Bird Flu - Is it Time for Vaccines?

[Moonbear]

Only one problem.
Remember the most knowlegeable doctors talking about Tamiflu a few months ago ... 'don't use it' they said 'because you will breed a version of H5N1 that is Tamiflu resistant.'
Now follow this http://search.yahoo.com/search?fr=slv5-&p=Tamiflu resistant&ei=UTF-8" and tell me the Tamiflu website has not done damage to our ability to make headway against the disease.
Now that BOTH Tamiflu and Relenza are ineffective, what will you do?

Who said both are ineffective? Those articles say Tamiflu is ineffective and governments shouldn't rely on just one treatment. Well, that would make sense whether resistant strains had already been found or not. Antivirals are really only a stop-gap measure anyway, they won't stop an epidemic, they'll just stop infected people from dying...if the drugs work on that strain.

By the way, you don't "breed" resistance for drugs, you select for resistance. The gene for resistance had to already exist in the virus.

 

[selfAdjoint]

Viruses can mutate rapidly and these resistance things are on the outside. I don't believe they have to have pre-existing resistance.

 

[The Smoking Man]

By the way, you don't "breed" resistance for drugs, you select for resistance. The gene for resistance had to already exist in the virus.

Cool, I always love it when people throw semantics at me.

I guess I'll go home now and tell my father he never actually used to breed championship boxers ... he selected for them.

So what you are saying is that now the main virus, the H5N1 has mutated to become resistant to Tamiflu, we have to wait for a version of 'SARS' which is a mutation that not only spreads between humans but also mutates to a weaker strain without the resistance of the main strain.

You'll also find that Tamiflu is a prophylactic for all flu, not just the SARS varient and seems to have its widest use in Vietnam and Japan both of whom have reported Tamiflu resistant strains.

Since it has been hypothesized that the origin of the future virus will be SE Asia and the Tamiflu antiviral is in rampant use there now, what we'll be hit by is most likely to be Tamiflu resistant strain.

What came out of http://www.cnn.com/2005/WORLD/asiapcf/09/30/birdflu.drugs.reut/" was a warning that we are putting all our eggs in one basket.

Since Tamiflu is a pill that has storage capabilities at room temperature, Roche has won out in the popularity wars at the expense of Relenza which is just as effective however it is an inhalent.

What is happening is that the work of 'Ward' (A Roche Pharmaceutical Engineer) is being publicised as the dfinitive work on the subject and the possibilities are running that not only will we be running at 100% production on Tamivar in the Roche labs but we will be converting over the generics to production of this medicine too.

Basically, the Hong Kong warning is that we are setting ourselves up for a big fall.

If it gets away from is in SE Asia which is using Tamivar in 100% of suspect cases, it will have to be a Tamivar resistant version.

Now, I am sure that Roche is very happy you are buying their product. They are even happier still that governments are not ony encouraging it's production they are even recomending they license production to the Generics. Never before in history has a Drug company been ordered to make money on this scale.

The problem is that when the virus finally hits the good ole USofA, you might as well suck the cardboard from the carton it comes in for all the good it will do you.

Since Tamivar is being used as the first line of defence in the nations originating the virus, it only follows that the pandemic will be resistant if it escapes and your only 'defence' is going to be the second line ... Relenza ... the inhalent (Which the HK doctors say should be receiving the attention it needs to produce at least an IV version).

Here's the plain, simple facts ... because Tamivar was used in the treatment of SARS and was found to be successful, the treatment of SARS reduced the fatalities to 10%. It is currently estimated that if a Tamiflu resistant strain goes global (Pandemic) we'll be looking at up to 70% fatalities.

The sad fact is, you won't be able to get Relenza for love nor money.

http://www.recombinomics.com/News/10150501/H5N1_H2H_Tamiflu.html" a little blurb on what they are seeing in Vietnam.

 

[The Smoking Man]

http://cnews.canoe.ca/CNEWS/Canada/...1263897-cp.html"
By HELEN BRANSWELL

TORONTO (CP) - There is additional, unpublished evidence of resistance to the anti-flu drug Tamiflu in human cases of H5N1 avian influenza, an U.S. expert in antiviral drugs hinted Saturday.

Dr. Frederick Hayden suggested data that have not yet hit scientific literature point to the existence of more cases where H5N1 viruses evaded the drug that countries around the world have been stockpiling as a hedge against a feared pandemic.

"There's other information that's not in the public domain right now," Hayden, a professor of clinical virology at the University of Virginia, said in an interview.

Hayden is co-chair of an international scientific group that closely monitors for emergence of viral resistance to neuraminidase inhibitors - the drug class to which Tamiflu belongs. He would not elaborate on how many cases may have been discovered.

Scientific and medical journals typically refuse to publish previously disseminated material, so researchers carefully guard new data until publication.

"I feel comfortable with the statement that was in the report that we put out from the Hanoi meeting . . . I think what the statement was 'several cases,' " he said.

The meeting Hayden referred to was a World Health Organization-staged gathering of international influenza experts that took place in Hanoi from May 10-12.

The report of that meeting, published late last month in the New England Journal of Medicine, contains a brief reference to drug-resistant viruses having been isolated "recently in several patients . . . who were treated with oseltamivir" - Tamiflu's generic name.

A footnote attached to the statement refers to a report of a previous WHO meeting of flu experts, held in Manila from May 6-7.

The Manila meeting report contains information on only a single case where Tamiflu-resistant virus was recovered from an H5N1 patient. That case, a 14-year old Vietnamese girl who fell ill in late February, is currently the only publicly acknowledged finding of a Tamiflu-resistant virus.

A detailed analysis of viral clones grown from a specimen taken from the Vietnamese girl was released Friday by the journal Nature.

There was some initial confusion attached to the publication, which a number of experts felt represented new evidence of resistance to the drug.

Dr. Yoshihiro Kawaoka, senior author on the Nature paper, had not been at either WHO meeting, nor had he read the report of the Manila meeting. He confirmed Saturday that the virus he and his collaborators studied bore the same identification number as the one reported on at the Manila meeting.

"It must be the same virus," he said.

The analysis Kawaoka and his co-authors produced showed that while the girl's virus was at least partially resistant to Tamiflu, it was fully susceptible to another neuraminidase inhibitor, zanamivir.

The authors suggested their findings point to the practicality of adding zanamivir -which is sold as Relenza by GlaxoSmithKline - to national pandemic stockpiles.

Some countries, notably the United States and Germany, have done so. But Relenza has never made huge inroads with consumers and is made in limited quantities.

http://cnews.canoe.ca/CNEWS/Canada/...1263897-cp.html

 

[The Smoking Man]

I wonder if Rummy has his stock in the same kind of blind trust Bill Frist uses.
Where is outsider when you need him. He would understand this "jack-move" better than me.
We have an epidemic, Bush declares Marshall law, and Rummy gets rich.
I know. I know.
But just because I am paranoid doesn't mean they are not out to get me!

I wonder if it the sam blind trust Cheney has when he calls a meeting with Halliburton people and refuses to divulge the content of that meeting... while still receiving 'deferred payments' (salary).

 

[Art]

It could take 5 or 10 or 50 years to make that jump.

The chief British medical officer gave a news conference a couple of weeks ago.

He explained that the danger is if a person already has a human form of flu and then contracts avian flu at the same time. The two can interact to produce a new strain which is potentially deadly.

He didn't believe this was likely to happen this year as he thought it was probably too late into the flu season for this particular combination to be statistically likely however he believes by next winter the odds favour the emergence of a new deadly strain.

 

[Astronuc]

Over time, aides and advisers said, the hope is that Mr. Bush will be able to re-establish his image as a strong leader by showing people that he has plans to address issues like high energy costs, illegal immigration and the risk of an influenza pandemic.

NY Times, October 30, 2005, The Overview
After Upheavals, President Seeks to Steady Course
By RICHARD W. STEVENSON and ROBIN TONER


Is Bush planning to exploit the fear of the bird flu pandemic!?

 

[The Smoking Man]

NY Times, October 30, 2005, The Overview
After Upheavals, President Seeks to Steady Course
By RICHARD W. STEVENSON and ROBIN TONER
Is Bush planning to exploit the fear of the bird flu pandemic!?

I can't wait until he declares a war on birds.

 

[Moonbear]

NY Times, October 30, 2005, The Overview
After Upheavals, President Seeks to Steady Course
By RICHARD W. STEVENSON and ROBIN TONER
Is Bush planning to exploit the fear of the bird flu pandemic!?

I have to admit I wouldn't mind him shifting focus to a war on flu. Who knows, maybe he'd botch it and accidentally improve health care. Okay, too much wishful thinking, I know.

 

[cronxeh]

I have to admit I wouldn't mind him shifting focus to a war on flu. Who knows, maybe he'd botch it and accidentally improve health care. Okay, too much wishful thinking, I know.

I'm afraid he will offshore this war and make the penguins fight it, and then realize they are birds themselves and turn against us

 

[Astronuc]

BBC On-line - Avian influenza

http://news.bbc.co.uk/1/hi/in_depth/world/2005/bird_flu/default.stm


I heard this morning that the US government has established an $8 billion plan to deal with flu. Of this $6 billion will be spent on vaccine readiness - a financial boon to the pharmaceutical companies.

And then down the road, the government will probably spend more $billions on different vaccines.

 

[Evo]

Of this $6 billion will be spent on vaccine readiness - a financial boon to the pharmaceutical companies.
And then down the road, the government will probably spend more $billions on different vaccines.

The problem with the vaccines is that they are only good that year, then they are thrown out.

 

[The Smoking Man]

The problem with the vaccines is that they are only good that year, then they are thrown out.

It goes deeper than that, Evo.

Vaccines are strain specific.

If you take the vaccine for Swine Flu, you can still get HK Flu.

Most vaccines are a cocktail of whatever is going around that year.

A mutation in the current year can make the whole thing worthless.

 

[rachmaninoff]

This is the part that cracked me up:

The president also said the United States must approve liability protection for the makers of lifesaving vaccines. He said the number of American vaccine manufacturers has plummeted because the industry has been hit with a flood of lawsuits.

http://www.nytimes.com/aponline/health/AP-Bush-Flu.html

 

[SOS2008]

So what do people think about Bush's 7.1 billion plan? http://msnbc.msn.com/id/9883713/ "I'm not going to take any chances." Could this be another photo-op for additional spending on protecting Americans...but are we really protected?

 

[Astronuc]

Wash your hands when in public, especially before eating in public.

Stay healthy - eat right, get plenty of rest, especially in cold winter months, take vitamin supplements if necessary, stay warm . . . the usual stuff mom and dad tolds us as kids.

Maybe wear a face mask too! . . . . especially when flying.

I remember from the various times I was in Asia that people with colds would where face masks out of consideration for the public around them. I don't see that at all in the US.

 

[cronxeh]

he wanted to stockpile enough vaccine to protect 20 million Americans against the current strain of bird flu as a first wave of protection.

Ahaha that's freaking awesome! Wait a minute, isn't that the population of Texas? (20,851,820)

Hi freaking larious

 

[Evo]

It goes deeper than that, Evo.
Vaccines are strain specific.
If you take the vaccine for Swine Flu, you can still get HK Flu.
Most vaccines are a cocktail of whatever is going around that year.
A mutation in the current year can make the whole thing worthless.

Correct, and a vaccine for the current bird flu, if it mutated to become transmisible bewtween humans, would not be effective.

 

[Astronuc]

Bush outlined a strategy that would cost $7.1 billion including:

-$1.2 billion for the government to buy enough doses of the vaccine against the current strain of bird flu to protect 20 million Americans; the administration wants to have sufficient vaccine for front-line emergency personnel and at-risk populations, including military personnel;

-$1 billion to stockpile more anti-viral drugs that lessen the severity of the flu symptoms;

-$2.8 billion to speed the development of vaccines as new strains emerge, a process that now takes months. The goal is to have the manufacturing capability by 2010 to brew enough vaccine for every American within six months' of a pandemic's start.

-$583 million for states and local governments to prepare emergency plans to respond to an outbreak.

AP

It is troubling that health experts say the money, especially the $2.8 billion for pharmaceuticals companies, could be better spent shoring up the public health infrastructure, which has declined as state and local governments cut spending.

 

[The Smoking Man]

AP
It is troubling that health experts say the money, especially the $2.8 billion for pharmaceuticals companies, could be better spent shoring up the public health infrastructure, which has declined as state and local governments cut spending.

Ironically, we are seeing a form of corporate welfare on a level not seen since 'aid to Africa' where, to receive the aid, they had to give up the purchase of generics and go to the American developer of the brand name.

You remember when the World court decided against the Pharmaceuticals in reference to Genetics ... the above offer was Bush's countermeasure.

When the countries did the math however, they found that they could purchase more generics at current levels of aid from other countries combined than they could the number of Brand Name items with American Aid.

Generics are 20-30 times cheaper.

I know the medicine I take here in China Rinatadine costs me 3RMB for 30 75 Mg capsules. When I buy it in the UK or the USA as Zantag, that same number of pills runs $30. ... 3RMB is a bit less than $.50. That's only a 600X mark-up.

That is the level of corporate 'welfare' you are seeing in the USA. Then figure in the fact that hospitals have been tagged for charging $18 for dispensing aspirin and what do you have?

Bird Flu is the biggest business opportunity to hit the states since Iraq and ... Rumsfeld has stock ... Go Figure.

 

[The Smoking Man]

More news from http://news.yahoo.com/s/nm/20051102/ts_nm/birdflu_usa_dc&printer=1" :

INCENTIVES FOR DRUG COMPANIES

The plan relies on private industry to do this and so far companies have been reluctant to commit to making more vaccine unless they are guaranteed reduced liability and can count on selling any vaccine they produce.

The federal officials declined to give details of what incentives they have offered drug companies to ramp up vaccine production but Leavitt said the plan provided some government support to help them move from old-fashioned egg-based technology to newer methods, and to explore ways to make more efficient vaccines.

The plan will help the United States prepare for the annual influenza season as well as be ready for any kind of pandemic, such as bird flu, Leavitt said.

Some members of Congress, who must vote for the funds to pay for the plan, raised questions at the hearing. Arlen Specter, the Pennsylvania Republican who chairs the Labor, Health and Human Services subcommittee, complained that public health facilities had been allowed to deteriorate badly.

"But we need to find some better way to know what the hell's going on because the executive branch won't tell us," he said. "And we need some whistle-blowers, starting with the secretary.

"We have a very high regard for what you people do. But you've got to help us help you."

Iowa Democratic Sen. Tom Harkin (news, bio, voting record) complained that the plan requires states to pay for 31 million treatment courses of Tamiflu and Relenza.

"How are you going to ask Louisiana right now to come up with money for that? Take Mississippi," he said, naming the two states hardest hit by Hurricane Katrina in August.

"We very clearly believe the states should contribute to this," Leavitt replied. "The actual percentage that they contribute, we're open to discussing on how we do that."

Washington Senator Patty Murray, a Democrat, said many people had lost trust in U.S. agencies such as the Food and Drug Administration, which will have to quickly determine that new vaccines and drugs are safe.

That's right the Drug Companies are now BARGAINING with the US government to meet the demand on condition of reduced liability and to be able to sell any vaccine they want.

Are any of you Republicans taking this in?

 

[Moonbear]

Oh, geez, I'm watching C-SPAN right now, and they have on some Congressional meeting about bird flu. It's making me nauseous to hear all the fear-mongering and stupidity of the members of Congress. They're acting like a pandemic is going to happen tomorrow, and as if boosting production of vaccines against current strains are going to help at all in protecting against some future outbreak of a strain capable of resulting in a pandemic. This gross lack of scientific understanding is disgusting.

Oh, wait, those of you in VA, you can be proud of your representative, Tom Davis. He just rebutted the fear mongering by Ohio's Kucinich quite nicely. (Kucinich is trying to force Roche to give up their Tamiflu license without realizing the implications that would have on any company ever doing R&D on an antiviral again...if they risk losing any profits to Congress just giving away their license, they simply won't even bother doing the research, let along getting a product to market).

It seems the secretary of HHS is starting to get through to a few of the less bull-headed ones.

 

[siddharth]

Some bad news. It looks like the freqeuency of the cases of the H5N1 strain being reported in poultry around the world has increased this year. But there have not yet been any cases where the virus has spread from human to human.

http://www.deccanherald.com/deccanherald/feb182006/update151132006218.asp"
http://www.suntimes.com/output/news/cst-nws-birdflu18.html"
http://www.dw-world.de/dw/article/0,2144,1908372,00.html"

 

[EnumaElish]

Has anything come out of spicy pickled cabbage (Korean kimchi) as a possible protection against the avian flu?

See http://news.bbc.co.uk/2/hi/asia-pacific/4347443.stm

 

[Art]

Some EU countries are starting to vaccinate their poultry stocks. The UK gov't is coming under fire from some domestic sources for opting not to.

EU to allow bird flu vaccination

Some EU members had opposed plans for vaccination
EU officials have approved plans by France and the Netherlands to vaccinate millions of poultry against bird flu.
The programme, initially opposed by several countries, will be limited to birds in specific high-risk regions.

It came as health officials in Austria said two chickens had the deadly H5N1 bird flu virus - the first time it has appeared among poultry in the EU.

http://news.bbc.co.uk/2/hi/europe/4734748.stm

BTW How long does the flu bug survive after the host is dead? Presumably cooking destroys the virus but would handling the dead poultry prior to cooking be dangerous?