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Antibiotic Resistant Infections Will be Problem During Pandemic
by Anthony L. Kimery
Tuesday, 19 August 2008
'Of course bacterial infection following influenza should be of concern'
Pandemic health preparedness authorities, virologists, and other scientists are expressing alarm over the findings of two new studies that indicate a potentially significant number of people died during the horrific 1918 influenza pandemic in part because highly opportunistic bacterial infections were able to flourish in these flu victims because the virus severely weakened their immune systems.
Scientists today also have found that the virulent H5N1 flu virus profoundly short circuits a person?s immune system, especially people with healthy systems.
But what's of particularly grave concern is that a terribly weakened immune system is vulnerable to aggressive bacterial infections like the virulent strain of Staphylococcus aureus that?s been linked to seasonal influenza deaths and has developed a resistance to many of the antibiotics used to treat it.
Last fall, the "Journal of the American Medical Association" (JAMA) reported that a strain of methicillin-resistant Staphylococcus aureus (MRSA) that has been spreading across the country is causing more life-threatening infections than public health authorities had thought, and killing more people in the US each year than AIDS.
The revelation that a pandemic strain of influenza could hasten the spread of antibiotic resistant bacterial infections like MRSA in flu patients is especially disturbing, and presents an entirely new set of challenges for pandemic preparedness planners.
HSToday.us earlier reported that hospital-acquired infections (HAIs) like MRSA that kill an estimated 90,000 to 100,000 Americans each year during routine hospital stays could be expected to run rampant during a health crisis in which tens of thousands ? or more ? persons require emergency medical care under what will likely be less than sterile and sanitary conditions. Conditions most authorities agree are primarily responsible for the transmission of HAIs like MRSA.
HAI infections can cause serious illnesses and, in severe cases, death. Indeed, infectious diseases are a major cause of illness, disability and death, statistics and authorities point out.
Consequently, "we have to realize that it isn't just antivirals that we need" during a pandemic, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and coauthor of one of the studies published in the "Journal of Infectious Diseases."
"We need to make sure that we're prepared to treat people with antibiotics," Fauci stressed.
?Yes, of course bacterial infection following influenza should be of concern, and antibiotic resistant bacteria of even greater concern,? Dr. Graeme Laver told HSToday.us.
A former professor of biochemistry and molecular biology at the John Curtin School of Medical Research at the Australian National University in Canberra, Laver played a key role in the development of the antivirals Tamiflu and Relenza.
Laver has been studying influenza viruses for nearly 40 years. Along with colleague Dr. Robert Webster, the two are credited with having first found the link between human flu and bird flu. In the 1960's, both received world acclaim when they developed a new and innovative generation of vaccines for flu viruses.
Both new studies ? the other published in "Emerging Infectious Diseases" ? indicate that opportunistic infections are able to take hold in the upper respiratory tract of flu victims because of the flu?s ability to provoke a severe immune system reaction called a ?cytokine storm.?
This problem is prevalent in victims infected with the H5N1 flu virus which, unlike seasonal flu viruses, upsets the chemical messengers that regulate immune function in a healthy, vigorous immune system, thus activating an inordinate number of immune cells.
Studies show children and teens between birth and 19 years of age account for nearly 46 percent of all H5N1 flu deaths in the world.
Similarly, the 1918 pandemic flu virus struck down an inordinate number of young, healthy adults.
Prior to the new studies linking virulent influenza to the onset of opportunistic bacterial infections, a team led by Menno de Jong of the Oxford University Clinical Research Unit in Ho Chi Minh City, Vietnam, urged that ?the focus of clinical [pandemic] management should be on preventing this intense cytokine response by early diagnosis and effective antiviral treatment.?
?If virus replication can be stopped in the early stages, then the likelihood of bacterial infection will be greatly reduced,? Laver said.
Laver earlier explained to HSToday.us that ?If people with flu symptoms take Tamiflu immediately, say within six or so hours after symptom onset, the infection should be rapidly terminated, the person should recover, and then, and this is important, should then be immune to reinfection for the rest of the pandemic.?
Laver said ?this has been called ?Aborted-infection Immunization,? and to use Tamiflu in this way would allow many health care workers and so on to go about their business without fear of reinfection.?
by Anthony L. Kimery
Tuesday, 19 August 2008
'Of course bacterial infection following influenza should be of concern'
Pandemic health preparedness authorities, virologists, and other scientists are expressing alarm over the findings of two new studies that indicate a potentially significant number of people died during the horrific 1918 influenza pandemic in part because highly opportunistic bacterial infections were able to flourish in these flu victims because the virus severely weakened their immune systems.
Scientists today also have found that the virulent H5N1 flu virus profoundly short circuits a person?s immune system, especially people with healthy systems.
But what's of particularly grave concern is that a terribly weakened immune system is vulnerable to aggressive bacterial infections like the virulent strain of Staphylococcus aureus that?s been linked to seasonal influenza deaths and has developed a resistance to many of the antibiotics used to treat it.
Last fall, the "Journal of the American Medical Association" (JAMA) reported that a strain of methicillin-resistant Staphylococcus aureus (MRSA) that has been spreading across the country is causing more life-threatening infections than public health authorities had thought, and killing more people in the US each year than AIDS.
The revelation that a pandemic strain of influenza could hasten the spread of antibiotic resistant bacterial infections like MRSA in flu patients is especially disturbing, and presents an entirely new set of challenges for pandemic preparedness planners.
HSToday.us earlier reported that hospital-acquired infections (HAIs) like MRSA that kill an estimated 90,000 to 100,000 Americans each year during routine hospital stays could be expected to run rampant during a health crisis in which tens of thousands ? or more ? persons require emergency medical care under what will likely be less than sterile and sanitary conditions. Conditions most authorities agree are primarily responsible for the transmission of HAIs like MRSA.
HAI infections can cause serious illnesses and, in severe cases, death. Indeed, infectious diseases are a major cause of illness, disability and death, statistics and authorities point out.
Consequently, "we have to realize that it isn't just antivirals that we need" during a pandemic, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and coauthor of one of the studies published in the "Journal of Infectious Diseases."
"We need to make sure that we're prepared to treat people with antibiotics," Fauci stressed.
?Yes, of course bacterial infection following influenza should be of concern, and antibiotic resistant bacteria of even greater concern,? Dr. Graeme Laver told HSToday.us.
A former professor of biochemistry and molecular biology at the John Curtin School of Medical Research at the Australian National University in Canberra, Laver played a key role in the development of the antivirals Tamiflu and Relenza.
Laver has been studying influenza viruses for nearly 40 years. Along with colleague Dr. Robert Webster, the two are credited with having first found the link between human flu and bird flu. In the 1960's, both received world acclaim when they developed a new and innovative generation of vaccines for flu viruses.
Both new studies ? the other published in "Emerging Infectious Diseases" ? indicate that opportunistic infections are able to take hold in the upper respiratory tract of flu victims because of the flu?s ability to provoke a severe immune system reaction called a ?cytokine storm.?
This problem is prevalent in victims infected with the H5N1 flu virus which, unlike seasonal flu viruses, upsets the chemical messengers that regulate immune function in a healthy, vigorous immune system, thus activating an inordinate number of immune cells.
Studies show children and teens between birth and 19 years of age account for nearly 46 percent of all H5N1 flu deaths in the world.
Similarly, the 1918 pandemic flu virus struck down an inordinate number of young, healthy adults.
Prior to the new studies linking virulent influenza to the onset of opportunistic bacterial infections, a team led by Menno de Jong of the Oxford University Clinical Research Unit in Ho Chi Minh City, Vietnam, urged that ?the focus of clinical [pandemic] management should be on preventing this intense cytokine response by early diagnosis and effective antiviral treatment.?
?If virus replication can be stopped in the early stages, then the likelihood of bacterial infection will be greatly reduced,? Laver said.
Laver earlier explained to HSToday.us that ?If people with flu symptoms take Tamiflu immediately, say within six or so hours after symptom onset, the infection should be rapidly terminated, the person should recover, and then, and this is important, should then be immune to reinfection for the rest of the pandemic.?
Laver said ?this has been called ?Aborted-infection Immunization,? and to use Tamiflu in this way would allow many health care workers and so on to go about their business without fear of reinfection.?
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