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Message 432 of 3073

From the Chicago Tribune

Study: Drug not working against flu
By Trine Tsouderos
March 02, 2009

An important antiviral drug no longer works against this season’s most prevalent type of flu, which has mutated into a resistant strain, researchers reported today in the Journal of the American Medical Association.

That drug – sold as Tamiflu in the U.S. – was one arrow in a very small quiver of antiviral medicines used to battle influenza, an illness that lands 200,000 Americans in the hospital and kills 36,000 every year, according to the Centers for Disease Control.

Public health officials and physicians called the development and spread of Tamiflu-resistant flu disturbing.

“It makes me nervous,” said Michael Koller, a doctor of internal medicine at Loyola University Medical Center. “We know that it keeps mutating and that is why it is still around. It manages to figure out ways to outsmart us and our medications.”

With Tamiflu no longer effective against this particular flu strain, known as H1N1, physicians are turning to zanamivir, which has problems of its own. The drug, which is inhaled, is not recommended for some of the very populations that would need it most – very young children and people with respiratory problems.”

For those people, CDC officials recommend a combination of Tamiflu and another antiviral called rimantadine, which was the subject of a flu resistance scare of its own in 2006.

“The problem is that we now have different flu strains that are susceptible to different antiviral agents, and clinicians often do not know what strain is infecting a person. The new recommendations try to account for these different factors,” said Alicia Fry, a medical epidemiologist in the influenza division of the CDC and a co-author of the JAMA report.

With so many problems with the antivirals, public health officials are urging people to get a flu shot, which offers good protection this year against the H1N1 strain.

“Flu season is still peaking,” said Koller, who noted that he started seeing a rise in flu patients around the first week of February. “There is no sign we are on our way down. It is not too late.”

One of the virus’ most astounding feats is that it managed to mutate into a resistant form and spread around the globe in a year.

Scientists began picking up hints that was happening during the last flu season, when reports came in from Canada to Russia to Hong Kong to the U.S. of Tamiflu-resistant flu. In the U.S., scientists found that about 11 percent of the H1N1 viruses were resistant.
Replies 1 - 10 of 12
May Not Work!
November 21, 2009 by Melissa Lind Though conflicting reports continue to come out, the total number of H1N1 or swine flu cases is still on the rise. Vaccine production has been slower than promised and many people are concerned about the safety of the rapidly produced vaccine. What may be particularly troubling is the rapid mutation of the swine flu virus into a more virulent form that is resistant to the primary antiviral treatment, "Tamiflu".

Mutated H1N1 Virus

Thus far, isolated clusters of Tamiflu resistant H1N1 have arisen in Wales, Norway, Brazil and the United States. Viral mutations in each area appear to be isolated, however in most cases the virus has become not only resistant to the standard treatment, it may have also become more virulent. Some cases of mutated virus have reportedly developed changes which allow it to penetrate further into airways and cause a more virulent reaction. Medical officials report that it is to be expected that a virus will mutate and do not appear to be alarmed at the type or threat of mutations thus far.

H1N1 Statistics

The US Center for Disease Control (CDC) estimates that 22 million people in the US have been infected with the virus and approximately 4,000 have died. Obtaining accurate numbers is challenging however, as many people are being discouraged from visiting a hospital or doctor's office to avoid infecting others. In addition, in most areas even when seen by a physician, patients are not being tested to confirm presence of the actual H1N1 virus as the test is quite expensive ($300 per test). In many areas, patients are not being treated at all if they are not within one of the risk category groups which include: age under 5, pregnancy and other health conditions that compromise the immune system.

over 2 years ago
The Flu Types—Seasonal, Pandemic, Avian (Bird), Swine
Influenza, or flu, is a respiratory infection caused by several flu viruses. Flu viruses are classified as types A, B, and C; type A has a number of subtypes. The flu is not the same as the common cold, nor is it related to what is commonly called the “stomach flu.”


Flu virus
Credit: NIAID

Seasonal Flu
Seasonal flu is the term used to refer to the flu outbreaks that occur yearly, mainly in the late fall and winter. It is estimated that between 5 and 20 percent of Americans come down with the flu every flu season.

Pandemic Flu
Pandemic flu refers to particularly virulent strains of flu that spread rapidly from person to person to create a world-wide epidemic (pandemic).

Avian (Bird) Flu
In nature, the flu virus also occurs in wild aquatic birds such as ducks and shore birds. It does not normally spread from birds to humans. However, pigs can be infected by bird influenza (as well as by the form of influenza that affects humans) and can pass on the flu to humans. In 1997, it was discovered that a virulent bird influenza had skipped the pig step and had infected humans directly, causing a number of deaths in Asia.

These instances of bird flu in humans have raised concerns that if this type of flu could at some point be transmitted between people, a new pandemic would occur. Thus, the term bird flu or avian flu is currently being used to refer to a possible pandemic flu.

Overview of the Flu
The flu, like the common cold, is a respiratory infection caused by viruses. But the flu differs in several ways from the common cold. For example, people with colds rarely get fevers or headaches or suffer from the extreme exhaustion that flu viruses cause. The most familiar aspect of the flu is the way it can "knock you off your feet" as it sweeps through entire communities.

The Centers for Disease Control and Prevention (CDC) estimates that 5 to 20 percent of Americans come down with the flu during each flu season, which typically lasts from November to March. Children are two to three times more likely than adults to get sick with the flu, and children frequently spread the virus to others. Although most people recover from the illness, CDC estimates that in the United States more than 200,000 people are hospitalized and about 36,000 people die from the flu and its complications every year.

Seasonal Flu Outbreaks
Seasonal flu outbreaks usually begin suddenly and occur mainly in the late fall and winter. The disease spreads through communities, creating an epidemic. During the epidemic, the number of cases peaks in about 3 weeks and subsides after another 3 or 4 weeks. Half of the population of a community may be affected. Because schools are an excellent place for flu viruses to attack and spread, families with school-age children have more infections than other families, with an average of one-third of the family members infected each year.

Importance of Flu
Besides the rapid start of the outbreaks and the large numbers of people affected, the flu is an important disease because it can cause serious complications. Most people who get the flu get better within a week (although they may have a lingering cough and tire easily for a while longer). For elderly people, newborn babies, and people with certain chronic illnesses, however, the flu and its complications can be life-threatening.

Flu Virus Characteristics
A flu virus is roughly round, but it can also be elongated or irregularly shaped. Inside are eight segments of single-strand RNA containing the genetic instructions for making new copies of the virus. Flu's most striking feature is a layer of spikes projecting from its surface. There are two different types of spikes: one is the protein hemagglutinin (HA), which allows the virus to "stick" to a cell and initiate infection, the other is a protein called neuraminidase (NA), which enables newly formed viruses to exit the host cell.


Influenza A virus. Credit: CDC


Virus Types A, B, C
Influenza viruses are classified as type A, B, or C based upon their protein composition. Type A viruses are found in many kinds of animals, including ducks, chickens, pigs, and whales, and also humans. The type B virus widely circulates in humans. Type C has been found in humans, pigs, and dogs and causes mild respiratory infections, but does not spark epidemics.

Type A influenza is the most frightening of the three. It is believed responsible for the global outbreaks of 1918, 1957, and 1968. Type A viruses are subdivided into groups based on two surface proteins, HA and NA. Scientists have characterized 16 HA subtypes and 9 NA subtypes.

Naming Viral Strains
Type A subtypes are classified by a naming system that includes the place the strain was first found, a lab identification number, the year of discovery, and, in parentheses, the type of HA and NA it possesses, for example, A/Hong Kong/156/97 (H5N1). If the virus infects non-humans, the host species is included before the geographical site, as in A/Chicken/Hong Kong/G9/97 (H9N2). There are no type B or C subtypes.

Where Influenza Comes From
In nature, the flu virus is found in wild aquatic birds such as ducks and shore birds. It has persisted in these birds for millions of years and does not typically harm them. But the frequently mutating flu viruses can readily jump the species barrier from wild birds to domesticated ducks and then to chickens. From there, the next stop in the infectious chain is often pigs.

Pigs can be infected by both bird (avian) influenza and the form of influenza that infects humans. In a setting such as a farm where chickens, humans, and pigs live in close proximity, pigs act as an influenza virus mixing bowl. If a pig is infected with avian and human flu simultaneously, the two types of virus may exchange genes. Such a "reassorted" flu virus can sometimes spread from pigs to people.

Depending on the precise assortment of bird-type flu proteins that make it into the human population, the flu may be more or less severe.

In 1997, for the first time, scientists found that bird influenza skipped the pig step and infected humans directly. Alarmed health officials feared a worldwide epidemic (a pandemic). But, fortunately, the virus could not pass between people and thus did not spark an epidemic. Scientists speculate that chickens may now also have the receptor used by human-type viruses.

Drifting and Shifting
Influenza virus is one of the most changeable of viruses. These genetic changes may be small and continuous or large and abrupt.

Small, continuous changes happen in type A and type B influenza as the virus makes copies of itself. The process is called antigenic drift. The drifting is frequent enough to make the new strain of virus often unrecognizable to the human immune system. For this reason, a new flu vaccine must be produced each year to combat that year's prevalent strains.

Type A influenza also undergoes infrequent and sudden changes, called antigenic shift. Antigenic shift occurs when two different flu strains infect the same cell and exchange genetic material. The novel assortment of HA or NA proteins in a shifted virus creates a new influenza A subtype. Because people have little or no immunity to such a new subtype, their appearance tends to coincide with a very severe flu epidemic or pandemic.

over 2 years ago
And, the point is?
LenRobertson's profile

over 2 years ago
The point is - you're wrong! This Government is up to something that will make the 1918 look like children's play compared to what will happen now when this runs rampant and they aren't even ready for it. 4,000 and counting died.

over 2 years ago
He's wrong about what? He only asked what the point of your post was and I am wondering too. What is it you think the Government is up to?
I know it is true that people with symptoms are discouraged from going into an office where they might infect others; it's then just assumed that they have H1N1 when it's possible they don't. Wonder if those people are added into the statistics as having H1N1? And as for the H1N1 cultures - I've been told that test is inaccurate 40% of the time; that's not much more reliable than flipping a coin.
midwife228's profile

over 2 years ago
You will see, will you not what this Government is up to in the very near future of this Pandemic and what is to come with who and what are coming over our borders.

Everyone laughs, but to me something is on the horizon and it isn't good and when and if this happens remember what I've said about this Government and what they are about to do to this country. Wonderful how fools are lead to believe Obama and hang on his every word like a god. He is in the New Age cult of Environmentalism, instead of "In God We Trust", which is being thrown out like a ol' rag, Obama is replacing God above and nothing Obama does is wrong, but right for this country. Live with it for you made your bed now lay in it, like people told me long ago. LOL

over 2 years ago
Like I said 1918 will be nothing compared to what is coming when this mutates and they aren't even ready for it, so alot more people will die.

Sure it slowed down abit, but that doesn't mean a thing for Winter if hard will rid it for awhile, then Spring will come and Hell will break lose again. Mutations will be harder to get rid of when Tamiflu will not help.

Someone in Government said: "that they can always use an emergency".

over 2 years ago
Len, tells me that it isn't serious enough - if he knew how to read, it is right there in front of him what is truly going on.

over 2 years ago
Again - what is it that you think the Government is "up to"? I hardly think the Government can control flu mutations...
midwife228's profile

over 2 years ago
Using an emergency for their own political gain.

Who knows what Governments are up to - to create emergencies so everyone will see them as a saint, instead of a sinner. You always have to have this question in the back of your mind: What if the Government started this all in one area of the World to bring it here for a experiment on others, but something goes awry and then it gets out of control.

The Government has done things in the past to people who were unaware, why not today at this moment in time? What is next?

over 2 years ago
Replies 1 - 10 of 12

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