On Tamiflu and bird flu<\/p>\n
In his article, The overuse of Tamiflu in treating avian flu
\n(The Jakarta Post, Dec. 3), Iwan Darmansjah questions the wisdom
\nof stockpiling Tamiflu, generic name oseltamivir. This is a
\nquestion many people have asked, first because an influenza
\npandemic is not an ordinary flu and second because of the 140
\ncases (all in Asia) of H5N1 infection confirmed by WHO, a very
\nsmall number were treated with oseltamivir and the clinical
\nbenefits remain unknown.<\/p>\n
The writer also questions the efficacy of Tamiflu in influenza
\nA and B infections, and the safety of Tamiflu. Two large data
\nsets presented in September at the second European Influenza
\nConference in Malta (www.eswi.org) address unequivocally these
\nquestions.<\/p>\n
A large U.S. study of more than 176,000 patients showed that
\noseltamivir significantly reduced the risk of pneumonia by 32
\npercent and of death by 91 percent. Additionally, in Canadian
\npatients with laboratory-confirmed influenza (A or B) requiring
\nhospital admission, oseltamivir reduced the risk of death by 68
\npercent.<\/p>\n
Elsewhere, a recent large-scale study examined the
\neffectiveness of oseltamivir in protecting family members who had
\ncome in contact with a person infected with flu: oseltamivir
\nprotected about 80 percent of contacts from flu infection.<\/p>\n
Regarding the reported 12 deaths in Japanese children treated
\nwith Tamiflu, the FDA Advisory Committee affirmed on Nov. 27
\n(surely after the writer submitted his article) the safety of
\nTamiflu in children. This was followed on Dec. 2 by the
\nconfirmation of the Japanese Pediatric Society, which established
\nno links between the deaths and Tamiflu.<\/p>\n
It was also reported that of the 24.5 million people in Japan
\nwho have used Tamiflu since 2000, 11.6 million (47 percent) were
\nchildren. The death rate under Tamiflu (1\/1000,000) was lower
\nthan the rate of mortality in children infected with influenza
\n(2\/1000,000).<\/p>\n
Given its beneficial effects on the treatment and prevention
\nof influenza, the prevention of complications and
\nhospitalizations, and on overall patient mortality, WHO experts
\nand others around the world have decided there is definite wisdom
\nin stockpiling oseltamivir as part of governmental pandemic
\npreparedness plans.<\/p>\n
In Asia and in Indonesia the plan should also focus on better
\nmonitoring of backyard farm hygiene and the large live-bird
\nmarkets, which are probably behind all the infection cases so
\nfar.<\/p>\n
Back to the medical side, Iwan Darmansjah mentioned rightfully
\nthat half of the deaths in the case of an avian flu pandemic
\nwould be due to Streptococcus pneumonia bacteria, the most common
\nvariety causing bacterial pneumonia and for which a vaccine
\nexists.<\/p>\n
He talked about the antibiotherapy aspect of the management
\nbut what about vaccination? With the threat of avian flu growing,
\nanother debate is open: how wise would it be to recommend
\npneumococcal vaccination? If envisageable, priority of use must
\nbe established and availability secured.<\/p>\n
What do Indonesian experts think? The question is perhaps
\nworth a local study.<\/p>\n
AIT-ALLAH MEJRI<\/p>\n
Jakarta<\/p>", "url": "https:\/\/jawawa.id\/newsitem\/on-tamiflu-and-bird-flu-1447893297", "image": "" }, "sponsor": "Okusi Associates", "sponsor_url": "https:\/\/okusiassociates.com" }