How to combat bird flu

Bird Flu is caused by the deadly H5N1 strain of the influenza A virus. It normally occurs in birds and is highly contagious to them. Researchers have found that the current circulating strains of the H5N1 viruses are becoming much more deadlier in mammals.

Practically, all the health news headlines in the last few months have been dominated by one news – the increasing spread of Bird Flu. Germany, France and even Spain have finally succumbed to the deadly ways of disease. Wild animals such as tiger and leopards have been detected with bird flu, but the news that shocked everyone was the reported death of a cat with bird flu. The chance that this major health problem will become even more acute has increased manifold, especially if the main domesticated animals like cats and dogs become infected. Where does that leave humans?

Avian flu has already killed 95 people (data available as of 6th March 2006) and seeing the trend, might kill even more. What started with 3 cases of infected dead people with the bird flu in Vietnam has now become a raging disease in the entire South East Asian region with Indonesia, Vietnam and Cambodia now joining the bandwagon.

The interesting thing about Vietnam is that though it had 93 cases of infected persons, only 42 deaths have been reported. On the other hand Indonesia, with just 27 cases, has 20 people dead. The chances are that, not all the cases may be reported to the authorities. What that means is that there are people out there with avian flu, who firstly don’t know that they are infected and secondly may not seek any treatment. This raises the possibility of the virus mutating within their bodies and the increasingly unwelcome prospect of human to human transmission. Though, no reported cases of direct human-to-human transmission have been reported, the risk of that happening is very high today.

Bird Flu is caused by the deadly H5N1 strain of the influenza A virus. It normally occurs in birds and is highly contagious to them. Researchers have found that the current circulating strains of the H5N1 viruses are becoming much more deadlier in mammals. From 1997 to 2006 the H5N1 virus strains have increased in virulence in experimentally infected chickens and mice. They are also much hardier. They now survive several days more in the environment. One path breaking study has shown that ducks infected with H5N1 virus are now shedding more viruses for longer periods without showing any symptoms of the disease. This means that, there is a very high risk of them transmitting the disease to humans.

In humans the flu symptoms include fever, cough, sore throat, muscle ache, eyes infections, pneumonia and acute respiratory distress. Since these viruses do not normally infect humans, we do not have any immunity against them. If there is a Pandemic, then millions will die. The last pandemic – The Spanish Flu of 1914-1918, killed 25 million people. Clearly we have to take steps to prevent bird flu.

One of the first steps taken by the international community was to ban import of bird and poultry products from the infected countries. But is this ban being enforced properly? There is a need to further tighten controls on the ban. Among, the various bird flu precautions is the need to keep strictly poultry indoors till the H5N1 infection dies out in wild birds. The ideal way to prevent any virus is universal vaccination.

Though scientists are confident of developing one. They are still months away from developing the technologies to mass-produce it. And, there is always the possibility of the virus mutating before that. But what about those already infected with it? Those who are currently infected need to be treated at the earliest. Already two anti-viral drugs Amantadine and Rimantadine have been found to be ineffective against bird flu. Currently, avian flu treatment revolves around two drugs that were found to be effective against the current strains of the H5N1 virus. These are Oseltamivir and Zanamivir. Studies comparing the two drugs have shown no major differences in terms of efficacy and tolerability in patients. The problem with Zanamivir is that it has to be inhaled and cannot be taken in orally. This makes it extremely inconvenient to use.

This makes Oseltamivir known by it’s popular brand name Tamiflu the ideal drug to treat bird flu. Tamiflu is the original research product of Roche, a Swiss pharmaceutical company. Tamiflu acts to inhibit the enzyme neuraminidase which is essential for viral replication. Therefore Tamiflu halts the spread of the virus. The earlier it is used the lesser the spread of the virus. Thus administering Tamiflu early is so important.

Recent studies in mice have shown that the current strain of the H5N1 virus requires much higher doses of Tamiflu and longer duration of administration (eight days) to induce the antiviral effects and survival rates seen with the 1997 strain of the H5N1 virus strain. However, early treatment will definitely provide the greatest clinical benefit.

The approved doses of Tamiflu are 75 mg twice daily for 5 days in adults and weight adjusted doses for 5 days in children older than one year of age. These include twice daily doses of 30 mg for those weighing 15 kg or less, 45 mg for those weighing between 15 to 23 kg, 60 mg for those weighing between 23 to 40 kg and 75 mg for those weighing more than 40 kg. But, these does are sufficient for treating only early approved mild cases of influenza A (H5N1). Higher doses of 150 mg twice daily in adults for 7 to 10 days can be considered for treating severe infections. However, we need more sufficient scientific data to be absolutely sure of this.

Tamiflu is available as 75mg capsules and as a 12mg/ml tutti-frutti flavored oral suspension for children who can't swallow pills. Tamiflu may be taken either with or without food. The most common side-effects are rash, swelling of the face, fever, nausea and vomiting. In children, vomiting, abdominal pain, nose bleeds ear disorders and conjunctivitis are more common. Also certain Tamiflu precautions need to be adhered to. Those allergic to the drug must consult their doctor immediately.

In the case of women who are already pregnant or planning to get pregnant or who are breast feeding, it is ideal to check with the doctor before taking this medication. For those already at high risk of getting infected must take a prophylactic dose of Tamiflu – which is 75 mg once daily for 7 days. These include people who are working with poultry, hospital staff, researchers and relatives of those who are infected. If you are a concerned parent or are a person at high risk of bird flu, especially an elderly person, do not wait – buy Tamiflu and combat bird flu. Tamiflu is easily available online through the internet. What more you can buy Tamiflu at very economical prices.

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