What is the risk of Avian Influenza to human health?

Anxiety over an H5N1 influenza pandemic has become significant in many countries. Medical experts around the world state that in the event of a bird flu virus mutation which is then infectious person to person, the medical outcome in terms of morbidity and mortality on humankind would be horrendous.

Until now human infections have been caused by direct transmission from bird to human or from diseased surfaces from bird excrement. People need to realize that it is unusual for human to human transmission. The odds of infection in this manner remain quite low and for those people who have become infected through avian contact the result has been a severe form of influenza and fifty percent mortality.

Apprehension is high in populations because of the ability for influenza viruses to change into a new strain with the potential to infect people around the world. This would be the case if the H5N1 virus began the steady mutation process and began claiming victims due to human to human transmission.

Up until now there is no sign of any form of person to person infectious capability with the H5N1 bird flu virus. Also there has been no confirmation by any firm means that a new strain of avian influenza is about to menace the world’s population. That said, agencies such as the World Health Organization or WHO are on guard for any unusual events with this avian virus, so we try and remain calm about it all.

Is There Anything We Can Do To Stop Bird Flu?

Currently there is really only a vaccine for avian flu that is so new it hasn’t been tested by difficult illness scenarios and is still really in production/trial phases. What people need to remember is that washing hands thoroughly and frequently is still probably the best preventative solution of all. If you have been exposed to the bird flu or contact has been made with an infected individual, you should wash your hands before doing anything. Keep your hands away from your mouth nose and eyes. When you wash your hands count to twenty to do the job thoroughly.

Remember your common sense precautions including hand washing, sneezing or coughing into a tissue or into the crook of your arm works too. Keep up with your seasonal flu injections. The annual vaccine for seasonal flu won’t help you with the bird flu but it will inoculate you against the seasonal variety. If a person was suffering with the seasonal flu and made contact with the H5N1 virus the result could be a viral perfect storm allowing the mix to mutate the avian strain into a different and perhaps more virulent and infectious.

There are some measures that can be taken to aid in the prevention of a severe global pandemic of avian flu which comprise:

Depending on personal circumstances some individuals are stockpiling N-95 face masks and or throwaway breathing apparatuses, some type of eyesight defense, hand protection, protective clothing, and hand sanitizer in addition to other practical safety gear.

Plan to teach anyone who will require it, the proper use of this equipment, disposal of waste and the process for disinfection of personnel and equipment. In the event of a pandemic the resources you need may not be available and it could be too late to prepare otherwise.

Be sure that all medical supplies are usable and there are sufficient stores of essentials. The medical kits should contain basic first aid materials and any prescription medications needed to get by. A supply of OTC medicines for stomach relief, pain killers, colds, cough and allergies. This kind of kit is useful in a number of emergency scenarios, not just a pandemic situation.

Be sure everyone at home and work are aware of sanitary hygiene like proper hand washing with soap & water particularly before and after meal preparation and after using the bathroom. Regular hand cleaning with alcohol based [minimum 60% alc.] hand sanitizer and proper etiquette for controlling coughs and sneezing when around others to avoid spreading germs.

Again, all people should have a supply of their prescription and non prescription medications on hand as well some energy drinks like Gatorade and other fluids containing vitamins etc in case of a long stay indoors.
Families should start stocking up on water and food in advance of a pandemic. Having enough essentials on hand during an outbreak in the local area that can sustain a family for 2 weeks is advisable. It must be reiterated that in case of a pandemic, it may not be as easy as just driving to your grocery store if employees are ill or stock isn’t being transported while the threat passes. Stores may close so be prepared.

Avian Flu: Potential Crisis

As of now the H5N1 avian influenza virus has been concentrated in Asia, the Middle East and areas of Europe. Everyone else is closely observing the bird flu virus trying to ensure it doesn’t enter anymore countries. The avian flu is fairly common in feral birds but can wipeout populations of domestic poultry/birds very rapidly. The worry is that humans are not equipped with a natural resistance to bird flu virus, so if it mutates and becomes aggressive in humans there is no defense, only medical intercession. Fortunately the strain has not yet mutated, unfortunately this also means that a vaccine cannot be produced to control a new mutation. Currently the only way to repel thee H5N1 virus is through stringent prevention measures that are followed by non infected populations.

Avian Influenza Pandemic Personal Preparedness Plan

In a pandemic there will most certainly be things you can do to limit exposure and keep your family safe. Social distancing is critical to avoid infection, even when there is only limited illness locally, in a pandemic this can change extremely quickly. Start planning now for future potential exposure to the virus. That means when the local outbreak is in full mode you want to remain isolated from everyone outside of your immediate family. You should leave your residence for essential shopping only such as fuel, water, drugs and food. Hopefully you have stocked a supply in advance but there may be a need to venture out so take some precautions.

With this in mind you should only be traveling to the grocery store, gas station, discount store, pharmacy, or convenience store. This is not an ideal time to be strolling through the mall or window shopping.

Go on these shopping expeditions during the slowest possible times so your exposure will be limited to as few people as possible. Now would be a good time to explore which stores are open 24 hours. Find out the hours of these stores and which are open late in the evening or early in the mornings. Find out the time that you will likely be the only patron other than a couple employees.

Be sure to have your vehicle/s topped up with gas since fuel may be out of stock due to a run at the pumps or lack of fuel delivery. Do not drive far for supplies given potential fuel supplies. Make substitutions in your planning if necessary – if a grocery store is open 24 hours at 4 mile distance it would be worth going at 5 am if variables above are right rather than going fifteen miles for the same thing – that would waste gas.
Walking is fine if you do so during the day though there will be more people out, your safety is more important. Some individuals tend to get reckless with their behavior in a time of crisis. Local law enforcement may not be as prevalent during a bird flu pandemic so walk in daylight if necessary and drive at night for your protection.

What supplies you should buy:

Bottled water – Canned vegetables – Canned fruit – Sauerkraut [promotes the development of good bacteria in your body which aids in repelling H5N1 [in Asia you can use Kim Chi] – manual can openers –garlic – onions – canned or cooked meat – fresh meat if you have the means to continue cooking it.
Fresh vegetables – fresh fruit – horse radish – ginger root – dried meat – cheese preferably low in fat – eggs – fresh milk – powder and canned milk – canned fish.

You need superior vitamins and health supplements, specifically vitamin C – selenium – zinc – Omega 3 – lysine – beta glucan – vitamin E – beta carotene – vitamin B complex – green foods that have chlorophyll – ginseng – resveratrol – magnesium – DHEA – quercetin – bioflavonoids – yogurt.

Soap [extra water for washing] – alcohol sanitizer wipes – Antiseptic hand lotion – propane – kerosene – First aid kit with tea tree oil and nu-skin – hot and cold packs – vaporizer – dental cleaning supplies – toilet paper and diapers – various cleaning soaps – reading materials – jigsaw puzzles and deck of cards.

What won’t be necessary:

Useless herbs and supplements that do nothing to augment your immune system – candy bars and snack foods – sugar and sweets – bread – rice – spaghetti and noodles/ pastas – cigarettes – alcohol – fruit juices – soda pop – Decrease your odds of becoming infected by the avian influenza H5N1 virus by boosting your immune system and to survive in the event that you are infected by it. Avoid anything that raises your chance of becoming infected by avian flu and avoid everything possible that can deteriorate personal immunity. A pandemic is something you have no control over but you can protect yourself and your family. It is not the time to be personally indulgent nor is it a time to be self conscious about protecting you and yours so take the required actions to beat the odds.

Bird Flu

Any chance for a vaccine to combat the H5N1 influenza will probably take a while yet to produce. Should the major pharmaceutical companies start producing immediately after an epidemic occurs, there won’t be enough of the vaccine to offer any kind of adequate provision for the nations that are in dire need – meaning the Asian countries. This means that for the foreseeable future antiviral medications such as oseltamivir –generic tamiflu and zanamivir – relenza and perhaps other older antivirals such as amantadine and rimantadine are going to be the first line of defense.

Drugs such as generic tamiflu and amantadine are referred to as neuraminidase inhibitors which both decrease and shorten the severity of flu symptoms and they can provide prevention measures from influenza as subsequent contact and seasonal prophylaxis medications. Influenza preparedness strategies recommended by the World Health Organization, WHO, and many governments globally as a rule support detection, isolation, primary responder protection, and beginning antiviral treatment therapy for those with the illness and those in contact with them. Most national governments have already begun warehousing at exorbitant costs, huge amounts of generic tamiflu [Oseltamivir] in preparation for a potential epic rash of illness.

in any case, the effectiveness of the neuraminidase inhibitors, even when taken as a prophylaxis in healthy people taken within the forty eight hour window from the beginning of flu symptoms is only small. The utilization of tamiflu in five of ten cases documented in Vietnam did not display any clear medical effectiveness and there was an eighty percent fatality rate found in this effort. Neither tamiflu – oseltamivir nor relenza – zanamivir, were directly evaluated in the restricted study.

Both antiviral medications have related pharmacological properties and both offer comparable effectiveness; zanamivir- relenza appeared to have fewer side effects to manage and a better resistance report. This resistance report would carry much weight in the event of a pandemic. The zanamivir is not being stockpiled in anywhere near the amounts as tamiflu is and this could be because of the potential challenges of administering an inhalant medication for children and intellectually impaired persons. Zanamivir does have some original and practical methods for use in children.

The incidence of bronchial problems and decreased lung utility is not very common, and those suffering with asthmatic conditions and chronic obstructive pulmonary disease or [COPD] are able to abide by the inhalation of the zanamivir – relenza, along with the placebo. Zanamivir has options for dry inhalant devices which are popular among these same patients even in times of problematic situations with their illnesses.

With this in mind, nation governments need to contemplate warehousing zanamivir as an antiviral option along with generic tamiflu as part of their emergency preparedness planning. The antivirals must be dispensed to ill patients and those who have been exposed to them within forty eight hours of becoming symptomatic. The logical position for health officials to take is allowing community health care services and drug store pharmacists to be responsible for getting the antivirals medications into the hands of those who need them in a timely manner rather than counting on potentially overstretched hospital based health providers to do the job.

All nations and their health services sector should include H5N1 study trials in their preparedness planning testing a dual role for tamiflu and zanamivir with prospective new medications and not; specifically testing SIRNA’s and interferon. These are in experimental phases now and hold promise as antivirals. More important is that these studies when conducted in the outset of a pandemic offer valuable data for late stage virus control and patient care. Vaccine producers are located mainly in wealthier industrialized nations and so delays getting the bird flu vaccine into the underprivileged Asian countries that need it. The wise decision would be to initiate some production of neuraminidase inhibitors and vaccine in these areas to rectify these shortages. Questions arise about drug patents during a pandemic that could lead to global crisis.

From a virus control perspective having available tamiflu and zanamivir antivirals stockpiled and or produced in these outbreak countries would aid in controlling the anticipated spread of the illness, nipping it in the bud so to speak. Developers such as Roche for oseltamivir [generic tamiflu] are already licensing out to many overseas countries. India has pharmaceutical companies prepared to begin producing generic tamiflu but cannot obtain government approval to do so. Restrictions and red tape need to be removed in order to take the fight to the virus with as much clinical punch as possible.

Medical study modeling has displayed to researchers that H5N1 influenza is more contagious than severe acute respiratory syndrome [SARS virus] and the preparations and management model for controlling SARS may not be sufficient for a pandemic of influenza, particularly H5N1. If this isn’t looked at and changes aren’t made to these plans the community health services in infected nations will become strained to the maximum in short order. SARS showed that when hospital personnel are under equipped in staff and resources they become discouraged and personnel begin to abandon their posts. Especially when these first responders begin to see their co workers become infected by clinic borne H5N1 contagion and they aren’t treated in an ICU setting. Health care officials at all levels of government must see that they protect their health care providers and show they are being conscientious. These health care professionals on the front line will also be depended on for their skills to handle the repercussions of a pandemic so their continued health should be paramount in the planning stages of a pandemic.

Bird Flu

The Message is clear that women who appear showing influenza type symptoms or illness need to be treated as quickly as possible. There shouldn’t be any waiting for a test result to verify the illness. There has been an update of the advice for preventative prophylactic treatment with antivirals in groups prone to risk [or chemoprophylaxis]. There have also been instructions updates for infant feeding that looks further into using masks and a requirement for a careful stance on stemming viral infection in infants though there is not much information to refer to. The recommendations are fluid based upon what is currently understood about the H1N1 viral spread within America and updates are planned as data becomes available.

The first known human infection with this strain of swine flu [the name was changed by the WHO to Novel influenza A H1N1 due to concerns over pork sales among other reasons] occurred in April 2009. The illness has been severe in pregnant women though the depth and transmission of this strain is under intense examination to better understand its effect on pregnant women and infants.

Though current information is not readily available, harkening back to past epidemics and pandemics is useful and available data for seasonal influenza and the effect on pregnant women is also being used in studies. There were an above average number of influenza linked fatalities in pregnant women throughout the Spanish influenza pandemic of 1918-1919 and the pandemic of Asian flu in 1957-1958. There have been unfavorable pregnancy results reported subsequent to prior influenza pandemics including miscarriage and premature births particularly in those women who contracted pneumonia.

Case studies and epidemiology reports carried out during pandemics past and interpandemic periods concluded that a women’s risk is greater during her pregnancy for complications related to influenza and there are signs of perinatal difficulties and delivery problems.

Women who become infected with the Novel influenza H1N1 strain of the infection it is predicted would have the normal respiratory illness seen in influenza cases presenting symptoms such as sore throat, runny nose, fever and cough. Perhaps accompanied by body aches, headaches, fatigue, diarrhea and vomiting and most pregnant women will proceed with a normal infliction of influenza without complication.

However, certain pregnant women will find the illness hitting harder and faster than others and possibly have secondary infections such as bacterial pneumonia. It’s during these difficult times for the mother that prenatal fetal distress caused by the maternal illness. There are reports of maternal fatalities as well as fetal complication outcomes linked to relentless illness. The ideal scenario would have the pregnant women being tested for influenza at an early symptomatic phase but delays in treatment for testing and awaiting those results are highly inadvisable since antiviral treatment are at their most effectual in the first forty eight hours of from the beginning of symptoms.

Testing will often take several days and may not be available at all for the Novel H1N1 though research is being undertaken vigorously to discover a rapid testing kit with great progress being made.

Primary health care providers need to be aware of the influenza outbreak in local areas of their practice and bypass the testing process in favor of treatment in those women who are pregnant and presenting symptoms of H1N1 influenza A illness.

Treatment and Chemoprophylaxis

Pregnant women who present with influenza like symptoms should undergo the earliest treatment possible with antiviral medications. Health care providers mustn’t wait for test results to come in to determine if influenza exists before starting treatment. Therapy should be initiated as soon as possible once symptoms begin to show for the best chance of success with these medications. The H1N1 influenza that is currently being transmitted has shown sensitivity to the neuraminidase inhibitor antiviral drugs zanamivir [Relenza®] and oseltamivir [Generic Tamiflu] but has built a resistance to adamantane antivirals amantadine [Symmetrel®] plus rimantadine [Flumadine®] .

Generic Tamiflu is an oral medication and the drug is absorbed systemically and the zanamivir is inhaled which lowers the systemic absorption somewhat. Tamiflu and Relenza as treatments and chemoprophylaxis course of therapies are suggested for women who are pregnant and are the same as if for an adult who is inflicted with seasonal influenza. In no way should a pregnancy be measured as a contraindication to tamiflu or Relenza usage. All indicators show pregnant women are more susceptible to harsh complications resulting from a bout with Novel H1N1 influenza A infection. They would benefit from a course of treatment or preventative therapy using Generic Tamiflu or Relenza, the risks outweighed by the antiviral use at this stage of infection in a pregnant women.

There have been some unfavorable reactions in those women who have ingested the antivirals generic tamiflu and Relenza though there has been no link between these adverse effects and actually taking generic tamiflu or relenza in pregnant women. It is recommended that health care providers stay up to date on CDC releases for the further use of generic tamiflu and relenza for H1N1 influenza A infection as the virus’ data is compiled over time so patients can further benefit.

Treatment Recommendations

Pregnant women showing flu like symptoms should have their medicinal therapy initiated before a firm diagnosis is confirmed. Because of its absorption process generic tamiflu is the drug treatment of choice and the treatment course recommended should last five days. There should not be any hold up of treatment while awaiting testing results since antiviral drugs for empirical use for anyone on this regimen need to be started within forty eight hours of the onset of influenza indicators being discovered. This therapy initiative is based on information collected from research conducted during seasonal influenza outbreaks.

This data also showed that there are benefits to those patients who are in hospital receiving the medication even after the forty eight hour time period so the antivirals are to be initiated for all high risk individuals who are symptomatic and in need of care whether or not the forty eight hour onset rule is exceeded, including pregnant women, persons with chronic illness and lowered immunity levels and those who require hospitalization.

Chemoprophylaxis Recommendations

Subsequent contact viral prophylactic use of medications like generic tamiflu and zanamivir should be judged useful for pregnant women who are confirmed or suspected of being infected with the Novel influenza A H1N1 virus. The medication most recommended for disease prevention or as a transmission inhibitor is likely zanamivir because of its partial systemic absorption properties. There could be certain problems associated with zanamivir usage because it is administered as an inhalant which may result in respiratory complications in women at risk of these ailments. Tamiflu then becomes the drug of choice for these patients.

The duration for this preventative treatment course is ten days after exposure to H1N1 virus was finally noticed. Pregnant women in multiple exposure situations to the virus in familial circumstances as an example, need to be monitored closely to determine the actual time period for preventative treatment depending on their medical situation and how it develops.

Hyperthermia [Fever] Treatment

One severe unpleasant symptom that affects influenza sufferers is the related hyperthermia or fever condition in a patient. Research has revealed that hyperthermia in pregnant women specifically in the first three months of pregnancy doubles the odds of having developmental problems with the fetal central nervous system or neural tube defects and could also be responsible for other birth defects and unfavorable birth results. Some research shows that hyperthermia related birth complications may be lessened by medications such as antipyretics or multivitamins such as folic acid which is highly recommended even for naturally progressing pregnancies.

Pregnancy related fever during labor constitutes further risks like developmental complications and neonatal problems such as seizures, cerebral palsy, encephalopathy and even neonatal fatality. Trying to determine the cause of a fevers effects from the fever itself is troubling so treatment of the hyperthermia is the first priority and Acetaminophen seems to be the choice option for fever control during a pregnancy.

The suggested dosages for antiviral drug treatment for novel influenza A H1N1 strain virus infections are as follows:

Tamiflu [Oseltamivir]

Adults should take 75 mg capsule twice daily for five days – 75 mg capsule once daily.

Zanamivir

Adults should inhale two 5 mg doses [10 mg total] twice daily for 5 days – Two 5 mg inhalations [10 mg total] once daily.

Other Ways To Reduce Risk For Pregnant Women

Currently there is not a vaccine available for the prevention of influenza A H1N1 infection though medical researchers are working feverishly to develop a potent anti virus vaccine. Therefore, the risk of getting infected by the influenza virus could be dramatically reduced if certain precautions are taken to decrease the chance of accidental exposure. Individuals should practice the following steps:

• Washing hands frequently for twenty seconds
• Minimize one’s contact with infected individuals
• Making certain those infected with the flu remain house bound [leaving only for medical aid]
• Coughing or sneezing into the elbow crook
• Practice social distancing by keeping at least six feet away from groups or crowded environments and staying away from areas of H1N1 infectious outbreak exposure.
• When required use a mask or respirator in the proper fashion.

Infant Feeding Considerations

Babies who are not being breast fed are at more risk of respiratory infection and are further susceptible to illness and a hospital stay than babies who are being nursed. Those women who remain influenza free should be positively reinforced to start or continue their breast feeding regimen and do so often. Under the proper conditions infants should be receiving their primary nourishment and nutritional enrichment from breast milk and so any bottle supplements should cease so babies can take in as many of their mothers antibodies as possible.

When considering H1N1 influenza and children it is thought that infants are at the most risk of all from H1N1 infection and precious little is known or understood about the infection in tiny infants. Recommendations such as only healthy adults should care for babies including feedings. Again little is known about the transmission of influenza A H1N1 virus through breast milk though reports of virus in the bloodstream for seasonal influenza is uncommon, the passing of infection into mother’s milk is likely just as infrequent an occurrence. If the possibility exists to pump milk from a virus infected mother for bottle supplementation feeding by a healthy family member, this process should be reinforced positively. It should once again be noted that generic tamiflu or relenza are not contraindicated for breast feeding.

Proper hygienic etiquette is crucial to women who are alone caring for infants while infected with influenza H1N1 virus. Ideally when ill there will be someone else available to assist with infant children. Women who are infected should also wear a facemask when feeding babies and caring for them in general to reduce the transmission of the virus.

Parents and caretakers need to be instructed on the proper methods for reducing the spread of infections like influenza A H1N1 virus which can result in respiratory complications and illness.

• Always wash hands and practice cough etiquette
• Use social distancing with children and keep them away from crowds.
• Be careful to control sharing of toys or other personal things which may have been in a child’s mouth and clean with soap and water if these items have been touched orally.
• Keep a supply of disinfectant wipes available for quick cleansing of hands or objects.

Swine Flu

Nearly one thousand virus samples of H1N1 pandemic influenza have been studied by the WHO’s Global Surveillance Network labs to test for antiviral medication resistance. All viruses showed sensitivity to tamiflu and zanamivir. The WHO and its members will carry on with their scrutinizing of tamiflu and relenza and virus resistance of the drugs.

The resistance shown to the medication tamiflu are considered irregular and random cases of resistance. There has been no extensive antiviral resistance displayed by pandemic H1N1 influenza viruses on these drugs in evidence so after assessing the threat potential the WHO has declined to modify their treatment direction and tamiflu remains an important tool in public health preparedness.

Tamiflu

Countries such as the United States, Great Britain among others, who signed contracts with the vaccine producing manufacturers, may be broadsided by those contracts not being honored. Some experts caution that as we enter further into the existing global pandemic, some nation’s governments could find they are facing massive pressure from their populations to safeguard their populace first before shipping the valuable and perhaps limited supplies of H1N1 vaccine abroad.

Countries like England that require all of their vaccine supply to be imported from overseas are vulnerable to broken contracts as is the United States and others who just don’t produce enough of their own vaccine at home. The U.S. now only manufactures 20% of the influenza vaccine that it utilizes and the rest is contracted out of country. One doesn’t have to stretch their imagination to far to understand that in the event of a severe outbreak within a vaccine producing country, governments may be forced politically to hoard the vaccine destined for other countries, regardless of any legal paperwork.

Some experts believe the pressure to forego shipments of vaccine in order to aid in saving their own people would be intense. If they did ship out the vaccine supply as ordered and left their own populace with little or none of their own the result would be chaos. Currently close to seventy percent of the worlds, influenza vaccine is produced in Europe and just a few nations are actually self-reliant in their vaccine stock. There is no easy solution to this potential nightmare scenario since new production facilities can’t open tomorrow. The solution just is not there for more vaccine production.

The World Health Organization [WHO] continues to announce increases in cases of H1N1 flu and the mortality rate continues to rise. The only viable solution for a lack of flu vaccine is to increase stockpiles of antiviral medications such as Tamiflu [Oseletamivir] and Relenza [Zanamivir]. The drugs can meet the demand for treatment and prevention by acting as prophylaxis for citizens who are exposed to illness and also treat influenza patients so illness is less severe. Production of antiviral medication like generic tamiflu has been ramped up substantially since the H1N1 virus reared its ugly head earlier this year after the initial outbreak was tracked to Mexico.

The use of antiviral medications would be a stop gap measure until enough H1N1 vaccine was available for everyone who needed it. To make this scenario even more real is the lack of the expected vaccine yield that was only twenty five to fifty percent of what was expected initially. There is talk that supplies would not be available to countries in need until perhaps the end of the year. The WHO is doing everything it can to see that stockpiles of Tamiflu are getting out to poorer countries and that production is at its peak. They are in contact with the developer and manufacturer oseltamivir – Roche Pharmaceuticals of Switzerland staying abreast of the situation.

Legal experts have spoken out on this situation of broken contracts and non-shipment of vaccine. International law does not have any resolution for contractual situations such as this. It is an unfortunate occurrence that is happening in the core of an epidemiological calamity. The contracts themselves could include a termination clause allowing the contract to be broken if there is an unpredictable situation like a health crisis.

Any nation that is producing influenza vaccine may arbitrarily choose to confiscate all vaccine supplies prior to shipping and place a prohibition order on the export of the vaccine, which would ultimately mean the contract would be broken. Private contracts are not political in the legal sense and are therefore not binding on the parties by international law as if they were two countries.

To this point, the H1N1 influenza virus has been relatively mild to moderate and the seasonal flu kills approximately half a million people every year and the medical experts expect this H1N1 flu to be about as virulent as the regular influenza. If this flu pandemic remains mild than there would be no reason to worry. There were three major pandemics in the last century and the last two in 1957 – 58 and 1968 – 69 found many countries scrambling for available vaccine, this time that is not the case with far more countries brokering deals for guaranteed delivery of vaccine. In the event of a global crisis with this pandemic flu there is no guarantee for any country regardless of how much money and or power they may brandish.

Swine Flu, Tamiflu

A recent study that was carried out found that it was safe and well tolerated in children who had asthma. This is important because asthmatic children can have problems when taking many kinds of drugs. Having a drug that can help against the potentially very harmful effects of flu is therefore important. The same study found that tend rug actually helped to improve an asthmatic child’s lung function, and decreased the effects of an asthma attack. In addition, the drug was found to help decrease the duration of a flu attack.

Some parents have reported an almost instantaneous improvement in their child’s health once they have taken Tamiflu. This is of course not impossibility, but it is not generally the norm in children. On the other hand, some parents report that once Tamiflu is taken, nothing happens in the way of beneficial health in their children. It is not a mystery why this is the case when you consider that one must take Tamiflu within 48 hours of the first influenza symptoms appearing. With many parents not being able to recognise flu symptoms straight away, one can see why this skewed perception of the drug’s effectiveness can happen.

Many people have complete faith in Tamiflu, and believe that it has a genuine positive effect the health f their children and their family as a whole. If a child takes Tamiflu and is around someone who has the flu, it is generally viewed that, in the best case scenario, they never develop symptoms. And if they do, then the symptoms will not be as severe as they could be.

There are some issues as regards Tamiflu. Some people view the cost of the drug to be quite prohibitive, for example. For such a world beater f a drug, it is not difficult to see why it does cost a lot to manufacture and distribute.

The fruit flavour Tamiflu suspension version is actually quite unpleasant for children to take. Anyone who has children and has trued to give them medicine that does not taste nice will understand the problems that come with that issue.

Also, may people feel that the side effects of Tamiflu can make it an unattractive drug to have to consider. No one likes unpleasant side effects, and some people believe the side effects of the Tamiflu drug to be more unpleasant than those suffered with other drugs.

As with most drugs, the side effects with Tamiflu are not common among all takers of the substance. However, they have been reported among enough people to make them worth considering. Vomiting is one of the side effects that have been reported among patients who have taken the drug. This can of course be particularly unpleasant, especially if it is suffered by children. However, if you feel that it is too unpleasant to bear, consult with your doctor, who may be able to offer some kind of respite from the vomiting, or advise on dosage levels.

Stomach pain can also be an issue. However, this, like any other side effect that is linked to any other drug, is not a common occurrence. Possibly quite unpleasant if suffered, your physician should be able to advise you on any relief that you can get for this complaint. If symptoms persist, again the physician may advise of a different dosage of the drug, or even advise that you stop taking the dug altogether.

There have been reports of potentially more serious side effects that have been suffered. These took place in only some areas of the world, and included some hallucinatory episodes suffered by users of the drug. Again, these side effects are very rare, and your physician can keep monitoring your heath while you are taking Tamiflu, to support if any such unpleasantness occurs.

Tamiflu is a very effective drug against the influenza virus. Side effects are rare, as with most drugs, and the beneficial effects, especially on the health of children, are considerable.

Tamiflu

The biggest single impact made on the fight against the flu virus has been the development and use of antiviral drugs. These wonder drugs, of which one is Tamiflu, have been highly useful and effective against the flu virus, with many people reporting a great reduction in symptoms within days, and sometimes hours of taking the antiviral drug. The antivirals have been particularly effective with children who, along with the elderly, are the most vulnerable when it comes to as flu virus.

In some cases, the antiviral drugs are taken quickly enough to seem like preventatives. This is because they do such a good job of reducing the impact of flu symptoms that people generally believe that they have been able to ‘miss’ the flu. While there is no cure for the flu, the high potency of antivirals when it comes to fighting symptoms can make people believe they have been cured of the virus.

Antivirals are considered to be a second line of defence against the flu. Of the four antivirals that are available in the United States, Tamiflu is one of those that are highly recommended for use against flu. This is because, unlike the other antivirals, it shows a high level of defence in a short amount of time. This makes it very effective, and much more powerful than any of the other antivirals that are available.

Your doctor will prescribe you Tamiflu if they feel that you need it to fight against the symptoms of the flu. They will have to take into account various factors before they prescribe. Needless to say, if you are suffering from any major illnesses or condition the chances of you being able to take Tamiflu can be reduced.
Tamiflu may be prescribed for you if:

• You have the flu and want to shorten the duration of the symptoms. The flu can be so devastating an illness that it can leave the sufferer bedridden for several days. The sufferer or a relative may seek out a Tamiflu prescription so that the length of the illness is reduced, allowing the sufferer to get back to work, for example. It is important to remember that the medication must be taken within 48 hours of first feeling ill form the symptoms of flu. If it is not taken within this time period, the effectiveness will be reduced significantly.
• You are in close contact with someone who has the flu. This may be a family member who you see on a daily basis. If this is the case, the doctor may prescribe you Tamiflu to reduce the chance so f symptoms becoming marked. You can ‘catch’ the virus within days of being in contact with someone who has it. If the physician knows that someone in your household has the flu, they may prescribe Tamiflu to prevent symptoms form becoming too debilitating.
• If there is a widespread outbreak of flu in the area and the local community authorities believe that there is significant risk to people who fall into the same age and circumstantial brackets as you do. For example, if you are an elderly person, there is every chance that they will prescribe Tamiflu without consultation. If you are a child, the same could be true. If there is an outbreak than the doctors in the area will act upon the advice of the authorities and prescribe immediately in the hopes of containing the outbreak.

There is every chance that Tamiflu, like other antiviral drugs, may not be appropriate for you. This is due to your medical circumstances air other complications. It may also be because you are taking other medications that will interact in a negative way with Tamiflu. Such negative interactions could include excessive drowsiness, medical ailments that come about due to the interaction between Tamiflu and another substance, or even just a sever impairment of Tamiflu’s effects.

Antiviral medications like Tamiflu can be extremely helpful in reducing the effects that flu can have upon a sufferer. The impact upon the symptoms can be so major, in fact, that the person can believe that they have been ‘cured’. Over time, Tamiflu has made a name for itself as being the most effective antiviral against a wide range of flu strains.

Other steps you can take to prevent yourself from catching the flu include washing your hands well on a regular basis. This simple step is something n that everyone can do after every meal, after using the toilet, and in the morning and night times.

Also, getting a good night’s sleep on a regular basis is highly important. The recommended amount of sleep for the average human being is eight hours. If you are making this amount every night then there is every chance that you are boosting your ability to handle the flu virus if there is an outbreak.

It is also highly important that you make sure that regular exercise is a part of your lifestyle. Whatever happens, if you do get the flu then having a lifestyle that contains regular cardio exercise will boost your chances of a good reaction with any kind of medication that you take. In other words, your body will be more responsive.

Tamiflu is one of the only antivirals that has effectiveness against all the flu strains that have been present in recent times. This means that as a treatment, it is unparalleled. Its effectiveness when it comes to preventative measures also places it highly favourably in the antiviral market.

Tamiflu

In the United States, the Department Of Health And Human Services is thinking about modifying the makeup of their national stockpile of antivirals, which contains eighty percent tamiflu and twenty percent Relenza. The government of Great Britain has upgraded their own stockpile by adding 10 million added doses of Relenza since it has not yet shown any resistance trouble, as has tamiflu.

Tamiflu comprises the majority of in each of the national antiviral stockpile of Canada, which is sustained at the National level and national emergency stockpile. Both of these stores of drugs maintained by the federal government are expected to be able to treat one quarter of the population in the event of a pandemic. This number seems to equal what other countries have warehoused while Britain has stored enough antivirals for half of their population.

Tamiflu

Deliveries of the medication Zanamivir – also known as Relenza – are being topped up in the nations stockpile senior health officials have stated, as a matter of course because of a possible pandemic.

There are also additional stores of the older influenza medication called amantadine being added to th burgeoning supply as a cost effective extra measure. Research is ongoing into utilizing a combination of tamiflu and amantadine or a counterpart med, rimantadine, to see if they can somehow reduce the chances of resistance with various flu strains on the small number of medications now available as a treatment for the flu strains.

Medical experts seem to agree that based on scientific perception, diversification of warehoused supplies makes good sense. The decision was made at the highest levels of government to do so. Health officials have said that there is ongoing debate amongst provincial and territorial governments about the value of also diversifying the medicinal assets within the national antiviral stockpile, which is the place most of the supplies of Canada’s influenza pandemic ready medications are kept. Any expense to increase this stock and to continue sustaining it is shared between provincial and federal agencies.

This national antiviral store of medication holds enough drugs to aid almost 5.6 million persons. Tamiflu is the majority stock numbering at ninety percent of the supply while Relenza makes up the ten percent balance.
For the previous five years or so numerous countries have begun to warehouse antiviral medications, mostly oseltamivir as a precautionary against a potential influenza pandemic. Oseltamivir was a pretty safe choice since it appeared to maintain its potency level against diverse strains of flu. Research data also appeared to display that viruses that did develop resistance were reduced in their ability to spread human to human.
Disappointment was palpable when this theory was proven erroneous during the influenza season of 2008. There was a resistant strain of influenza A virus H1N1 type discovered in Northern Europe that spread rampantly around the globe.

Tamiflu

Included in this increase where previously excluded pediatric groups and those other people or groups who did not figure in the original parameters for receiving the drug as a preventative medicine. The influenza virus can cause serious complications and even death in those patients with seriously compromised immune systems. This would include HIV patients [infected toddlers and infants specifically] and young kids.

The antiviral medication oseltamivir [or tamiflu] has been accepted as a treatment and preventative therapy for influenza virus in patients who are one year or older. Its medicinal counterpart Relenza has been approved for treating serious but uncomplicated illness due to influenza contagion within adults and kids seven years and upwards. They must be indicative of the flu for less than a two day period and may also be treated as a therapeutic prevention drug in adults and children over five years of age.

The Emergency Use Authorization for tamiflu means tamiflu may also be utilized as a treatment and preventative drug in babies under one year old, and also to give optional dosage proposals for kids older than one year of age. As well, based on these EUA’s, both antiviral drugs can also be dispensed to bigger sub sections of society without the need to obey the instructions for the meds based on labeling which otherwise would be the case and provide written description of the emergency utilization. The drugs can also be dispensed by a larger segment of health care providers such as health officials and volunteers as allowed by state and regional laws or health service crisis reactions.

The Emergency Use Authorization though only temporary includes the following broader provisional policies, which are to expire when the emergency is ended:

• Tamiflu can be used as a treatment as well as a preventative therapy for infants under one year of age. As of now, tamiflu can be used on children one year or older. The new options for infants under one year were decided upon after review of safety and pharmacokinetics trials data by manufacturer Roche and the Collaborative Antiviral Study Group NIAID/NIH [National Institute of Allergies and Infectious Disease – National Institute of Health]. Also age appropriate dosage options in older kids formed part of the new proposal. These new EUA options are for the oral use of tamiflu and are as follows:
• Extended EUA tamiflu dosage options for treating influenza in patients with body weight [in kg] body weight [in lbs] dosage by age treatment doses for five days.
• Over 40 kg – over 88 lbs over 10 yrs 75 mg twice a day
• Over 23 kg to 40 kg over 51 lbs to 88 lbs 6 – 9 yrs 60 mg twice a day
• Over 15 kg to 23 kg over 33 lbs to 51 lbs 3 – 5 yrs 45 mg twice a day
• Under 15 kg under 33 lbs 1-2 yrs 30 mg twice a day
• Dosing for Babies younger than one year
• Not considered by weight 6 – 11 months 25 mg twice a day
• 3 – 5 months 20 mg twice a day
• Under 3 months 12 mg twice a day

The bottle dispenser for tamiflu oral suspension medicine is marked of in gram measurements and is available for children weighing more than 40 kg or adults who have a difficult time swallowing pills. Dosages are measured as follows for heavier/older children and adults – 30 mg’s measured followed up by 45 mg measured. For babies under one year a different type of measuring tool needs to be used which can discharge 2 ml [roughly 25 mg], 1.6 ml [approx. 20 mg], or 1 ml [or 12 mg].

Dosages for the current swine flu or H1N1 are equal for each age group however; doses are only given once each day instead of twice a day. When administering preventative dosages they should be consumed for a ten day course after contact with an infected individual or in the event of a localized outbreak.

Utilizing Tamiflu and Relenza for those patients excluded from current labeling instructions. Both medications are presently cited for use on patients showing heightened but uncomplicated influenza and the symptoms have been present for under forty eight hours. This EUA calls for utilization of tamiflu and Relenza in more severely infectious persons or those who have displayed symptoms for more than the forty eight hour time period. This is based on research data and the latest understanding of how H1N1 influenza reacts with different appearances. After considering patient susceptibility and the availability of these antivirals, physicians or health care providers can make an individual risk reward appraisal concerning how best to use these products.

Tamiflu