationally and internationally, Tamiflu is being stockpiled as a potential weapon in an influenza pandemic. It has shown some effect against avian influenza in studies, although one strain isolated in Vietnam showed resistance to the drug.

In general, the drug can cut one or two days from your flu symptoms if you take it within 48 hours of developing the disease. It also can reduce by 30 to 50 percent potential complications of influenza, according to Dr. David Shay with the influenza branch of the Centers for Disease Control and Prevention, or CDC.

The hope is that, if avian influenza mutates into a form that can be passed from person to person, these antiviral treatments may reduce the number of people who die from the disease. Others have said the drug can be given to people who had contact with a person struck by the flu, preventing them from getting it and perhaps containing an outbreak.

Used preventively, it is 70 to 90 percent effective in helping exposed people avoid getting sick, Shay said.

Such an approach is not cheap. A treatment course of the drug, given to someone who already has the flu, costs $60 to $80, according to Overturf. When it's used to prevent the flu in someone who has been exposed, four treatment courses -- $240 to $320 -- have to be given, he said.

"No one in Southeast Asia has been receiving it prophylactically (as prevention)," said Overturf, referring to the region where bird flu has infected some humans. "And we probably won't be able to afford (to use in widely as a prevention drug) here, either."

"There is nothing we can say about how useful it would be in an H5N1 pandemic," said Shay.

The virus has appeared to be susceptible to the drug in test tube and mouse experiments. "But the mouse is not a very good animal model for flu in people," he added.

Also, the virus has to change somewhat before it poses a danger to people. There's no way of knowing if its apparent susceptibility to the drug would be greater or less in a mutated virus.

In the Oct. 31 Newsweek, Dr. Julie Gerberding, CDC director, was quoted as saying, "I think it's a complete misdirection of energy to be so focused on the issue of stockpiling (Tamiflu). There is no evidence that it will make a difference if we are hit with a pandemic."

The 1918 flu, that killed many otherwise healthy young people, multiplied so quickly in their bodies that people told of many people who were healthy in the morning but dead by that night.

Could an anti-viral medication have any effect against a virus that overwhelming? "That's a good question," Shay answered.

Also, in the same way that bacteria develop resistance to antibiotics, viruses evolve to become resistant to anti-viral drugs to which they are exposed, Albanese noted. If Tamiflu is widely used in a pandemic, then, the virus may develop resistance before it is beaten.

Ultimately, if the drug is used in a pandemic, medical experts will be learning as they go about how to use it most effectively. And doctors and nurses on the front lines will have to struggle with rationing it to those who most need it, while others will be crying out for help.

"We're going to have people in pharmacies held at gunpoint to cough the stuff up," predicted Albanese.

Source: Albuquerque Journal

More News in this Category