Swine flu pandemic fears

[Prospector]

But why are they in short supply ?

It is unethical for a doctor to prescribe relenza to a healthy individual, with no obvious risk of developing swine flu, and hence restrict the availability to people who have or are at high risk ( social justice )

The thing is, everyone has the same risk of developing swine flu, or the prevailing flu, if they associate with others, once the virus is known to be in the same geographical area. Certainly if they travel in planes, or lifts, or trains.....

In this particular case, people with a weakened immune system are at no more risk than others who seem otherwise healthy. Given we cannot dose everyone, do we give all the medications to people in Nursing Homes, which might mean that young people at University, or schools, or work in large public areas for example, who are probably most at risk, don't receive treatment?

Thank you Prospector for the ingredient. I'll buy it from Herbies some wonderful receipe for anise

http://en.wikipedia.org/wiki/Star_anise

Star anise, star aniseed, badiane or Chinese star anise, is a spice that closely resembles anise in flavor, obtained from the star-shaped pericarp of Illicium verum, a small native evergreen tree of southwest China. The star shaped fruits are harvested just before ripening. It is widely used in Chinese cuisine, in Indian cuisine where it is a major component of garam masala, and in Malay–Indonesian cuisine. It is widely grown for commercial use in China, India, and most other countries in Asia. Star anise is an ingredient of the traditional five-spice powder of Chinese cooking. It is also a major ingredient in the making of phở, a Vietnamese noodle soup. It is used as a spice in preparation of Biryani in Andhra Pradesh, a state of southern India.

Shikimic acid, a primary feedstock used to create the anti-flu drug Tamiflu, is produced by most autotrophic organisms, but star anise is the industrial source. In 2005, there was a temporary shortage of star anise due to its use in making Tamiflu. Late in that year, a way was found of making shikimic acid artificially. A drug company named Roche now derives some of the raw material it needs from fermenting E. coli bacteria. There is no longer any shortage of star anise and it is readily available and is relatively cheap.

Star anise is grown in four provinces in China and harvested between March and May. Its also found in the south of New South Wales. The shikimic acid is extracted from the seeds in a ten-stage manufacturing process which takes a year. Reports say 90% of the harvest is already used by the Swiss pharmaceutical manufacturer Roche in making Tamiflu, but other reports say there is an abundance of the spice in the main regions - Fujian, Guangdong, Guangxi and Yunnan.

 

[GumbyLearner]

Some experts have pinpointed Swine Flu
as coming from a small town named La Gloria.

http://cosmos.bcst.yahoo.com/up/player/popup/?rn=3906861&cl=13211188&ch=4226723&src=news

 

[Soft Dough]

The thing is, everyone has the same risk of developing swine flu, or the prevailing flu, if they associate with others, once the virus is known to be in the same geographical area. Certainly if they travel in planes, or lifts, or trains.....

In this particular case, people with a weakened immune system are at no more risk than others who seem otherwise healthy. Given we cannot dose everyone, do we give all the medications to people in Nursing Homes, which might mean that young people at University, or schools, or work in large public areas for example, who are probably most at risk, don't receive treatment?

As you are saying I do not have the same risk as an air hostess in mexico, or a waitor in a restaurant near an international airport, or as a doctor in a hospital. Therefore, since there are finite supplies, doctors should only prescribe it to people who need it.

I agree with your last point, re nursing homes, no we do not give it to anyone, it is a treatment, not a preventative, so obviously we give ( and doctor's should only prescribe) it to people who will have any benefit.

 

[Prospector]

I agree with your last point, re nursing homes, no we do not give it to anyone, it is a treatment, not a preventative, so obviously we give ( and doctor's should only prescribe) it to people who will have any benefit.

Tamiflu and Relenza are proven as prophylactic -ie they can be given preventively. Indeed, this is probably what is planned in the event of a pandemic; people in emergency care services (Doctors/Nurses/essential suppliers) may well be given the drugs as a precaution.

 

[Soft Dough]

Tamiflu and Relenza are proven as prophylactic -ie they can be given preventively. Indeed, this is probably what is planned in the event of a pandemic; people in emergency care services (Doctors/Nurses/essential suppliers) may well be given the drugs as a precaution.

They do not prevent at all, there is no modification of immune system.

They are drugs which treat infection ( ie they inhibit synthesis of viral rna ) therefore the virus needs to be in the body.

I can see that the earlier the better, in appropriate groups.

What can be achieved by having thousands of doses sitting in cupboards when there is no need is nothing compared to what can be achieved if it is prescribed and taken appropriately ( ie there is no reason to give it to people to take as there will no doubt be people who develop colds and use it )

There is no indication for a doctor to prescribe these unless the person is at risk or has the condition.

Unfortunately if you do not understand medical ethics and the concept of social justice, then you will struggle to understand this.

I am not saying it is unwise to have some relenza at home, just that the doctor shouldn't be dishing it out without a reason.

 

[Green08]

First confirmed death from swine flu in the States - Texas a child. Just on CNBC

 

[spooly74]

An article below from a very good blog which has recently been covering Swine flu. A priceless quote at the end of the paragraph which sums up the difficulty in trying to prepare for any outbreak.

Swine flu: what did you expect?

...
Another thing that most people and probably most clinicians expect is that we know a lot about influenza. Perhaps because of the increased scientific interest since bird flu (an increased interest which will pay off handsomely in this outbreak, by the way) we do know quite a bit, but we also now know many of the things we thought we knew about flu, like the main ways it is transmitted from person to person, we don't really know. For example, how likely is it that you can get flu by touching a door knob or arm rest that someone with the flu just touched? Or that you can get the flu by sitting in the same emergency department waiting room (but not next to) other flu cases? These are open questions (see some of our many posts on this here, here, here, here). Why is flu seasonal? We don't know. We'll try to get to some more of these questions in the days ahead, since we have many new readers, but one big thing to know was emphasized by Acting CDC Director Richard Besser at the White House briefing yesterday: the influenza virus is highly unpredictable and our certain knowledge of it very scant. If you've seen one flu pandemic, you've seen one flu pandemic.
...
http://scienceblogs.com/effectmeasure/2009/04/swine_flu_what_did_you_expect.php#more

 

[Prospector]

They do not prevent at all, there is no modification of immune system.

They are drugs which treat infection ( ie they inhibit synthesis of viral rna ) therefore the virus needs to be in the body.

I can see that the earlier the better, in appropriate groups.

OK, Have done some more checking and it can be given prophylactically, but not in the strict sense as in taking blood thinners for reducing blood clotting. Tamiflu is recommended when people have been exposed to the flu - as opposed to simply 'just taking it in case'. I dont think (but maybe they would) people would take it without having faced a risk through contact. Which is why hospital workers would receive it as a preventive, because they most likely would have had contact.

http://www.rxlist.com/tamiflu-drug.htm

Standard Dosage – Prophylaxis of Influenza
Adults and Adolescents
The recommended oral dose of TAMIFLU for prophylaxis of influenza in adults and adolescents 13 years and older following close contact with an infected individual is 75 mg once daily for at least 10 days. Therapy should begin within 2 days of exposure. The recommended dose for prophylaxis during a community outbreak of influenza is 75 mg once daily. Safety and efficacy have been demonstrated for up to 6 weeks. The duration of protection lasts for as long as dosing is continued.

Not sure what your point is here though!

Unfortunately if you do not understand medical ethics and the concept of social justice, then you will struggle to understand this.

The concept has nothing to do with social justice, just good medical practice. I think even I can work that out!

 

[brty]

Green08,

I noticed that too, so much for being 'mild' outside Mexico.

This thing obviously takes its time with infections, the reports say that it really started a month ago. We really need to see what happens to those infected after they have had it for a week or so.

If this takes time to infect people, and then takes time to really make them sick, then the reported cases of all, sorry most being "mild", mean nothing.

The Governator has not called a state of emergency without a little bit of understanding of what is going on.

brty

 

[Soft Dough]

OK, Have done some more checking and it can be given prophylactically, but not in the strict sense as in taking blood thinners for reducing blood clotting. Tamiflu is recommended when people have been exposed to the flu - as opposed to simply 'just taking it in case'. I dont think (but maybe they would) people would take it without having faced a risk through contact. Which is why hospital workers would receive it as a preventive, because they most likely would have had contact.

http://www.rxlist.com/tamiflu-drug.htm

Standard Dosage – Prophylaxis of Influenza
Adults and Adolescents
The recommended oral dose of TAMIFLU for prophylaxis of influenza in adults and adolescents 13 years and older following close contact with an infected individual is 75 mg once daily for at least 10 days. Therapy should begin within 2 days of exposure. The recommended dose for prophylaxis during a community outbreak of influenza is 75 mg once daily. Safety and efficacy have been demonstrated for up to 6 weeks. The duration of protection lasts for as long as dosing is continued.

Not sure what your point is here though!

The concept has nothing to do with social justice, just good medical practice. I think even I can work that out!

It has to do with both social justice and good practice.

And wrt tamiflu, it is not prophylactic, but the sooner you take the tamiflu the better response you will have in fighting the infection. If it is prescribed for use for someone exposed to influenza, it is a good choice, like rifampicin if you are exposed to meningitis, but a good doctor will not give people rifampicin capsules "just in case" they come into contact with somebody who has meningitis.

 

[Struzball]

First confirmed death from swine flu in the States - Texas a child. Just on CNBC

The toddler was a Mexican who crossed the border for treatment, officials said.

A mexican.. from mexico..

http://www.news.com.au/story/0,27574,25407487-5018988,00.html

 

[lthigham]

Denmark is planning purchase or Relenza. The countries leaders are concerned about resistance to Tamiflu.

http://in.reuters.com/article/rbssHealthcareNews/idINLT89242720090429

 

[lthigham]

Also, there was a post on another forum that India planning to stockpile Relenza - I am not sure the source.

 

[lthigham]

Finland orders 90,000 Relenza. Seemingly, they are fearful of Tamiflu reistance as they are ordering more Relenza than Tamiflu .

http://www.yle.fi/uutiset/kotimaa/2009/04/finland_in_line_to_get_swine_flu_vaccine_713415.html

"Government Decides to Acquire More Antiviral Drugs

Already on Tuesday the government decided to acquire more antiviral drugs and protective clothing for medical personnel.

More than 880,000 doses of the antiviral Relenza are to be stockpiled, and 90,000 more doses of Tamiflu, in addition to the more than 90,000 that have already been stockpiled."

 

[metric]

wonder how long before the GW nuts start claiming GW caused the swine flu?


.

 

[Prospector]

wonder how long before the GW nuts start claiming GW caused the swine flu?

I'd give it another day, maybe less!

 

[Calliope]

Give a pig a bad name. In Egypt they are going to cull all their pigs. Talk about hysteria. Luckily it wasn't called Mexican flu

 

[Aussiejeff]

Al Queda?

 

[Agentm]

First confirmed death from swine flu in the States - Texas a child. Just on CNBC

in poorer areas of mexico, having medical care at your door is not a thing that all have. its possible the 7 deaths there were on people who perhaps got to medical care too late for the facility to be able to help. one mexican child, not infected in the usa but visiting usa has died, this has caused the WHO to go to level 6. the classification for the WHO to go to level 6 requires a death on 2 continents. mexico is obviously not on the american continent anymore.. i will check my maps again. until now i always had it next to texas.

with normal flu still outperforming the swine virus by a distance of miles, i am still curious as to how the WHO is making these decisions.

again i hope i am right and i really dont think a pandemic is the right classification as yet.. but the pandemic label will stick now with the manner in which this flu outbreak is being reported, with comparisons to other outbreaks and "global pandemics" being the norm.

CSL got some virus sample just the other day from NZ, they will culture it and start their processes, as soon as the WHO gives them some of their samples to ensure its the right one, they can green light a program for their flu shots, i think the PR lady said 10 weeks later they will have enough. They can easily have supply for every australian to be given a flu shot in about 6 month.. 180 days..

given that csl do this twice a year, modify their flu shots to match up with the strains running through the community, i think this flu virus, which is pretty nasty and a new strain, is causing more deaths solely because its a new strain, and in no time the csl manufacturer and others globally will have the flu shot up and running and the swine flu will be under wraps.

perhaps my view is simplistic, but imho there is need for caution, but the death rate imho is not increasing at pandemic levels.. and i still find it amazing that mexico is now classified as a new continent..

for me its not much more than a new flu strain.. and imho there are plenty more than 1500 flu cases world wide and the death rate ratio may be slightly higher due to its origin in a relatively poor country with lesser medical facilities than in other regions..

in america the 1918 spanish flu had a high mortalty rate

"The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1% "

but in india it was higher.. 50 per 1000 people infected

its possible imho that more than just 1000 have been infected with the A H1N1 virus, so statistically i wonder if the flu is as lethal as the WHO is perhaps suggesting?

one thing is for sure, its getting a hell of a lot of attention and this strain doesnt stand a great chance of becoming a pandemic unless i am missing something here?

 

[bowman]

World Health Organization has just upped the swine flu pandemic alert to 5 out of 6.

I think this came out after the US markets closed.

http://www.theaustralian.news.com.au/story/0,24897,25407576-601,00.html