Anyone else see this? Article doesn't sound too worrisome. Should we be worried?




http://www.reuters.com/article/domesticNews/idUSTRE5214YM20090302

We are prescribing relenza instead. No big deal.

I first read this news a while back. Probably back in the fall, when the flu season was just starting here in North America.

We've been lucky this flu season since it's been a mild one. On top of all the other awful news going on since last fall, a bad flu season to boot would've been miserable.

A couple things to keep in mind:

1. The flu has multiple strains that circulate at any given time and that mix changes over time. So if the predominant strain now is resistant doesn't necessarily mean that the "flu" (in general) will always be resistant in the future.

2. As far as pandemic potential goes, there's no guarantee that the next pandemic disease will be the flu, or a particular strain of the flu that is already resistant to anti-virals. But obviously, a pandemic flu strain that is also resistant to Tamiflu and other anti-virals makes a lot of our centrally stockpiled pandemic medications useless. Or another scenario is that a deadly strain of influenza swaps genetic material with a mild strain that is resistant and then you have a much bigger problem on your hands in a short period of time.

You can worry about it all you want, but what can you do about it?

It is kind of like the weather that way. It changes all the time and we have professionals watching it already.

You can make it known to your politicians that you support scientists more than preachers and maybe you will get better medicines instead of more prayers. (maybe)

You understand that the normal flue vaccine is a yearly remix intended to provide protections against the most dangerous strains that year. It changes every year.

During the last bird flu scare quite a few people invested goodly sums of money, often a thousand dollars or more, to lay in a supply of Tamiflu. Of that a good part has expired and now we find out that it may be of little or no use with the next round of viruses.

Bottom line is that nobody knows what is coming and, as always, funds are limited so it is important not to get too far ahead of ourselves and invest too much based on what we assume, fear, will happen. Get too far ahead of yourself you may find yourself with the wrong supplies and no resources left to get hold of the right stuff.

IMO the best plan is to focus on supplies that can be used in a variety of ways and situation. To avoid, for the most part, stocking things that have but one use.

So who's bright idea was it to create a stockpile of worthless vaccine? Weren't they aware it could so easily become obsolete? Yeah, I'm not worried, just a little surprised they didn't see this coming after all the fanfare with Tamiflu. Reminds me of the Maginot Line.

Tamiflu and related anti-virals are not vaccines. Two totally different things.

It's only "worthless" if the next pandemic is a Tamiflu-resistant flu, but like I mentioned earlier, no one knows what disease will be the next pandemic. When the decision was made to stockpile it, the avian flu that experts were afraid might become the next full blown pandemic wasn't Tamiflu-resistant like this most recent case. Tamiflu is not a silver bullet to cure any flu epidemic. It spares some infected people from death, and for the rest of the populace, it simply buys you time until either the pandemic runs its course naturally or a vaccine is developed. Vaccines take many months to produce in quantity, even in the best case scenario.

And people would be screaming bloody murder at the government if the next pandemic is a flu strain that Tamiflu works against but no Tamiflu was stockpiled.

It might help here to say "changes over time, at a rate faster than the production cycle of the vaccine".

In other words you can't usefully produce a vaccine based on the flu seen in the public: by the time the vaccine batch is ready it will be some other strain that is the problem, and the vaccine you made does no good.

In effect vaccine manufacturers have to guess ahead of time what will be needed. Sometimes they guess right and sometimes not. In years they don't you have a big stockpile of the "wrong" vaccine that is "wasted" because it is not needed, and the vaccine you do need isn't available.

To understand why anyone would "waste" huge amounts of money on what might be the wrong drug read up on the Spanish Influenza (which started at Camp Funston in Kansas, not in Spain). Public health officials will go to any length to avoid a repeat of that.

This doesn't deal with Tamiflu, per se, but my wife is a hospital pharmacist. She called me yesterday from work to say she wasn't feeling well (I had been sick for three days with some virulent GI problem so I suggested she head home). Well, she didn't until she thought she couldn't make it so I suggested she see a doctor there at the hospital. Long story short, she has both A and B strains of influenza and had taken the vaccine. They repeated the swab after the first positive because she had taken the vaccine. So whether I had influenza or not, I don't know for certain, but she did. Which, of course, is in consonance with the above post on vaccines not working. Viruses mutate, or those who decided which flu viruses to choose as the likely pathogens in a given year's vaccine make imprecise choices.

You, of course, are correct; the only reason I phrased it that way--incorrectly--is that she has subsequently had some lower GI problems which I can only suppose would indicate a mixed infection. So she might have a touch of what I had on top of her own, rather than the other way around. Since January I have had pertussis, and now whatever I am just about over, so I've something of a scourge. My days of saying, "I never get sick" are over.