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Bird Flu Drug Rationed
For Bird Flu Victims Only
By Jo Revill
Health Editor - The Observer
7-24-5
 
The anti-viral drug being stockpiled to combat bird flu will not be used to prevent the disease spreading. Ministers have decided it will be given only to people who are already infected and whose health is in serious danger.
 
The move has surprised experts working on plans to combat the anticipated pandemic of the disease. They had expected it would be given out in the early stages of any outbreak to prevent the disease from spreading.
 
But ministers decided against this move because they fear the nation's entire stocks of Tamiflu, or oseltamivir, would be used up within days if given as soon as people were exposed to the virus. The drug, made by Roche, is in short supply throughout the world.
 
As a result, key workers such as NHS staff and police officers - who were originally expected to receive the drug automatically - are unlikely to get it, raising the question of how emergency services will be kept running if staff succumb to the infection.
 
At a conference in London last week, Dr Jane Leese the senior government medical officer in charge of pandemic plans, said they were working on the basis that the drug could not be given prophylactically - in other words as a preventative measure.
 
She said: 'Although it can be taken over time to prevent you getting flu, that would consume a huge amount of the drug, for a very inefficient use for the savings, so this is a strategy for treating ill patients.'
 
This decision was backed by a Department of Health spokesman. 'Under our current plans, we would be unlikely to use the drug for post-exposure prophylaxis for healthcare workers or for close family members of cases. As the drug takes seven to 10 days to develop an immune response, we don't believe it would be the most effective use of the stockpile.'
 
Tamiflu stops infection spreading between cells by inhibiting the actions of the enzyme neuraminidase. The drug is available in Britain as a medication for the elderly because it works on different strains of flu. Trials have suggested it will work against an avian flu strain as a treatment and also as a preventive to stop people from becoming infected in the first place.
 
The government's decision to ignore this latter use has surprised health professionals. Professor John Oxford, head of virology at Barts and the London Hospital, said : 'If you gave this to everyone as soon as the virus arrived on our shores it would obviously go very quickly, but if you give it to people once they have been exposed, that would be a sensible halfway house measure. Personally, that's what I would want for myself, knowing that you get 90 per cent protection from the virus if you use it prophylactically.'
 
Although Britain will eventually have 12 million doses of the drug, it currently has only 100,000 doses stockpiled because the manufacturers, Roche, cannot increase their capacity any more quickly to make enough to satisfy global demand. As there are three million key workers in Britain, it would be impossible to give the drug as a preventive measure to all.
 
It has also emerged that the government will not automatically start to ban flights from Asia once the disease becomes a fully human form of flu.
 
Studies show that banning international travel would not prevent it from entering the UK as there are so many potential points of entry and it would only have the effect of delaying the disease.
 
The UK is working on the basis that 25 per cent of its population would be infected, and that the pandemic would last three months. Although flu usually affects the very old and the very young worst, the cases in south east Asia have been predominantly in young and middle-aged people.
 
The government has given a conservative estimate that there would be 53,000 deaths in Britain from a pandemic, but the number could be as high as 300,000 if just 2 per cent of those infected died - the mortality rate seen in the Spanish flu outbreak of 1918, the last major pandemic.
 
http://observer.guardian.co.uk/uk_news/story/0,6903,1535044,00.html
 

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