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News of the Day ... In Perspective11/04/2005Shipments of Tamiflu stopped to prevent �hoarding� Yesterday, no fewer than five patients asked the Chief of Staff at Carondelet St. Joseph�s Hospital in Tucson for a prescription for Tamiflu, to have just in case dire predictions of a worldwide pandemic of avian influenza come to pass. But the drug is at present unavailable to private persons. Roche Holding AG has temporarily suspended shipments of Tamiflu to U.S. pharmacies �because of hoarding.� HHS Secretary Mike Leavitt said, however, that U.S. government orders would be filled. So far, national agencies have ordered enough Tamiflu and Relenza for about 5 million people. The Bush Administration hopes to stockpile enough vaccine for 20 million people and enough antivirals for another 20 million (CBSNews.com 10/27/05). While the AMA is opposed to personal stockpiling, public health authorities had not taken a clear stand as of Oct 28. Dr. Craig Conover, medical director for the Illinois Department of Public Health, said that while personal hoarding was unfair, �I have heard people say that the more this gets used, the more manufacturing ability they�ll develop. We�ve chosen to wait for CDC guidance on this� (MSNBC.com 10/28/05). In 1997, the H5N1-type avian virus (named for the type of hemagglutinin and neuraminidase proteins in the viral coat) emerged in waterfowl in Hong Kong, and for the first time began to affect humans. In the last two years, H5N1 viruses have infected 112 persons and killed 57 of these. In the 1918 influenza pandemic, mortality was 1 to 2% of those infected. In the SARS epidemic, each infected person on average infected three others, with a generation time of about ten days. Influenza typically moves much more rapidly, with a generation time of three days. According to Donald S. Burke, professor of International Health and Epidemiology at the Johns Hopkins Bloomberg School of Public Health, avian influenza is an �immediate and real threat to our national security� (Wall St J 11/3/05). The Administration is pressing for the authority to use troops to enforce a quarantine (see report of Bush press conference, Detroit News 10/4/05). Kimberly-Clark Health Care says it has ramped up face mask production to keep up with demand for surgical N-95 masks. Some orders have been 50 times normal. [Don�t forget about the conjunctival route of infection, cautions AAPS.] In France, the government has bought 200 million facemasks and sufficient quantities of drugs to cover its entire population. In Britain, the Blair government is reportedly making contingency plans to create mass mortuaries capable of dealing with as many as 700,000 bodies (wsws.org 10/7/05). Additional information: Vaccine trials: www.newscientist.com Program for tracking influenza in the U.S. only, made available by Roche Laboratories: http://www.tamiflu.com/consumer_dtflutracker.asp Model Emergency Health Powers Acts: www.aapsonline.org
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