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Science

Bird Flu May Be Developing Drug Resistance 169

Posted by Zonk
Pingular writes "The virus currently causing bird flu in humans may be developing resistance to the only drug that can so far combat the infection. From the article: 'A previous paper in the journal Nature described a single case of drug resistance in a patient being treated for avian flu. However, in this case the patient had been given low doses of Tamiflu before becoming infected, as a family member had been stricken. Lead researcher Dr Jeremy Farrar described the latest findings as "very worrying" - but said they were not surprising.'"
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Bird Flu May Be Developing Drug Resistance More

Bird Flu May Be Developing Drug Resistance

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  • Tamiflu (Score:5, Interesting)

    by Anonymous Brave Guy ( 457657 ) on Saturday December 24, 2005 @08:37AM (#14331947)

    Tamiflu was never expected to be a completely effective counter to a mutated strain of bird flu. It might help some people for a short time, which is great of course, but we'll still need a tailored vaccine that currently takes a few months to produce if we're going to beat it on a wide scale. This is why the medical profession is so worried about it, and why so much effort is currently focussed on cutting the time from identifying the mutated strain to availability of a matching vaccine.

    • Re:Tamiflu (Score:3, Informative)

      by jurt1235 ( 834677 )
      Yes, there was a second drug mentioned in one of the earlier articles which was expected to be much more effective. So no news here.

      • Re:Tamiflu (Score:5, Informative)

        by Sad Loser ( 625938 ) * on Saturday December 24, 2005 @11:09AM (#14332369)

        oseltamivir (the real name of TamiFlu) is a viral inhibitor which helps protect cells. It does not work like some antibiotics which (often) actually kill the harmful agent. It may reduce the severity of symptoms, but we know that most of the time it doesn't make a lot of difference. The liklihood of it working in H5N1 has probably not been helped by the Chinese spraying their flocks of chicken with these types of drugs, which will tend to select resistant strains.

        If there is one lesson you learn from this, it should be this: only vaccination of large numbers of people will prevent significant disease. If your government is telling you that you will be fine because they are stockpiling oseltamivir, the experts in virology/ infectious disease/ emergency planning/ public health suggest otherwise.

        The problem is we don't know what the pandemic will be. Current H1N5 'Bird Flu' is only one candidate virus for combination with a 'traditional' influenza virus to make a new mutant strain to which most of the population has no resistance.

        [IAAD, am involved with pandemic influenza planning]

        • Re:Tamiflu (Score:5, Interesting)

          by Anonymous Coward on Saturday December 24, 2005 @11:52AM (#14332518)
          My girlfriend is a microbiologist with a specialization in human pathogens, so if anybody would be an expert here it is her.

          And she says that in the early stages of a bird flu outbreak, Tamiflu is an effective counter to it. Yes at medically useful doses it has a chance of killing you, but that chance is significantly lower than your chance of dying WIHTOUT it.

          The problem comes when it reaches the epidemic stage. You see Tamiflu WILL NOT CURE an infection, it only gives the body enough lead time to build up specialized immunity cells to fight off the infection. During this entire period the virus is still active inside the patient, and still replicating (just at a vastly loweer and non-life-threatening rate). The end result is that it turns patients into incubators for the evolution of resistant strains. The more people that take Tamiflu, the higher a chance for a resistant strain to develop.

          The horror story of this is that Tamiflu-using patients are STILL contagious, and this is an airborne disease. With flu-like symptoms, there is almost no chance that an infected person will be quarantined in time to prevent them infecting others. As the resistant strains enter the general population, furhter Tamiflu treatments result in even MORE resistant strains being developed. Eventually the amount of Tamiflu required to recover from the virus will be so high that you have a better chance of survival WITHOUT Tamiflu.

          And while edpidemiology resources are being devoted to making the Tamiflu patent holder wealthier, they are not being devoted to the creation and production of a brd-flu VACCINE.

          And in the end, thanks to Tamiflu and money-hungry politicians, we end up with a new Smallpox.

          A much better viewpoint on a potential bird-flu epidemic is to flatly IGNORE Tamiflu, and nip the potential evloution war we cannot win in the bud. Instead devote all the Tamiflu production resources to producing a vaccine for the non-human bird-flu strain, and begin mass vaccination of domestic bird populations. This will slow down the spread of the virus to the human population, as well as giving us a biological base for a human-usable vaccine.

          Then when the human jump ACTUALLY occurs, it is a relatively simple matter of biological cut/paste with the human strain to create a human-usable vaccine. The same manufacturing and distributing capacity used for mass domestic bird vaccination can then be easilly switched to human vaccination.

          Poof! Bird-flu scare solved, loss of life minized, and all for FAR CHEAPER than the cash we will have to spend (and lose) taking the Tamiflu route.

          • You're right about spending a lot of money on oseltamivir being a bit of a waste. Your ideas, while fine from a lab point of view, are not possible in the 'real world', which is why public health people/ epidemiologists generally run the show in this kind of event, not lab people like your girlfriend, or clinicians (like me), although I am on a committee of 20 planning for pandemic influenza covering about 1m people.

            Part of the problem with the purchase of oseltamivir from a political point of view is th
          • Comment removed based on user account deletion
          • In addition to what other readers have said, I want to add that developing a vaccine isn't realized over night.
            And also, in fighting a disease, every weapon you could use need to be considered (and maybe used if the cost/benefits ratio is interesting). Once used at scale of whole population, nothing is 100% efficient. There's very seldom a one-solution-fits-all. You always need to have as much alternative as possible.

            So yes. In *theory* the vaccine is the best way to go. But in the meantime, in the real wor
        • > oseltamivir (the real name of TamiFlu) is a viral inhibitor which helps protect cells. It does not work like some antibiotics which (often) actually kill the harmful agent.

          Clarification: antibiotics don't kill viruses at all. They're only good for bacterial infections.

          Sinusitis, URI, pneumonia, septic wound: take antibiotics.

          Influenza or other virus: get a vaccination, get one of those new anti-virals, or treat the symptoms and tough it out.

  • This has already (Score:4, Interesting)

    by zegebbers ( 751020 ) on Saturday December 24, 2005 @08:38AM (#14331948) Homepage
    affected Roche financially more info here [reuters.com].

  • Humans lack drug resitance (Score:5, Funny)

    by wombatmobile ( 623057 ) on Saturday December 24, 2005 @08:39AM (#14331951)
    at this time of year [abre.org.br]...

  • In related news... (Score:5, Funny)

    by Skiron ( 735617 ) on Saturday December 24, 2005 @08:39AM (#14331952)
    ... President Bush decides to bomb the Canary Islands in a bid to stop a global flu outbreak...

  • Armagedon ready for Christmas (Score:5, Interesting)

    by FishandChips ( 695645 ) on Saturday December 24, 2005 @08:53AM (#14331989) Journal
    My understanding is that one problem here is that Tamiflu is currently the only drug of any use. If there is more than one treatment available, then combination treatments can be used and so cut down the rate at which resistance arises.

    I guess the reality is that we can't really be sure what will work and what will not work until after the virus has mutated enough to spread from human to human. And let's hope that never happens. Or, if it has to happen, that the mutation weakens the virus enough to keep things small scale.

    I'm a little dubious about Tamiflu. A problem with piling up supplies of Tamiflu at home, for example, is that if you get a bug, how can you know without a test that it is the killer bug? The risk is that you may have a standard bug and then mistakenly use your one and only heavy artillery round on the wrong target. After that, you are foobarred.
    • Whatever happened to "drink lots of fluids and rest up?" I know the Bird flu is nasty, but the human body is actually pretty good at fighting this stuff off. Given half a chance.

    • Re:Armagedon ready for Christmas (Score:4, Insightful)

      by Jeff DeMaagd ( 2015 ) on Saturday December 24, 2005 @10:43AM (#14332280) Homepage Journal
      I don't think Tamiflu was the only drug to be of use, but it is the best one. There was cheaper one but stupid Chinese government recommended using it in birds food and water supply, which is the best recipe for creating immunity.
    • My understanding is that one problem here is that Tamiflu is currently the only drug of any use.

      Tamiflu is a generic antiviral/antflu agent which has not been effective against avian flu in any practical tests.
      http://www.wnd.com/news/article.asp?ARTICLE_ID=47 7 25 [wnd.com]
      Relenza is the other main antiviral drug which may be an effective palliative. It's worth remembering though, these drugs will not prevent the spread of a pandemic.

      They may at best alleviate the illness of some of the victims, but that's it
    • Repeat after me and the history of the human population and their ability to get rid of a virus.

      You can't.

      How does the TV ad that comes on at dinner time about herpes go? Something like:

      Its not about a cure, its about suppression.

      The only progress that humans have ever made in viral medicine are vaccines that load up our body with the virus early in life so that our bodies are not as susceptible to it when it comes again. The virus comfortably lives in our bodies for the rest of our lives. Is tamiflu a c

  • Drug Resistance (Score:4, Informative)

    by Anonymous Coward on Saturday December 24, 2005 @09:05AM (#14332019)
    There are too many instances where people will not finish the prescribed antibiotics and/or then share the remainder with someone who has 'similar' symptoms. Unfortunately, this allows/encourages microbes to alter their structure and become resistant.

    After reading the article, it sounds possible in this instance that - because the individual had recently been previously given Tamiflu for a different reason - the virus was given the opportunity to develop resistance. There is also the possibility that the Tamiflu did not work because its mechanism (inhibition of influenza virus neuraminidase, with the possibility of alteration of virus particle aggregation and release) has specific peak/load times based upon exposure or prophylaxis - and again, the individual had already been dosed.

  • bird flu training itself to resist teraflu? (Score:5, Informative)

    by drgonzo59 ( 747139 ) on Saturday December 24, 2005 @09:05AM (#14332020)
    To most people such claims as "the virus is developing the ability to resist some drug" might sound as if the microorganisms can think and somehow train themselves to defend against drugs.

    But what that means is that the virus undergoes mutations at a certain rate. And eventually one of those mutations might lead to resistance to the drug. All the other variants will be destroyed but that very small population which has the resistance will spread very rapidly.

    That is why some say that not taking the full dose of antibiotics and using antibiotic soaps in homes can lead to the breeding of super-bacteria. A problem bigger than bird flu at this moment is antibiotic resistant staph bacteria (methicillin-resistant S. aureus aka MRSA). When you hear about people getting sicker just by being in the hospital - they probably caught MRSA. The deadliness and the number of cases from such infections have gone up even though it would make sense for them to go down with all the advances in medicine and hygiene. Some speculate that soon there will be another strain of staph bacteria (VRSA) vancomycin resistant S. aureus which would pretty much be resistant to all the known anti-biotics. All that has to happen is for microorganisms to mutate and spread faster than it takes for us to find new antibiotics.

    • "To most people such claims as "the virus is developing the ability to resist some drug" might sound as if the microorganisms can think and somehow train themselves to defend against drugs.
      But what that means is that the virus undergoes mutations at a certain rate."

      What THE HELL are you talking about? Natural selection? Evolution based on random mutation??

      We all know God INTELLIGENTLY TWEAKS those virus strands to make them resistant to drugs, FOR THE GOOD OF MANKIND!!

      Oh wait..
    • That's only if you believe in that Godless evolution claptrap they got all the kids learning in the schools. God made the flu, and if He wants to smite the sinners, He shall do so. It is God's will.

    • The process is called "evolution." Use the word.
      • I don't think it is considered evolution in the classic sense. Just because you really, really want to use the word "to stick it" to those crazy people from Kansas doesn't mean that you should. What happens is that bacteria has a specific set of genes that will mutate faster and those genes will protect it from certain molecules. So we have seen staph mutate to protect itself against different antibiotics and that can happen very quickly but staph will probably not turn into a fungus or an insect just as qu
        • Use the word "evolution" because "evolution" is the right word for the process described.

          "Biological evolution (from Latin evolvere = to unroll) is the process by which populations of organisms acquire and pass on novel traits from generation to generation."
          -- the Wikipedia [wikipedia.org] entry [wikipedia.org].

          For unclear reasons, you danced around the obviously correct choice.

          Now you have cited the tangentially related phenomenon of bacterial antibiotic resistance. Why have you brought up staph? Influenza, whose etiology is viral, not b
          • In my post, the topic was the resistance of harmful micro-organisms to antibiotics, which includes bacteria and viruses. What is the problem with that?

            If you want to talk about viruses only, reply to a different comment and use the word "evolution" as many times as you want in your post. Nobody is going to stop you (aside from almighty moderators, of course;)

            For unclear reasons you are desperate to have the word "evolution" some place in the comment so here you go: EVOLUTION, better now?

            Quoting Wikipe

            • Quoting Wikipedia is the same as quoting yourself, since you could have technically gone and edited the entry to support your point of view.

              You have a bit to learn here. Wikipedia provides records of article changes. Look at the history [wikipedia.org]. None of the edits today involved the sentence in question. I would have had to travel backward time to change it for this particular discussion. I suppose I could have written that sentence in the past, but I did not. I have not edited that article at all.

              But what that mean

    • But what that means is that the virus undergoes mutations at a certain rate. And eventually one of those mutations might lead to resistance to the drug. All the other variants will be destroyed but that very small population which has the resistance will spread very rapidly.

      That is why some say that not taking the full dose of antibiotics and using antibiotic soaps in homes can lead to the breeding of super-bacteria.

      Are you suggesting that by using antibacterial soaps at home, we're killing off the non-res
      • I don't have enough evidence to support that, but it makes sense and others have recommended not to use antibacterial soaps at home. Here is an excerpt from some By Dr. Joseph Mercola [mercola.com]:

        In the study, published in the March 2, 2004 journal Annals of Internal Medicine, people who used antibacterial soaps and cleansers developed cough, runny nose, sore throat, fever, vomiting, diarrhea and other symptoms just as often as people who used products that did not contain antibacterial ingredients.

        and then from t

    • Not at all, an intelligent designer creates a new virus after we solve the previous problem. It could be the intelligent designer is testing us or that it just likes to see huge numbers of us die periodically smothering as our lungs fill up with fluids. Virii are clearly to complicated to have come about randomly so all the pain and suffering they inflict must be with a purpose as well. :)

      What's the use of max karma, if you don't spend it once in a while.

  • In other news (Score:3, Funny)

    by Timesprout ( 579035 ) on Saturday December 24, 2005 @09:07AM (#14332027)
    Flu develops resistance to birds.
  • of the guy who led the Tamiflu development team. She was exteremely bright, very cute and completely dyslexic and I completely failed to make any kind of romantic impact on her. Curse my failed dreams of marrying into a monied geek/scientist family!

    Yes completely offtopic and mod me whichever way you like :)
  • The real solution, and I think everyone will agree with me on this, is to kill all the birds.
    • We can also stop AIDS and other communciable diseases in humans by killing them as well.
      • We can also stop AIDS and other communciable diseases in humans by killing them as well.

        Hey... We can stop the spread of AIDS if people stoped having sex or used protection. Too bad the bird flu isn't spread by sex with birds.
    • Well, maybe this flu is the birds' reaction to humanity's hundreds years long actions towards making them extinct :] Meaning we don't really need to kill them all now, we are already killing them for a long time now. Eventually they will all perish, maybe they'll take some of us with them as they go :P
       

  • Question on immunization (Score:4, Interesting)

    by sphealey ( 2855 ) on Saturday December 24, 2005 @09:36AM (#14332083)
    Here's a question that has been bothering me for a while. The various health agencies have believed for a while that it is possible that the H5N1 virus could mutate into a form that spreads easily among humans. Of course, they cannot know in advance what that mutation will be, and once the mutation appears it will take 18-24 months to develop a vaccine for that specific strain.

    So - wouldn't it have made sense to create a vaccine for H5N1 itself, and add that to this year's usual 3-flu cocktail? My understanding is that the human immune system maintains a library of antibodies for viruses that have challenged it in the past. Wouldn't there be a greater liklihood that an H5N1Mutant antibody could be developed if there was already an H5N1 antibody in the library? Again, my understanding is that the difference in surface structure between the primary and the mutant is usually fairly small.

    Am I oversimplifing things too much? Or would there be a danger that vaccinating people for H5N1 would actually _increase_ the chance of the mutant developing?

    Enlightenment from people who deal with the squishy stuff would be appreciated.

    sPh
    • >Am I oversimplifing things too much?

      Not at all actually. But consider the timeline.

      The flu has not mutated into the form that is highly
      contagious to humans yet. When that occurs there will be
      a race to cultivate the vaccine. During the period between
      the high volume production of the vaccine (months, many months)
      the death toll could be significant.
      • My Bad (to coin a phrase), I didn't address your direct question. As to that, I don't think so (as there does not exist a 'cocktail' for the common cold virus) but I really do not know.

        See Thing's comment below for more scary details. Erk!

    • Re:Question on immunization (Score:4, Informative)

      by GoofyBoy ( 44399 ) on Saturday December 24, 2005 @09:54AM (#14332131) Journal
      >wouldn't it have made sense to create a vaccine for H5N1 itself

      One of the only ways to create a vaccine is to use bird eggs and then use the resulting "stuff" (I can't recall if it is the the developed antibodies or weak/dead viruses) and inject that into humans.

      The problem with H5N1 is that since its an avian flu, it kills the bird embryo before you can develop/grow anything useful for humans.
      • The "stuff" is actually viral proteins extracted from a dead virus. Ignoring the fact that it's an inefficient and not particularly successful method of inducing immunity in the first place, you're right - using eggs to make large quantities of H5N1 is impossible.

        The way to do it would be using a recombinant vaccine.
      • > The problem with H5N1 is that since its an avian flu, it
        > kills the bird embryo before you can develop/grow anything
        > useful for humans.

        Interesting. How do they make the vaccine for chickens used in, e.g. Vietnam? Is there any other way to make the vaccine other than using egg base?

        sPh
        • Recombination is cut'n'pasting piece of DNA around.

          One, very-high tech, way to produce vaccines other than "grow it on some host medium"
          is to analyze the virus' DNA, find which gene code for the proteins that the anti-bodies react to (hoping that : there are such proteins that can generate immunity per se, ex.: if you inject them purified. And those proteins should depend only on known gene, no yet unknown post-processing [sugar appending] should be needed), create artificial plasmid with said gene, inject
    • IIRC, one of the reasons this virus has been so hard to make a vaccine for is that it is so deadly to chickens. Current flu vaccine production has a relatively low-tech method of production: they infect chicken eggs, and let them incubate a little while. then, they empty the eggs, and filter out all the antigens. h5n1 is so deadly to chickens, that it kills the embryoes long before they have a chance to produce anything of use.

    • Yes, the body does maintain a "library" of antibodies keyed to the proteins on the surface of viruses it has overcome in the past.

      The problem is that at one point there may be a "protein envelope" that the immune system cannot match up to, in which case resistance is not just futile - its impossible. Think of a new flu that the body can't manufacture a "key" to fit into the protein coat of the virus - a vaccine won't help.

      • The problem is that at one point there may be a "protein envelope" that the immune system cannot match up to, in which case resistance is not just futile - its impossible. Think of a new flu that the body can't manufacture a "key" to fit into the protein coat of the virus - a vaccine won't help.

        And this hasn't shown up in the billions of years viruses have been around? The reverse could be true as well. A cell wall with no protein 'ports' for a virus to latch on to.

        Realistically speaking, a virus has to h

    • Re:Question on immunization (Score:4, Informative)

      by RatPh!nk ( 216977 ) <ratpH1nk&gMail,com> on Saturday December 24, 2005 @11:33AM (#14332464)

      In my almost professional (not quite finished with med school) opinion, the answer would be no. Think of all the vaccinations we have to date, and how few (if any) mutations there have been that have evaded vaccinations.

      The immune system is different from antibiotics because it will kill all of the critters. There is also a systemic response, fever, sequestering copper and iron, lowering blood glucose levels etc...ABs do this (not in entirety)...and AB have the side effect of killing your natural flora as well, which can predispose you to secondary infections (see C. difficile in people on broad spectrum AB)

      Vaccinations contain attenuated/dead/non-virulent organisms, with their full complement (not an immuno joke...though it could be) of surface proteins, glycoproteins, etc... Your body will recognize several of these sites as foreign and produce antibodies to them. This aids their destruction through phagocytosis, and other nasty things like membrane attack complexes [flickr.com].

      It would take something tantamount to a complex change of presentation for some organism to avoid a vaccination.

    • INAImunology Expert, but from the few stuff I've alread read, you got it right. Vaccinating people against the H5N1 would probably make its mutations as lethal as an ordinary flu.

      But the amount of flu vaccines that are created nowadays is very small. There are very few factories, and almost all their production is already spent dealing with ordinary flu on hightly sucseptible people. And the factories of flu vaccines would generate even less vaccines against the H5N1 than against our ordinary flu. That hap

  • Possible alternative (Score:5, Interesting)

    by fionbio ( 799217 ) on Saturday December 24, 2005 @09:54AM (#14332129)
    Arbidol [arbidol.ru] (in Russian) is virtually unknown outside Russia, while it seems that it was shown to be able to defeat bird flu virus. For some discussions in English, look e.g. here [ryanschultz.com].

    I've heard that Tamiflu is preferred for political reasons. Maybe there's actually something wrong with Arbidol, but here in Moscow they claim that Arbidol can cure bird flu in their rather widespread advertisements and aren't driven to court for that.

    • There is no doubt that Tamiflu is preferred for politcal reasons.

      The ONLY way that Tamiflu will lose the government contracts is if Haliburton comes out with a vaccine of their own.

    • Arbidol (in Russian) is virtually unknown outside Russia, while it seems that it was shown to be able to defeat bird flu virus. For some discussions in English, look e.g. here. I've heard that Tamiflu is preferred for political reasons. Maybe there's actually something wrong with Arbidol, but here in Moscow they claim that Arbidol can cure bird flu in their rather widespread advertisements and aren't driven to court for that.

      I'm sorry to break it to you, but the absence of a lawsuit or regulatory act

      • We have plenty of snake oil here, including homeopathy, various "supplements" and so on. But such stuff isn't recommended by Ministry of Health. Also, it's also usually rather hard to find actual manufacturers of snake oil products, and they usually don't bother with scientific explanations of underlying principles, referring to various mystery "energies" and so on.

        Arbidol is actually recommended by Russian Ministry of Health as profylaxys of flu. Its manufactures don't try to hide themselves from general

    • I remembered having read somewhere about Rumsfeld being involved as a shareholder of Roche. Did a quick Google and found (amongst others) this: http://www.currentconcerns.ch/archive/2005/06/2005 0602.php [currentconcerns.ch] . Interesting, isn't it?

  • Bovine Exriment Catapult ahoy! INCOMING! (Score:2, Insightful)

    by Anonymous Coward
    1: Tamiflu doesn't cure the disease, it "treats" the flu, meaning it lessens the symptoms of it. One of the reasons people die from the flu is their lymph system becomes so clogged due to immunological response they literrally cease breathing and die, which is why tamiflu helps as it lessens the response and keeps most people from dieing.

    2: How can the bird flu develope a resistance to it, especially since it isn't an epidemic yet? How many people have been infected? How many DECADES did it take for us

  • Tamiflu wasn't meant for the bird flu... (Score:5, Insightful)

    by bocephus909 ( 941174 ) on Saturday December 24, 2005 @10:05AM (#14332167)
    Having just written two term papers analyzing the social construction of the bird flu, I'm loaded with more H5N1 knowledge than I ever thought possible. Part of the problem is that Tamiflu isn't designed to fight the bird flu, it's not a vaccine, it's an anti-viral (and, up until the end of 2004, it was one of Roche's least successful drugs). It operates by reducing the spread of a virus within the body, alleviating the severity of the effects of normal flu strains in humans by up to 38%, and reducing the time of infection by up to two days. It does NOT cure/prevent bird flu, but it is believed that it might be effective in lesseing the communicability of the disease. There are other anti-virals, such as GlaxoSmithKline's Relenza, that should have roughly equal effectiveness. BUT, guess what? The creator/patent-holder of Tamiflu is Gilead Sciences Inc; a company whose CEO from 1997-2001 was none other than Donald Rumsfeld. The wife of former California Gov. Pete Wilson is on the board, as well as George Schultz (US Sec of State from '82 - '89). These political connections might be a key reason why the Bush Administration hasn't invoked the WHO's TRIPS Agreement, which allows for compulsory licensing (in which, in the face of a potential health crisis, the patent on a drug is broken, allowing other companies to produce the drug, while a modest licensing fee is paid to the patent holder), and would actually allow the US to stockpile enough of the drug to make a serious impact (WHO recommends that a country have enough anti-virals to treat 25% of its population, given the current productive capacities of Roche, the US won't have that amount until around 2011). In light of the recent discovery that the 1918 flu outbreak was, in fact, a strain of the bird flu that had mutated amongst bird populations until developing in a strain that was capable of human-to-human transmission, scientists DO have a genome sequence of one such iteration of the virus, which could be used to develop vaccines (that may or may not work). Most health officials agree, however, that spending money on drug stockpiling is an empty gesture, and that available treatments should be sent instead to the poor East Asian countries where an outbreak is most likely to occur (and who can least afford to pay for the drugs). Even then, the drugs are not recommended as a primary means of prevention, rather, improvement in monitoring/reporting infrastructures, as well as new medical technology, is the suggested course of action. I could go on, but suffice it to say, it's not surprising to hear about Tamiflu's lack of effectiveness, and were it not for the fact that the "BIRD FLU PANDEMICPALOOZA" were just a big political opportunity for the Bush Administration to assert themselves as competent and forward-thinking after the Katrina tragedy and the recent drop in US public support for the Iraqi War, that is, if the Bushies REALLY wanted to fight the flu and not just use it as a means of gaining some good PR while lining the pockets of their friends, then Tamiflu would almost never be mentioned in the press. End Rant.
    • WHO's TRIPS Agreement, which allows for compulsory licensing (in which, in the face of a potential health crisis, the patent on a drug is broken, allowing other companies to produce the drug, while a modest licensing fee is paid to the patent holder), and would actually allow the US to stockpile enough of the drug to make a serious impact (WHO recommends that a country have enough anti-virals to treat 25% of its population, given the current productive capacities of Roche, the US won't have that amount unti
    • Please learn to use paragraphs.

      Tamiflu is owned by a Swiss company. I don't understand why the Bush administration would want to promote the products of a company that competes with US drug businesses.

  • So? (Score:4, Interesting)

    by hackstraw ( 262471 ) * on Saturday December 24, 2005 @10:15AM (#14332201)
    I'm fairly paranoid and all that about things. But a birdie flu is not something that bothers me less than people being bothered by it.

    From the bird flu FAQ [bbc.co.uk], around 200 people have died from it, and it was compared to the last plague, SARS, to the 800. How about this silly question? "Can avian flu be passed from person to person? There are indications that it can, although so far not in the form which could fuel a pandemic." Or this? "Does this mean there is likely to be a large outbreak of bird flu? Experts are concerned that this could happen. But in the Thai case, the virus was only passed to close relatives and spread no further." Or this? "What would be the consequence if this did happen? Once the virus gained the ability to pass easily between humans the results could be catastrophic. Worldwide, experts predict anything between two million and 50 million deaths."

    So the worst case guestimate is that 0.7% of the population might die. Lets compare that to real data. The population [census.gov] appears to be growing. And, over the past month, on average 6 million people are net gained on this planet. And this growth is estimated to continue at the same rate until July, 2006.

    So, if everybody forgets to die and fuck for 8 months its the same thing as the worst case scenario from something that may not be contracted from person to person.

    Be scared, very scared.

    Wake me up when a good plague comes though. I remember when they would wipe out 1/3 of the population, and we would be grateful, and life went on without laws protecting drug companies from being sued for potentially killing people who make drugs to keep stuff like this from hurting us. Now that, my friends is something to be worried about.

    • Re:So? (Score:3, Interesting)

      by DigitalRaptor ( 815681 )
      I'm not worried at all about getting the bird flu and dying, or losing a family member or friend to it.

      What I am very worried about is the economic consequences to the worlds reaction to it.

      The current Bush plan calls for the closing of all interstate and air travel, and the closing of all ports, the moment the bird flu is detected on U.S. soil in a human communicable form.

      I don't know about you, but that would have serious consequences for me. No gas at the gas station. No food at the grocery store. You
      • You have made some very good points.

        In fact, as I think about it, I would guess it's a matter of when, not if, all transportation will be shut down. If not for this disease, then another like it. If not now, then in a few years.

        The solution is to have a year's supply of food and water in your house. Start now. Start out by getting 3 days' worth of food and water (don't forget the first aid kit), and go on from there. For a teensy bit of extra money every month, you can have a stockpile of food befo

      • " I'm not worried at all about getting the bird flu and dying, or losing a family member or friend to it."

        I am! Even more with people around me who can just think about the economical consequences of something like that.

        Guess what, the chance of you or I diyng is hightly increased by a flu pandemic. That number, 0.7% (that is the lower guestimate I alread read about it), means that near 1 person on each 100 on the world will die from the disiase. What else cause so many deaths? Are you comparing it with

    • Re:So? (Score:2)

      by Inda ( 580031 )
      I believe Bird Flu is the latest 'big thing' the media are using to drive newspaper sales, TV advertisement placements, etc. I also think people should stop and think a little before passing rumours onto friends and family. If I'm told one more time that Christmas Turkey from Asia can give you Bird Flu I'm going to scream.

      "Flu kills about 12,000 people a year, although twice in the last 15 years the death toll has reached nearly double that." - http://news.bbc.co.uk/1/hi/health/4459140.stm

      That's 12,000 Flu
  • I for one welcome our newly resistant Bird Virus Saviors.... who will one day defeat our future Martian Overlords!
  • This is from NEJM (and my ID Blog [blogspot.comn])

    Here are the current physician points of interest being batted about on this topic:

    Avian Flu Deaths Linked to Tamiflu Resistance:

    • 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 an

  • Evidence of the Intelligent Design of the Virus (Score:3, Funny)

    by victorvodka ( 597971 ) on Saturday December 24, 2005 @11:14AM (#14332393) Homepage
    I have RTFA and determined that there is no way such resistance could have simply evolved - to have done so would be like a tornado going through a junk yard and a 747 being the result. Therefore I must conclude that the new resistance of the Avian Flu virus was intelligently inserted, i.e., designed, much the way God designed our eyes, tonsils, and (most thoughtfully of all) our precious wisdom teeth
  • See Bird Flu Drug Rendered Useless [washingtonpost.com] for how China fucked the rest of the world by misusing a human antiviral drug on chickens.

  • A Not Uncommon Problem... (Score:4, Informative)

    by Biomechanical ( 829805 ) on Saturday December 24, 2005 @12:23PM (#14332624) Homepage

    I would not be surprised to find out that pretty much all the virus and infectious bacterial agents in nature tend to build up resistance to the various drugs that are used to combat them.

    I haven't read through all the comments, so someone's likely to have already said this but,

    The best thing for people to do with regards to their health is build up their immune system without drugs. Eat more foods with anti-viral, and anti-bacterial properties.

    Garlic's a good one, all round. Peppers - capsicum, chili - are good too, and can add a nice little kick to an otherwise mild tasting meal. Having fish? Add lemon juice, or orange for a slightly sweeter taste. Salad? Add some shallots or onions.

    I think the biggest problem though with the enhanced diet approach is that too many people cook their food too much.

    I will happily nibble on raw onion, raw garlic, shallots, a capsicum, chili. I may not be very approachable if I'm breathing in your direction, but I wouldn't be approachable if I was sick either.

    Boost your immune system, don't rely on the drugs. What happens when you catch a new strain of something that there is no drug to combat it with? Don't just eat healthy, eat health-enhancing foods, and your body will still catch things, but it'll be a lot more ready to fight them.

    I don't get very sick these days, but when I do - even if it's a really bad cold or flu that's knocking people about here and there, and there's warnings about it on the news, fairly common around here during the winter months - I tend to get better within fourty-eight hours.

    I've caught things that have had friends and family in bed for days, taking drugs prescribed by a doctor and complaining about how crap they feel, and while they do that, I'm seriously chowing down on various strong foods, making myself sweat and do a lot of physical exertion, and keeping myself hot and active, flushing myself through with lots of water and hot soups.

    It's simple, but it tends to work. The strongest drugs I take these days are aspirin if I get a migraine, and no, I'm not one of these anti-drug guys. I smoke, which I know doesn't help normally, and I like to drink alcohol, I just don't like to try and combat every little ailment I have with drugs, and my body tends to resist communicable illnesses that people around me have got.

    Eat healthy, and you'll be healthy. Eat health-boosting foods, and you'll tend to gain resistance to little nasties.

    • I would add...

      Make sure to get sick once in a while.

      Make sure to get enough sleep.

      If an epidemic breaks out- remember OTHER people get you sick, not getting wet or cold. Try to work from home if you are a computer type.
    • It is my (possibly flawed) understanding that the H5N1 virus kills by overstimulating the immune system, resulting in a cytokine storm which (in this case) destroys lung tissue. Hence (like the 1918 flu), those with the strongest immune system (young adults) are most at risk.

      If this is true, building up your immune system (if that is really possible) would seem counterproductive.

    • If you happily nibble on raw garlic, then you probably don't get sick because no one comes close enough to infect you.

  • I call BS on this one (Score:2, Insightful)

    by spahn ( 227384 )
    Just because someone died from bird flu after taking tammiflu doesn't necessarily mean that it's developing a resistance to the drug.

    First off, the "bird flu" doesn't transfer from human to human yet. In order for it to "develop a resistance" it's got to be able to go somewhere once this so called resistance has developed. Well, this can't exactly happen since it can't be transferred from human to human yet.

    Secondly, the article reports that the people given tammiflu did get better first. This doesn't ne
  • See this, for example, for a quite an interesting analysis of how disease affected history. http://www.amazon.com/gp/product/0385121229/103-89 20737-8104634?v=glance&n=283155 [amazon.com]
  • The reason for the concern about Tamiflu resistance (as opposed to resistance to Relenza) is that Tamiflu can prevent infection by non-resistant influenza. Hence public health officials were hoping to use it to stop the spread of an epidemic of human-to-human mutated bird flu by giving it to those who might have been exposed or would soon be exposed, thus isolating the mutated flu and letting it die out. This is similar to the approach of "ring vaccination" used to stop smallpox (except that here there is n

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