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HalfMooner
Dingaling
Philippines
15831 Posts |
 Posted - 02/27/2006 : 20:54:39 [Permalink]
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Would you medical folks who post here care to comment on Tamiflu and possible avian flu vaccines?
Specifically, is Tamiflu worth acquiring in advance? If so, how should it be used? Should probenecid be used, both to make it more effective in individuals, and to make limited supplies work for more people?
Is an effective avian flu vaccine in the offing?
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“Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive. |
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Dude
SFN Die Hard
USA
6891 Posts |
Posted - 02/27/2006 : 22:30:11 [Permalink]
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quote:
Is an effective avian flu vaccine in the offing?
Not yet. And when the need for it arises it will be impossible to make enough unless there is significant pre-planning in place.
I may have read something about a vaccine currently being used on birds, but it only prevented them from developing the flu. The birds could still be carriers.
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Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson
"god :: the last refuge of a man with no answers and no argument." - G. Carlin
Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 02/28/2006 : 01:27:09 [Permalink]
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Interestingly I've just re-read Laurie Garrett's The Coming Plague chapter on swine flu. The vaccine they made worked for people born before 1956 and not so well for those born after. It was speculated that a flu pandemic that year was similar enough that the new vaccine acted as a booster for those that had had the 56 strain but for those born after there was no antibody to boost. Not that you can draw conclusions so easily but for the experimental H5N1 vaccine they have made, it takes 2 larger doses to be effective rather than the one smaller dose of regular flu vaccine. This also fits with what we know about kids who need 2 doses the first year if under age 9. Of course all of this is just useless information if you aren't in the vaccine field since as Dude says, when the time comes there won't be enough vaccine anyway. If they started now, which would likely be with a formula that was a poor match, in 6 months there would be less than enough for 5% of the world's populations according to the vaccine manufacturers own estimates of total production capacity.
Tamiflu and Relenza, a similar drug you inhale the powder instead of swallow the pill, are two drugs that do treat influenza including H5N1 with the exception of a single strain that showed Tamiflu resistance but was still susceptible to Relenza. But there are two serious problems. You have to take it the first day of symptoms for it to do any good. That means you have to know the difference in flu symptoms vs other infections. It might work if started on day two. By day three the damage has been done and the drug will have no effect. Tamiflu will also prevent the flu in people exposed. That will be useful for health care workers but you can also expect doctors to ignore reality and waste Tamiflu on every critically ill patient. Doctors have a very hard time doing nothing even if the something won't work.
The second problem is again production capacity. Tamiflu is a complex drug to produce so drug factories cannot switch to Tamiflu production quickly. If the flu breaks out in a year, we may have more drug reserves. OTOH, if the flu breaks out in a year, the overuse and misuse of Tamiflu now will likely create drug resistance by a year from now. Amantadine and Ramantadine are similar antiviral flu drugs. The virus has been intermittently resistant to both drugs and this year's strain is completely resistant. In addition to human use, there are reports of Chinese farmers feeding these drugs to chickens to prevent flu disease. It's no wonder H5N1 is already resistant to both of those drugs.
If you can get Tamiflu (some pharmacies have it still but distributors don't), it's expensive but people are putting some away for themselves. Of course they need to know when to take it or it'll go to waste. And by individuals storing it, the public health can't direct its use to the most effective situations like health care workers. Imagine though being a public health worker with the job of delivering Tamiflu to designated recipients and your kids get sick. Or being the nurse or fire fighter with access to Tamiflu for yourself but not your ill children. Worst case scenario flu pandemic and the Tamiflu issues are going to be very messy.
I've been trying to get some probenecid but the distributor is out of that as well. That reminds me I should make another effort. It needs more testing but probenecid should make Tamiflu supplies stretch further. I don't think anyone is moving fast enough on the probenicid. It's very disheartening to know we have many measures that should be in place already but aren't even moving forward. |
| Edited by - beskeptigal on 02/28/2006 01:32:06 |
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HalfMooner
Dingaling
Philippines
15831 Posts |
Posted - 02/28/2006 : 01:50:18 [Permalink]
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Dude and Beskeptigal, thank you so much for your replies. Looks like I should concentrate my preparations on the N95 masks and hand-washing. Maybe developing an obsessive-compulsive hand-washing urge would help me to do this right.
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“Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive. |
| Edited by - HalfMooner on 02/28/2006 01:50:58 |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 02/28/2006 : 02:06:39 [Permalink]
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Here you are up in the middle of the night again, HM.
I have both Tamiflu and Relenza on hand. But it's really more for my son than me. I have no concern that I won't be able to avoid the virus. But my son is not so skilled. It was very expensive but so is my monthly health insurance so I looked at it that way.
The hardest thing for me will be worry about food other people handle. I've been noticing lately all the places for potential exposure. Fresh food seems to pose the most problems. I'll have to give up the cut up salads in the bags. Those have been a nice convenience. And no more food out. Too much chance someone coughed or put their hands on something.
But that will only be if it gets really bad and it may not. We do have a lot more knowledge about public health than they did in the early 1900s. I'm still thinking it will be bad but manageable here. From Africa through India, Eastern Europe to Asia will be the places that really do poorly. I don't know how Mexico and further south will do. They may also not do so well depending on specific region.
And it is still possible H5 just won't make that species jump. |
| Edited by - beskeptigal on 02/28/2006 02:08:22 |
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HalfMooner
Dingaling
Philippines
15831 Posts |
Posted - 02/28/2006 : 10:06:52 [Permalink]
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That was an early-to-bed night for me, B. My general goal is getting to bed by 1 AM, and I nearly made that last night, for a change.
Let's do hope everything goes as well as possible with avian flu. I did see that at least one company is gearing up for possible production of a vaccine using bacteria to make it in vats, which could make ramping up quick mass production much easier than the usual technique of using chicken eggs. Maybe that'll help.
I will probably get some Tamiflu, myself, once I've saved for it. As you say, it's not cheap.
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“Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive. |
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BigPapaSmurf
SFN Die Hard
3192 Posts |
Posted - 02/28/2006 : 10:32:12 [Permalink]
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| Bird flu has been detected in a cat in Germany. I dont know what if any impact this will have though. |
"...things I have neither seen nor experienced nor heard tell of from anybody else; things, what is more, that do not in fact exist and could not ever exist at all. So my readers must not believe a word I say." -Lucian on his book True History
"...They accept such things on faith alone, without any evidence. So if a fraudulent and cunning person who knows how to take advantage of a situation comes among them, he can make himself rich in a short time." -Lucian critical of early Christians c.166 AD From his book, De Morte Peregrini |
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HalfMooner
Dingaling
Philippines
15831 Posts |
Posted - 02/28/2006 : 11:27:56 [Permalink]
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BigPapa pointed out: quote:
Bird flu has been detected in a cat in Germany. I dont know what if any impact this will have though.
Hey, at least the cat was trying to help, it would appear.
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“Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive. |
| Edited by - HalfMooner on 02/28/2006 11:28:23 |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 02/28/2006 : 14:18:07 [Permalink]
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quote:
Originally posted by BigPapaSmurf
Bird flu has been detected in a cat in Germany. I dont know what if any impact this will have though.
It means nothing we didn't already know. It's a reminder this virus has crossed many species barriers, but H5N1 killed 40 some tigers in a zoo a year or so ago that were fed infected raw chickens. It's speculated the cat feasted on a sick bird. |
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InsultMohammed
New Member
USA
11 Posts |
Posted - 03/06/2006 : 13:59:10 [Permalink]
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| I've been watching the course of H5N1 HPAI since '04, and the one site that seems to have the most up to date and seemingly honest information is Recombinomics.com It's also nice having all of the information in one place. |
| Edited by - Valiant Dancer on 03/06/2006 14:01:14 |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 03/08/2006 : 02:47:52 [Permalink]
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quote:
Originally posted by InsultMohammed
I've been watching the course of H5N1 HPAI since '04, and the one site that seems to have the most up to date and seemingly honest information is Recombinomics.com It's also nice having all of the information in one place.
I wouldn't put too much credibility in everything they put on that site, though the news updates might be OK.
This statement:quote:
However, rapidly evolving viruses simply recycle old mutations via recombination. This method is much more efficient and follows specific rules. These rules appear to be followed by all viruses, including influenza, HIV, SARS, WNV. These rules allow vaccines to be prepared before viruses emerge. These observations will produce a paradigm shift in the study of molecular evolution via recombination, which will provide solutions for unmet health needs
is not accurate. Influenza changes both by recombinant and direct mutation. It also has certain unstable sections of its RNA that allow for regular mutation of the viral envelope while conserving the innner core. As for the other viruses I've not read any research claiming they recycled their genetic material to produce changes.
It sounds like some Creationist idea that there is no real evolution. That's absurd. Change the selection pressures and you will get novel mutations of just about any microorganism. |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 03/08/2006 : 03:00:03 [Permalink]
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And reports like the one found here should be read with caution. A lot of these cases do not end up being H5N1 when final tests are in. More cases end up being ruled out and only a few which were thought not to be H5N1, turn out to be ruled in.
There have been a few cases where authorities claimed it wasn't H5N1 only to have final tests confirm it was. But, for example, in Turkey where 20 some cases were initially suspected only a little more than half actually were bird flu. It was good news and bad. Good that fewer people really had it and bad that the fatality rate was twice as high (and consistent with the rates elsewhere).
There are worried people everywhere so anyone with a fever who has been near poulty is suspected of having H5N1. But people die of pneumonia all the time, bird flu or not.
Don't get me wrong. I do expect one of these times it will be the real first human to human outbreak. And the tests are lagging behind case presentation by days to weeks. But I have read hundreds of "this might be it" cases in the last year. We need the test results to confirm cases otherwise they remain as suspect only. |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 03/08/2006 : 03:11:18 [Permalink]
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| In fact, the more I read, the more I doubt the information on this site. Where is the information on how these news reports were of confirmed cases of H5N1? Even if you don't trust the WHO lab and reports, where's the evidence these guys are going by? And considering they present themselves as a research related site, it is very unprofessional. |
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beskeptigal
SFN Die Hard
USA
3834 Posts |
Posted - 03/08/2006 : 03:13:04 [Permalink]
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| Here's a much more reliable site, InsultM. |
| Edited by - beskeptigal on 03/08/2006 03:14:16 |
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