Avian Flu - Oseltamivir/Tamiflu Resistance
- From: koza@xxxxxxxxxx
- Date: 15 Jan 2006 09:58:55 -0800
The following information about Avian Flu is both important and
disturbing.
----------------------
>Date: Fri, 13 Jan 2006 23:04:06 -0800
> To: Rick Koza
> From: "Henry I. Miller"
> Subject: Re: Interesting thoughts on bird flu
" Fascinating -- and bad news -- if it's confirmed;
Tamiflu would be in even shorter supply if we have to raise the dose
significantly.
> I haven't seen those data anywhere else."
> Thanks for sending.
> Henry Miller
> Henry I. Miller, M.D.
> The Hoover Institution
> Stanford University
> Stanford, CA 94305-6010 USA
"Dr. Miller is a director of Consumer Alert, a national
consumer advocacy organization; a director of the
American Council on Science and Health; an Adjunct
Scholar at the Competitive Enterprise Institute; and a
scientific advisor to the George C. Marshall Institute
and former FDA consultant."
------------------------------
http://www.recombinomics.com/News/12220501/H5N1_Tamiflu_Resistance_Mutants.html
"Tamiflu was used in vivo at a tiger zoo in Thailandlast year.
Initially a small number of tigers were
infected with H5N1. Tamiflu was used to treat the symptomatic tigers
and was used prophetically to
prevent spread. These efforts were not successful and all exposed
tigers (147) died or were euthanized.
Mice were used in additional in vivo tests of Tamiflu. Although mice
were treated with 20X the
prophylactic dose prior to infection, 50% of the mice died after 5 days
of treatment (the FDA approved protocol). Extending treatment to 8 days
reduced the death
rate to 20%. The higher dose was used because of differences in drug
metabolism, but the above data indicated that even 20X the approved
dose was sub-optimal.
Thus, the above data indicate the FDA approved prophylactic or
treatment dose for Tamiflu is sub-optimal for H5N1 infections. Use of
Tamiflu at sub-optimal levels can give rise to resistant
H5N1." (Article abbreviated)
---
Oseltamivir Resistance - Disabling Our Influenza Defenses
Dr. Moscona is a professor in the Departments of Pediatrics and
Microbiology and Immunology at Weill Medical College of Cornell
University, New York (Dec 22/05).
"The study by de Jong et al. confirms that oseltamivir-resistant H5N1
virus is now a reality. ... This frightening report should inspire us
to devise pandemic strategies that do not favor the development of
oseltamivir-resistant strains. Improper use of personal stockpiles of
oseltamivir may promote resistance, thereby lessening the usefulness of
our frontline defense against influenza, and should be strongly
discouraged."
More with Dr. Moscona at -
http://content.nejm.org/cgi/content/full/353/25/2633
--------------
Associated Press Writer
01/15/2006
"Clinicians should not use rimantadine and amantadine ... because the
drugs will not be effective," said CDC director Dr. Julie Gerberding.
The two drugs have been used for years to combat type-A influenza.
CDC officials took the unusual step of calling a Saturday news
conference to announce that the predominant strain this season _ the
type A H3N2 influenza strain _ was resistant to the older drugs.
The CDC tested 120 influenza A virus samples from the H3N2 strain and
found that 91 percent, or 109, were resistant to the two drugs. Two
years ago, less than 2 percent of the samples were resistant. Last
year, 11 percent were, the CDC said.
Gerberding said the agency was not sure how the resistance occurred,
saying it may have been the result of a mutation in the H3N2 flu strain
or could have come from overuse of the drugs abroad, such as in
countries that permit them drugs to be purchased without a
prescription.
http://www.azdailysun.com/non_sec/nav_includes/story.cfm?storyID=123066
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