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  • Friday, October 28, 2005

    flu the coop

    From an NPR health Q&A: (available here)

    Q: I work as a volunteer social worker. My organization has distributed Tamiflu to each of us -- how effective is it with avian flu? -- Renee Rivera, Ho Chi Minh City, Vietnam

    A: I would tell her not to take the Tamiflu since there is not a threat of human to human spread right now. When you start taking Tamiflu inappropriately, it can lead to resistance of the virus in question to Tamiflu, that's the first thing. As far as how effective Tamiflu is against the serious complications or the serious nature of H5N1, we don't really know. We know Tamiflu works reasonably well in the seasonal flu, the H3N2 flu that predictably circulates each year in this country. It lessens the number of days of symptoms and from a broad stand point, lessens hospitalizations. We don't have hard data because there have only been 118 people infected, and they haven't had a situation where they can give some of them Tamiflu and others not, and compare whether Tamiflu works. We're assuming that it will work with H5N1 with a reasonably good basis for that assumption, but there's no definite proof that it would make a difference with regard to hospitalization or life or death.

    my take:
    Flu viruses mutate a lot. That is why the flu shot next year will be different than the flu shot this year. So keep getting the flu shot, they say.
    Just not Tamiflu.
    What is going on here? Don't take it, the virus may become immune... Is the flu virus this year immune to the flu drugs from past years? Does that make it more virulent?
    I'd really like to know what the chances are of a person who has never had the flu shot catching the most recent strain of flu as compared to the chances of a person who has had all the flu shots catching it. Are all these innoculated people creating an environment that encourages the mutation of the flu that is more likely than previous strains to infect those who have not had the shots? And should that make us rethink the blanket policy on free flu shots for everyone?
    Sadly, I dont think a study that answers these questions is even possible.

    Now, I'm not saying that nobody ought to get the shot, but I dont think everyone should.

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