The rapid development of resistance to Tamiflu was a “surprise,” but shouldn’t have been, says David M. Weinstock, MD, of Harvard Medical School in Boston, who co-authored an editorial accompanying the new studies. The exact same pattern of resistance developed against two older flu drugs, adamantine and rimantidine, he explained. In 2006, the CDC recommended doctors stop using these drugs to treat patients with the flu, and use Relenza or Tamiflu instead.
Some experts had suspected that the Tamiflu-resistant strain might be less likely to spread, and less likely to make people sick. But the new report on cases from the 2007-2008 flu season by Dr. Dharan and her colleagues shows that this is not the case. Their analysis of 1,155 influenza A (H1N1) samples from last year’s flu season found the resistant strain made people just as sick as the non-resistant strain. However, according to Dr. Dharan, “there’s nothing that makes us think that this virus is more transmissible or causes more serious disease.”
This study also showed that the resistance wasn’t due to people over-using Tamiflu, but something that just happened on its own. “There’s an innate property of the virus that confers innate resistance to this medication,” Dr. Dharan explains.
Right now, doctors have no easy way to tell if someone is infected with a flu virus that is resistant to a particular drug, although such tests could become available years down the road. Pediatricians often use rapid tests that can determine if a sick child really has the flu. Such tests aren’t typically used in adults, according to Dr. Moscona, because their symptoms are much more straightforward: they quickly get a fever and respiratory symptoms.
There is a test available to distinguish between influenza A and influenza B; if your strain belongs to the B family, Tamiflu will still work for you. But this test is rarely used, Dr. Weinstock says. (In general, three types of influenza viruses circulate every year—two A strains and a B strain.)
If you do suspect the flu, get yourself to the doctor ASAP, Dr. Moscona urges. The earlier you receive treatment, the more effective it will be.
Most importantly, get vaccinated, experts say. If you haven’t gotten a flu shot or inhaled vaccine yet, it’s not too late; the flu season won’t be over for a few more weeks. But it’s best to get immunized as soon as the shot becomes available, in October, well before the flu season is in full swing, according to Dr. Dharan.
You should also stay informed. Flu treatment recommendations have changed rapidly, and patients who keep track of them may be just as well informed as their doctors, who likely aren’t getting the information any sooner, according to Dr. Weinstock. “This is the kind of thing where patient education really could be very useful.”
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Comments (8)
Interesting article but misses an important point: the rise of antibiotic/antiviral resistant flu parallels the widespread practice of feeding poultry/birds antibiotic treated feed…most new strains of flu originate in birds.
I had influenza strain A this year, that was resistant to Tamiflu. I made it to the doctor within the required 24 period to start antivirals. Problem is NOT ONE pharmacy in my area(large urban area) stocked the Rilenza drug. All said they could get it in within 3 days, but that would have been too late. Maybe someone at the CDC should have informed pharmacies of the new information released in Dec 2008. Might have helped me and others.
It startles me to realize that people don’t pay attention. In history we learn that the flu virus has killed more people than many wars. And in biology we learn that virus’ are prone to mutation. Just as in bacteria this high mutation rate leads to drug resitance. Why does the high mortality rates and increasing drug resistance suprise us? Because somebody didnt pay attention in high school.
With the continued over immunization of the populace for everything under the sun we are basically screwing with the bodies natural ability to fight off disease. The human immune system is an amazing thing and here the human race is running around and leading people to think that we all need to get every new immunization that they come up with regardless of how dangerous the sickness it treast. For the most part there aren’t that many diseases that should be immunized for and in the case of flu only small portions of the population actually are in need of immunization.
Last week I took a flight to New York and the person I was going to see did not even show up. I came home then last week with a terrible flu, I think that it was that. I took bottles of cough medicine, and still have a cough. It was awful.
I had chills and sweats, and could not get any relief.
Marilyn Bloch
Maybe if they stopped recommending “nearly everyone with the flu” get antivirals, the incidence of resistant strains would be less frequent. Any smart doctor would recommend only the immune-compromised, elderly and children receive antivirals–the rest of us can deal with it and stay home for a couple of days.
Dominic: “the rise of antibiotic/antiviral resistant flu parallels the widespread practice of feeding poultry/birds antibiotic treated feed” -antibiotics have absolutely nothing to do with the flu which is caused by a virus. Antibiotics have nothing to do with a virus. They are unrelated. *Corinna: “Maybe someone at the CDC should have informed pharmacies of the new information released in Dec 2008.” -They did. That’s why they were sold out. *Jason: “Why does the high mortality rates and increasing drug resistance suprise us? Because somebody didnt pay attention in high school.” -It doesn’t surprise anyone. It says so in the article. *Jayson: “For the most part there aren’t that many diseases that should be immunized for and in the case of flu only small portions of the population actually are in need of immunization.” -Totally false. There are many diseases that should be “immunized” for and the more people that get the flu vaccine the less the disease spreads. That is how we stop epidemics that killed millions in history. *Sara: “Any smart doctor would recommend only the immune-compromised, elderly and children receive antivirals–the rest of us can deal with it and stay home for a couple of days.” -Why aren’t you teaching in medical school? And getting sick from the flu lasts longer than a couple a days.
You could sit down and discuss with your bridesmaids about your plans to buy cheap bridesmaid dresses due to limitations in budget.