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stress quick treatment for H1N1

stress quick treatment for H1N1

Patients who have flu-like symptoms and are having trouble breathing should get quick treatment with the antiviral drugs Tamiflu or Relenza, even before getting a flu test, U.S. officials said on Tuesday.

And doctors should consider setting up a system so that patients most likely to become severely ill from H1N1 swine flu have a prescription on hand so they can just call up to get the go-ahead to take the drugs if they develop symptoms, the U.S. Centers for Disease Control and Prevention said.

“Treatment should not wait for laboratory confirmation of influenza because laboratory testing can delay treatment and because a negative rapid test for influenza does not rule out influenza,” the CDC says in updated guidelines, available here

“The very young and very old, people with chronic medical conditions and pregnant women in general ought to be treated with antivirals when they have an influenza-like illness,” the CDC’s Dr. Anne Schuchat told reporters.

But most people will not need any treatment at all for H1N1 because most of those infected so far have recovered on their own. “They can be cared for with mom’s chicken soup at home, lots of fluids and rest,” Schuchat said.

The latest guidance suggests officials are keen to make sure people who need it get very quick treatment, while making sure people who do not need the drugs do not abuse them.

Both GlaxoSmithKline’s Relenza and Roche AG’s Tamiflu can help save the lives of patients severely ill with any influenza, if given within a day or so of symptoms starting. They can also ease the misery of milder cases and even prevent flu if people take it just after exposure.

But supplies are not infinite and health officials worry that the more people take them, the quicker the virus will evolve resistance, rendering them useless. Two older flu drugs, amantadine and rimantadine, are already useless against seasonal flu.

The CDC is clear that some people should take the drugs prophylactically — to prevent infection. That includes some healthcare workers and people with high-risk conditions such as asthma who know they were in close contact with an infected person.

But the new guidance adds an option to watch and see if the person gets a fever. “Instead of the preventive use of antivirals, clinicians may consider watchful waiting,” Schuchat said.

A vaccine against H1N1 swine flu is being tested but will not be available until mid-October. The CDC recommends that about 160 million people line up for the first doses starting then.

“Virtually all the influenza circulating now in the United States is the 2009 H1N1 strain,” Schuchat said. It has not mutated and the vaccine is still a good match, she said.

She said only a handful of cases of resistance to Tamiflu, known generically as oseltamivir, have been reported.

In the United States, 24 elementary, middle or high schools closed because of H1N1 outbreaks last week, letting 25,000 students out of class. The CDC advises against closing schools unless so many students or staff become ill that the school is overwhelmed.

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Early use of antivirals key in H1N1 flu: WHO

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Early use of antivirals key in H1N1 flu: WHO

Early use of antivirals is effective in treating H1N1 flu and health authorities must be vigilant for signs of drug resistance, the World Health Organisation said on Friday.

Drug-resistant pandemic flu viruses have appeared infrequently so far and there is no evidence they are spreading, but further cases are likely, the WHO said on its website.

Growing international experience showed the importance of the early use of oseltamivir, manufactured as Tamiflu by Roche Holding and Gilead Sciences, or zanamivir, an inhaled medicine produced as Relenza by GlaxoSmithKline in swine flu cases,” the WHO said.

“The experience of clinicians, including those who have treated severe cases of pandemic influenza, and national authorities, suggests that prompt administration of these drugs following symptom onset reduces the risk of complications and can also improve clinical outcome in patients with severe disease,” the Geneva-based U.N. agency said.

“This experience further underscores the need to protect the effectiveness of these drugs by minimizing the occurrence and impact of drug resistance,” it said.

Most people who contract pandemic influenza suffer only mild symptoms before recovery without treatment, but children, pregnant women and those with some existing health conditions are vulnerable to a more severe attack or even death.

The WHO, which declared H1N1 a global pandemic in June, says one third of the world’s population of nearly seven billion people could catch it.

The risk of resistance is higher in patients who suffer from weak immune systems and have already been treated with oseltamivir, it said.

It is also high in people who are treated with the antivirals as a prophylactic — as a precaution after exposure to someone with influenza, but nevertheless develop the disease.

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New flu drug may resist mutations: researchers

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New flu drug may resist mutations: researchers

A new type of experimental flu drug that stops the virus from infecting cells appears to stop it from mutating into drug-resistant forms, researchers reported on Sunday.

Tests in mice and in lab dishes show that NexBio Inc.’s drug Fludase can stop the seasonal influenza virus from infecting cells and can fight strains of virus that have evolved resistance to Tamiflu, Roche AG’s popular influenza drug, the company said.

“Extensive, prolonged nonclinical influenza studies have not shown the development of any meaningful resistance,” the company said in a statement released at the Interscience Conference on Antimicrobial Agents and Chemotherapy in San Francisco.

Privately held NexBio Inc. said tests showed that Fludase, also known as DAS181, worked against the new H1N1 swine flu virus too.

Influenza viruses very quickly change to put up a strong defense against antiviral drugs. Last year the seasonal H1N1 virus developed strong resistance to Tamiflu. Two older flu drugs, amantadine and rimantadine, now have very little effect against influenza viruses.

Tamiflu and a similar drug, GlaxoSmithKline’s Relenza, affect a compound in the flu virus called neuraminadase — which gives flu viruses like H1N1 the “N” in their names.

Fludase affects the human cells that influenza infects, not the virus itself and that should make it less likely to cause the virus to develop resistance, company spokesman Dr. David Wurtman said.

It affects the sialic acid receptor — the molecular doorway that flu viruses use to attach to cells, he said.

“It makes it impossible to spread, so it can’t infect neighboring cells,” Wurtman said in a telephone interview.

Teams at the U.S. Centers for Disease Control and Prevention, University of Hong Kong and Saint Louis University in Missouri ran the experiments, the company said.

“Based on these encouraging data, we are moving forward with our ongoing clinical development of DAS181, and we will continue to work closely with FDA (the U.S. Food and Drug Administration), CDC and NIH (the National Institutes of Health) on this clinical program during the current pandemic,” Dr. Ronald Moss of NexBio, who presented the study, said in a statement.

Health experts predict that new drugs to fight flu will soon be needed, as the virus is mutation prone. Many are in development — furthest along is BioCryst’s peramivir, which would be made and sold in partnership with Japan’s Shionogi.

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