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Influenza World brings you the latest news and updates in the flu field from around the world.

 
Experts say new drugs needed to fight flu pandemic
27 February 2009

HONG KONG (Reuters) - Experts on Friday urged governments on Friday to diversify their stockpiles of drugs and called for more new medicines to fight what could be the world's next flu pandemic caused by the H5N1 bird flu virus.

Many advanced countries stock up on oseltamivir and zanamivir, two varieties of the same class of drugs that stops the H5N1 virus from multiplying.

But oseltamivir has proven to be largely useless in fighting the H1N1 seasonal human influenza virus and experts are questioning how well, and how long, the drug would stand up against the H5N1 virus, should it unleash a pandemic.

"We have been extremely foolish on our policies of stockpiling drugs. We have been stockpiling two varieties of the same drug," virologist Robert Webster at the St Jude Children's Hospital in the United States said at a medical conference in Hong Kong.

He said the resistance of the H1N1 virus to oseltamivir was as high as 98 percent worldwide.

"The likely scenario is that the (H5N1) virus will become resistant when you start using more and more (of one) drug, you get resistant (H5N1) mutants," he told Reuters later.

The U.S. Centers for Disease Control and Prevention said in December 2008 that 49 out of 50 H1N1 virus samples tested were no longer sensitive to oseltamivir, which is made by Roche AG and Gilead Sciences Inc.

Relenza, known generically as zanamivir, is made by GlaxoSmithKline under license from Australia's Biota Inc.

Viruses and bacteria are sturdy organisms that fight hard to survive and adapt swiftly to drugs that are used to kill them, quickly becoming resistant to them.

Experts at the conference said most H1N1 viruses were sensitive to oseltamivir just a few years ago but learnt to adapt to the drug very quickly.

They warned that H5N1 could learn to adapt quickly to oseltamivir, just as H1N1 has done, because both viruses share a similar "N1" protein component.

Scientists in Vietnam reported in the past how certain strains of H5N1 were no longer sensitive to oseltamivir, resulting in the deaths of several infected patients.

Experience with viruses similar to H5N1 suggests that it would best be tackled with a combination of drugs, Webster said.

"Studies with HIV, leukemia have shown that we have to use multiple drugs," he said. He suggested that oseltamivir and zanamivir be trialled alongside other drugs like ribavirin and the adamantane class of drugs, like amantadine and rimantadine.

Malik Peiris a microbiologist with the University of Hong Kong said: "There is a need for developing new antivirals (drugs). Some are in very early clinical trials but development should be stepped up so there is a diversification of options."

  • "I would describe flu as something that makes you feel very, very ill. You get a headache, aching bones, and are generally fed up"
  • "When I get flu symptoms I feel like a train has run over me"
  • "I felt very sick and, during the first week, I had high temperature. Flu was very different to a cold. I went back to work after two and a half weeks. Then I suffered a setback for another week"
  • "I run a guesthouse; flu would be a real pest for me. I couldn’t cook, I shouldn’t cook, and I wouldn’t cook, so I would need to get a lot of extra help in. It would cost me a lot more money. So flu’s a real problem, a right downturn"
  • "I work on my own and when I can’t work, I have to try not to infect my little children, so they avoid getting the flu as well"
  • "I feel a little numb, like I’m in another dimension. Because in general I have sore throat, headache, I feel all clogged-up. Usually a sensation like I’m floating in the air"
  • "Shivers, sweats, makes you ache. Last time I had flu I was off for two weeks"
  • "I think that I would probably be concerned that I would pass flu onto my children, who might not be able to deal with it as well as I would"
  • "Flu makes you feel like you’ve been hit over the head with a baseball bat. You don’t feel like you can get yourself out of bed as all your energy is drawn from you"
  • "I was incapable of working. It just wasn’t possible at all… and my flu dragged on for more than a week"
  • "I have no strength. It annoys me because I can do nothing, it seems like I’m wasting my time"
  • "Flu’s like being hit by a truck because you feel completely gone. There is no energy left in your body. You are suffering from high temperature. You’re sweating a lot and you feel really unwell"
  • "First of all infinite tiredness, then I feel like sleeping and don’t want to eat"
  • "I felt really miserable because my muscles and my bones were aching. Well, I can hardly describe it, I just felt really awful, absolutely miserable"
  • "It’s like there’s something huge treading on your head, like a deafening noise that destroys the eardrums"
  • "The fever was constantly rising – I immediately measured my temperature as soon as I got home. It was 41°C and it kept rising and I was wondering what’s going on. I was really scared! Everything was hurting and it all happened so fast. Flu came out of the blue"
  • "I always feel like my limbs have iron weights tied to them and I’m going to fall over any minute, a really stuffy runny nose and feel antisocial"
  • "I was totally dependent on others! I was incapable of doing anything at all"
  • "The real flu knocks you for six – you just don’t want to move or do anything. It’s not very nice"
  • "Not being able to go to work. Not being able to do the things I have to do at home and the commitments that I have day by day"