Thursday, December 22, 2005

Bird Flu Update

I have lifted the following “Action Points” from MedPage Today, which is the medical news service of The University of Pennsylvania School of Medicine, Office of Continuing Medical Education.

MedPage Today Action Points

· Advise patients who ask that the H5N1 strain of avian flu - while seen as having the potential to spark a human pandemic - is so far mostly confined to birds and shows little sign of being able to cause widespread disease in humans.

· Note that this study shows that the H5N1 virus, when it does infect humans, can develop resistance to the antiviral drug Tamiflu (oseltamivir) with fatal consequences.

· Advise patients that this study suggests stockpiling Tamiflu may not be appropriate, and inappropriate or inadequate use of the drug may lead to resistance; such improper use is likely without medical guidance.

· Note that accompanying editorials to this study suggest that the public health perspective clearly indicates that a physician has an obligation not to prescribe Tamiflu for stockpiling- a position that is tantamount to a prohibition against prescribing it.

For the whole story and details of the study, please see:

My interpretation of the above action points:

· There is no indication at all that there will be a bird flu pandemic.

So far, an avian flu pandemic remains hypothetical, and the H5N1 strain has not shown itself able to pass easily from human to human despite isolated cases. More commonly, people infected with the strain have acquired it from contact with infected birds.

As of Dec. 15, according to the World Health Organization, 139 people have been infected with the virus and 71 have died.

· Tamiflu can actually contribute to patient mortality, especially if not used optimally.

· If you are not a doctor, do not purchase Tamiflu “just in case…”

· If you are a doctor, do not prescribe Tamiflu unless your patient needs it to treat a regular old flu that s/he already has.

Hmm, maybe now Donald Rumsfeld will sell his shares in Gilead Sciences (the patent holder for Tamiflu).

* This post is a follow-up to my post of 2 November, “The 7.1 Billion Dollar Panic”.

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