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by Marijana Domazet, Monday, 25 March 2013 | Categories: Influenza | Tamiflu

Although the most notable outbreak of the swine-flu peaked in 2009, the reports regarding the virus and its treatment have continued to make headlines in mainstream media. A few days ago, researchers in Australia presented findings that indicated that a cluster of virus samples showed that it was resistant to oseltamivir in around 10% of cases in New South Wales. Oseltamivir is the active ingredient in Tamiflu.

These findings were presented at the Annual Scientific Meeting of the Australasian Society for Infectious Diseases. The emergence of this resistant strain of this virus, which is called H1N1pdm09, gave rise to several concerns among public health experts. The first concern came from the fact that this virus was found in the community, rather than with sick patients who had pre-existing conditions, which resulted in a weak immune system. This implied that the concern for the spread of the virus would not only be for particularly vulnerable patients, but also for healthy individuals. The second concern came from the fact that the H1N1pdm09 had spread to individuals who had never been treated with Tamiflu. This indicated that the virus could spread quite effectively from one person to another even if there is an oseltamivir intervention. The final concern, which was never stated by researchers, but has been noted in mainstream media, was the controversy regarding the efficacy of Tamiflu that had been reported in the last 12 months.

We were not surprised to read about a treatment resistant virus developing, as it has happened in the past with other diseases and treatments. Adamanatane was used to treat influenza but this is now largely obsolete for this purpose following a development of resistance. However, we were surprised to see that not all the reports had put the findings into context. The Australian researchers reported that they had found this to affect two per cent of their study sample, and a total of eight resistant cases were confirmed in the UK to date. Naturally it could be argued that these numbers are concerning, however they are far from alarming. Similarly, while it is important not to underestimate a new resistant strain of the virus, this strain is just one of many viruses that are circulating. This is in stark contrast to how it was when the swine flu was the dominant virus in 2009. Perhaps the most encouraging news was the fact that although H1N1pdm09 appears to be resistant to oseltamivir, other reports suggested that the same virus might be sensitive to zanamivir (which is the active ingredient in Relenza). Relenza operates in a different way from Tamiflu (even although it also disables the influenza virus through neuraminidase inhibition).

We feel that once these findings have been put into context, they show a more realistic version of the implications of this new virus. The importance of monitoring the spread of new viruses and strains of viruses is understandable, but our interpretation of the findings to date suggests that it is too early to be alarmed by these reports. The really scary flu virus is H5N1. If that started to pass from human to human in meaningful numbers then we may have a very serious problem.

by Robert MacKay, Tuesday, 11 December 2012 | Categories: Tamiflu

The editor or the BMJ has written to the chairman of NICE requesting that they withdraw their recommendation on Tamiflu. While we support the open data campaign by the BMJ, we are not supportive of the NICE recommendation being withdrawn prior to the review of the data that have been withheld by Roche. It is our view that Roche must comply with its promise made back in 2009 to provide access to all data relating to oseltamivir, the active ingredient in Tamiflu. GSK, the manufacturer of Relenza, has already promised to make anonymised patient level data available to researchers. This level of access really should be the norm; it is actually outrageous that commercial organisations can withhold this sort of information from genuine interested parties such as academics, the medical profession and regulators such as NICE. Issuers of marketing authorisations can request this information but we understand that no request was made by the European Medicines Agency for these data. The recent infringement proceedings brought against Roche by the EMA would suggest that the company itself has not even properly evaluated the data gathered. We know from clinical practice that Tamiflu works but the profession and regulators need to know the full story.

by Robert MacKay, Thursday, 13 October 2011 | Categories: Influenza | Tamiflu

Those considered high risk for the flu virus this year are being warned by the Department of Health to get the jab that will protect them from the 3 main flu viruses. For the second year in a row, pregnant women have been added to this list and are urged to avail themselves of this free vaccination before there is a shortage as there was last year due to those eligible coming forward much too late.

Statistics reveal that less than 50% of the under 65s eligible actually received a vaccination against the flu virus last year. This is a worrying fact considering that 602 people died from the flu in 2010, 70% of which were between the ages of 15 and 64 years.

People who are eligible for the flu vaccine on the NHS are the over 65s, people under 65 who have a chronic medical condition or a weakened immune system and pregnant women. Anyone falling into these categories should contact their GP in the first instance.

The Online Clinic can prescribe antiviral medications such as Relenza and Tamiflu in advance of need. These medications must be taken within 48 hours of the onset of symptoms.

by Robert MacKay, Friday, 07 January 2011 | Categories: Tamiflu

It has been reported that supplies of Tamiflu, the antiviral prescribed for the treatment of flu, are low and according to the Department of Health, this is not a national shortage but rather local supplies experiencing temporary depletion. The NHS however says that this is an issue concerning the national supply. Where the NHS cannot provide immediate supplies, private healthcare can.

For Tamiflu to prove effective, it must be taken in the early stages and within 48 hours of symptoms developing. Tamiflu is also taken to prevent the virus from manifesting if you has been in close contact with an infected person.

The manufacturers say that they can meet the demand of the public but the warning goes out to pharmacists and those who have the power to prescribe Tamiflu, to ensure they order sensible amounts of the drug and to avoid stockpiling. It is stockpiling that will cause a national shortage.

Tamiflu and Relenza are available for next day delivery at The Online Clinic following a short online consultation with one of our doctors.

by Robert MacKay, Wednesday, 29 September 2010 | Categories: Tamiflu

Previously criticised for its ineffectual role in the H1N1 pandemic of 2009, Tamiflu is now to be praised for its effects on flu patients thanks to research carried out by the Chinese Centre for Disease Control and Prevention.

The study published in the British Medical Journal showed that out of 1,200 patients who were being treated in a hospital for swine flu, those who were treated with Tamiflu were 80% less likely to develop pneumonia.

Moreover, the research uncovered that beginning the course of Tamiflu (oseltamivir) within 2 days of experiencing flu symptoms, reduced the spell of fever and the patients became less contagious.

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