It’s time for another “told you so” moment. As I’ve been warning for months, the widespread use of Tamiflu to ward off swine flu has started to breed drug-resistant varieties. Now, the media reports the first case where a resistant strain of swine flu has spread from one person to another. While there have been several dozen previous cases of drug-resistant swine flu reported, those were isolated cases, unlike this incident where one person developed the resistant variety and then infected another.
It happened at a summer camp in North Carolina, where 600 kids received prophylactic doses of Tamiflu to keep them from getting sick after a few campers came down with swine flu. Two teen girls who roomed in the same cabin subsequently came down with swine flu anyway — both suffering from a drug-resistant variety of the disease. While experts say that it’s possible the girls simultaneously developed resistant forms of the virus, it’s far more likely that the mutated, drug-resistant virus spread from one girl to another. The fact that both girls had the same, never-before seen mutation of the virus makes the latter scenario even more probable.
The good news is that the girls had mild cases and both recovered. The bad news, if it can be called “news,” is that the incident verifies what I’ve been saying all along — that drug-resistant mutations of swine flu are inevitable, and that these drug-resistant varieties can and will spread, given the cavalier way that Tamiflu has been distributed to the masses. To recap from my last newsletter on the topic, Tamiflu targets a protein called neuraminidase that lives on the surface of flu virus cells. This protein helps the flu virus break through the walls of cells it’s trying to invade so it can move into those cells and replicate itself. Tamiflu inhibits the neuraminidase protein, so that the virus can’t leave its original cell to infect other cells. If it can’t migrate, eventually the virus dies.
The problem is that viruses, including all forms of the flu, excel at mutating, and given enough exposure to anything that inhibits them, they find a way around it. This is particularly true if the inhibiting substance is as simple in composition as Tamiflu, which basically targets just that one protein, neuraminidase. The pharmaceutical industry keeps developing flu-fighting drugs and antivirals that target viruses on just one dimension, and so it isn’t surprising that every new pharmaceutical antiviral that comes out breeds resistant strains and so gets rendered useless. The more it’s used, the faster the flu virus finds ways to mutate around it.
Apparently, this past summer, many camps throughout the US engaged in the practice of distributing Tamiflu to campers in fear of widespread outbreaks. By the middle of July, the Centers for Disease Control had issued a statement urging camps to refrain from giving out Tamiflu wholesale to healthy campers, both to conserve the limited supplies of the drug available and also to prevent the emergence of resistant varieties of the disease. Unfortunately, by that time, campers coast to coast already had received their doses — and that’s just the tip of the iceberg. As I’ve noted before, personal and business stockpiling of Tamiflu has continued unabated since the first appearance of Avian flu in 2005. In spite of World Health Organization recommendations to distribute Tamiflu only to swine-flu infected individuals who are very young, old, pregnant, or who have compromised immune-systems, several countries including England hand out Tamiflu to anyone who claims illness, no doctor referral needed.
In essence, it seems that most of the public and even some key health practitioners and government authorities don’t “get it” when it comes to Tamiflu. They see it as the “miracle cure” and want to be sure that those they care about have their dose on the ready, or even more, that they take it in advance as a protective agent. For instance, the director of one of the camps that handed out prophylactic Tamiflu to its residents, Camp Modin in Maine, took issue with the CDC on its call to refrain from giving out Tamiflu.
“The evidence speaks for itself,” said the director, Howard Salzberg. “I have no children with swine flu at this moment, and we are confident that the Tamiflu helped us remedy the situation. I understand the concerns of the C.D.C, but there is a uniqueness to the camp environment, similar to health care centers and nursing homes.” (Thank you, Mr. Salzberg, but actually, the evidence doesn’t speak for itself. You might as well say, “Everyone at camp drank Coke, and no one got the flu. The evidence speaks for itself; Coke prevents Swine Flu.”)
The physician-father of one of his campers, Dr. Marc Siegel, agreed with Mr. Salzberg. He said he wasn’t worried about depleting national stockpiles since he figures a vaccine will be coming out soon, so might as well nip the bug in the bud via Tamiflu in the interim. (Dr. Siegel probably needs to keep up on his medical journals a bit better. It seems he’s missed all the reports about the explosion in antibiotic and antiviral resistant pathogens over the last few years.)
Meanwhile, rather than join the mass rush on Tamiflu, which as I’ve said continually will most likely be severely compromised by the time flu season hits, and rather than nurse some hope that Relenza (the other drug effective against swine flu) will still work by that time or that the vaccine will be ready and safe — you’d be smart to stock up on natural solutions. They’re safe; they’re cost-effective; and they work on multiple fronts. And here the operative phrase is “they work” — and should continue to work against drug-resistant strains long into the future.
See guidelines and suggestions for protecting yourself in my newsletter of August 3, 2009.