- The Washington Times - Friday, October 14, 2005

From combined dispatches

The bird flu virus found in a Vietnamese girl was resistant to the main drug that’s being stockpiled in case of a pandemic, a sign that it’s important to keep a second drug on hand as well, a researcher said yesterday.

But he said the finding was no reason to panic.

The drug in question, Tamiflu, still attacks “the vast majority of the viruses out there,” said Yoshihiro Kawaoka of the University of Tokyo and the University of Wisconsin at Madison. The drug, produced by Swiss-based Roche Holding AG, is in short supply as nations around the world try to stock up on it in case of a global flu pandemic.

The European Commission announced measures yesterday to combat the spread of bird flu, telling European governments to pinpoint the areas most at risk and to separate poultry from wild birds, which carry the virus.

The commission was acting on the advice of EU health and veterinary experts, who held an emergency meeting after confirmation that the deadly H5N1 strain of bird flu had reached western Turkey and was poised on Europe’s doorstep. EU veterinary experts said that the outbreak of bird flu including a lethal strain found in Turkey does not “at present” pose a risk to public health.

Turkish medical staff yesterday tested nine persons from the western town of Turgutlu for possible bird flu after 40 pigeons died, state-run Anatolian news agency reported.

No sign of illness had been detected but they remained in a hospital for observation, the agency quoted local health official Osman Ozturk as saying.

Portugal’s Health Minister Antonio Correia de Campos said yesterday bird flu could reach his country within a year if the worst happens. He told reporters the probability of this happening was remote, but he said the nation would be ready if an outbreak of the lethal strain of the disease, which has killed more than 60 people in Asia since 2003, should occur.

The flu virus mutates with ease, but it’s still unknown if it mutates into a killer strain or one that’s relatively harmless.

On its Web site, the World Health Organization said: “Further sporadic human cases can be anticipated,” as “human exposure to animal virus could be greater in the coming months,” given that it will be rainy in some areas of Asia where the bird flu has struck, such as Indonesia.

Mr. Kawaoka said the case of resistant virus in a 14-year-old Vietnamese girl is “only one case, and whether that condition was something unique we don’t know.”

He also said it’s not surprising to see some resistance to Tamiflu in treated individuals, because resistance has also been seen with human flu.

In lab tests, the girl’s Tamiflu-resistant virus was susceptible to another drug, Relenza, which is made by GlaxoSmithKline.

Mr. Kawaoka and colleagues report the case in the Oct. 20 issue of the journal Nature, which released the study yesterday. The researchers conclude that it might be useful to stockpile Relenza as well as Tamiflu.

There’s no evidence that the H5N1 viruses — like the one recovered from the girl — are becoming generally resistant to the class of drugs that includes Tamiflu, the federal Centers for Disease Control and Prevention said yesterday.

Both Tamiflu and Relenza are being stockpiled by the U.S. government. Doctors have good reason to believe Tamiflu would be effective at combating a pandemic strain of bird flu, although it’s not clear how long people would have to be treated or what doses they would need, said Dr. John Treanor of the University of Rochester.

In adults with mild cases of ordinary flu, Tamiflu speeds up recovery by a day or two, he said. But its effect on severe flu like bird flu isn’t clear.

The new report, while not surprising, shows scientists must find out more about how people with bird flu respond to Tamiflu and how often they shed a drug-resistant virus, he said.

The shed virus could become a problem if it is transmitted to other people, he said. He noted that in the new report, as in prior studies, the resistant virus was less able to reproduce itself than a normal virus was, which might cut down on the chance of transmission.

The girl, who had been caring for an older brother with the disease, had been taking low doses of Tamiflu as a preventive measure when the virus was isolated in late February. She later got sick and was given higher doses. She recovered and left the hospital in March.

Mr. Kawaoka said it’s not clear whether the low preventive dose had encouraged the emergence of drug resistance.

Dr. William Schaffner of Vanderbilt University called the report important and said it shows the importance of watching for drug resistance.

“It is not unusual to find the occasional resistant virus,” he said. “It could be just a biological oddity, or we could see this more frequently.

“This is a blip on the radar screen, and it surely does mean that we have to keep the radar operative,” Dr. Schaffner said. “We have to keep testing more viruses.”

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