Tuesday, December 19, 2006

Re overblown Avian Flu hype and Tamiflu issues

Earlier this year, the media and some bloggers (primarily on Daily Kos) were quite shrill in warning us of the dangers of Avian Flu. Were they right? Was there so much to fear?

According to a CBS News report yesterday titled "Bird Flu Alarm Bottoms Out:"

It's that time of year again — avian flu panic season. As the weather turns colder in the Northern Hemisphere and the flu starts making its annual rounds, the media and their anointed health experts are chirping and squawking once again about how we could be blindsided by a pandemic that some have estimated could kill a billion persons worldwide. ...

Not coincidentally, an avian flu bureaucracy has become entrenched. Like all bureaucracies, it will fight to survive and thrive, egging on governments to provide ever more money. The alarmingly titled 2006 Guide to Surviving Bird Flu is published by no less than the Department of Health and Human Services. Never mind that no one in this country has yet even contracted bird flu. Congress last year allocated $3.8 billion to prevent the ballyhooed catastrophe (Bush requested almost twice that amount). The latest "scary news," promulgated in the November 23 issue of the New England Journal of Medicine by über-alarmist Robert Webster of St. Jude Memorial Children's Hospital, is that human cases of H5N1 contracted from birds are continuing to increase. Indeed, confirmed cases for 2006 are running ahead of those for last year. But the difference is slight; 97 worldwide for all of last year versus 111 through the end of November 2006. This difference could be entirely explained by better surveillance. Moreover, the real concern is not sporadic bird-to-human transmission, but human-to-human transmission. Far more people die of tuberculosis in an hour than all those known to have died from H5N1.

So it's time to revisit the allegations and show that, as small as the risk was a year ago, it's nevertheless dropped considerably since. ...

Hysteria over an avian flu pandemic has been very good for the Chicken Little media, authors, ambitious health officials, drug companies, and even Bush bashers. (An alarmist fantasy published by Nature magazine in May 2005 concluded by predicting a pandemic outbreak in December of last year, laying the blame entirely at the president's feet.) But even as many of the panic-mongers have begun to lie low, the vestiges of hysteria remain — as do the misallocations of billions of dollars from more serious health problems. Too bad no one ever holds the doomsayers accountable for the damage they've done.

(I omitted the scientific data but encourage all to read the full CBS article - it's chock full of data to support the article author's opinions on this point.)

When the scare first really started appearing all over the blogosphere, I noted that, coincidentally or not, Donald Rumsfeld held a substantial investment in the company that owned Tamiflu, the only curative drug (as opposed to symptom masking drugs) manufactured and available on a fairly wide scale. Wouldn't you love to be a shareholder of the firm that was getting millions of orders not only in America, but internationally, due to all the hype and hysteria?

Well, now we see that, along with billions of dollars wasted on stockpiles of a medicine we will not likely need to use in large quantities, the medicine itself may be more dangerous than had been thought.

Some recent morning, in my waking fog, I heard on NPR a story about the dangers of Tamiflu. I tried to find a US newspaper story on this, but the best I can find is one from Ireland, from the Irish Medical News site:

Ireland’s main defence against a flu pandemic, Tamiflu, has been linked to 25 deaths worldwide and several hundred cases of serious neuropsychiatric events in young people, including delirium, hallucinations, convulsions and suicidal behaviour.

The adverse effects have prompted international warnings from several North American and Asian health agencies. However, no such warnings have been issued in Ireland or Europe, and the HSE has admitted it knows nothing about any problems with Tamiflu, despite the grave reactions linked to the drug.

Meanwhile, the US Food and Drug Administration (FDA) and Health Canada have asked that Tamiflu manufacturer Roche include new warnings on the label of its anti-viral drug which will state reports of neuropsychiatric events such as self-injury and delirium in patients with influenza. While Roche has issued the new warning labels, it cannot confirm any direct link.

In a letter to US doctors, released in mid-November, Roche says that “the relative contribution of the drug” to these cases “is not known”, but it advises doctors and parents to “closely monitor patients for signs of unusual behaviour throughout their course of treatment.”

In the US, we spent, according to the CBS report cited above, $3.8 billion to fight the strain H5N1. The good news is that $1 billion of that is going into research to find faster ways to develop vaccines (the current chicken egg incubation method takes 9 months; mammalian cell incubation can be done in 90 days, per the CBS piece). So the bad news is, where did those other billions go? To a drug that has enough potential harmful side effects to warrant warnings by the US government?

I'm glad to see someone in the mainstream media acknowledging, appropriately, that the hype was overblown. For now, the danger appears anything but imminent. But I'll leave you with this weird tidbit from a USA Today article from August 1, 2006:

Using a new method to test potential pandemic flu strains, scientists have created a virus that contains genes from human and bird flus and found it lacks what it takes to cause a pandemic.

The researchers combined genes from a human flu strain, H3N2, and the H5N1 bird flu strain that emerged in Hong Kong in 1997, which is an earlier version of the deadly strain that is circulating in parts of Asia, Africa and Europe. They found that in animal experiments, the mixed virus lacks "the key property that predicts pandemic spread."

But experts say other gene combinations or mutations could turn H5N1 into a pandemic strain.

...The experiments were risky in that "the possibility was there" that a highly transmissible pandemic strain might have been created in the lab, said researcher Jacqueline Katz, "but the study was conducted using the most stringent safety precautions" in a biosafety level 3 lab.

The question that haunts me is this: If government scientists did succeed in creating a pandemic strain, would we be told? I wonder.


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