A head-in-the-sand approach’: The U.S. strategic drug stockpile is inadequate for a bird flu outbreak
BY
CAROLYN BARBER
June 24, 2024 at 1:25 PM EDT
……
What’s even more worrisome in the U.S., though, is what happens next. Assuming the H5N1 outbreak eventually reaches far more people than the
three who’ve been confirmed so far in connection with dairy cows, how prepared are government agencies to react to widespread infection or a pandemic?
Increasingly, experts fear, the answer to that question is a grim one. “Our antiviral supply for influenza is inadequate,” says Rick Bright, immunologist and former director of the Biomedical Advanced R&D Authority. “We need to diversify it—and even that is not enough, with what we have approved (to treat flu). We need to be developing additional treatment options.”
An inadequate national stockpile
The issues are multifold. The antiviral that the U.S. has in the greatest supply, Tamiflu, has been
questioned not only for its path to government approval (virtually all of its clinical trials were drug-company sponsored), but also for its ability to reduce the risk of
hospitalization or
serious complications of flu. Yet sources told……
In response to information obtained by the author of this article and viewed by
Fortune that has not previously been made public by the CDC,
a spokesperson confirmed that oseltamivir (generic for Tamiflu) showed a 16-fold reduction in its ability to inhibit the H5N1 virus collected from an infected dairy worker in Texas, when compared to the activity against a seasonal virus.
That reduction is considered minor, the spokesperson said, and the CDC continues to recommend “prompt antiviral treatment with oseltamivir for patients with confirmed or suspected H5N1 virus infection.”
….
That finding, though, confounded experts. “While (the reduction doesn’t mean the Texas virus will be fully resistant to Tamiflu, it is a clear indication that the virus has reduced susceptibility,” says Bright. “Most likely it would take a higher treatment dose or a longer duration of treatment with Tamiflu to be able to treat someone with this H5N1 virus
, but more testing is needed
…At this point, we cannot rest comfortably that what we have in the stockpile will be sufficient or even adequately effective against H5N1 viruses in people.” (A CDC study did find that the virus was sensitive to some of the other anti-viral drugs tested, including Baloxavir.)……
No ‘miracle drugs’
Even if Tamiflu worked well, the approximately 55 million treatment courses the U.S. has on hand would be inadequate to treat large-scale human H5N1 infection, especially if it was used preventativelyfor close contacts, as the CDC currently
recommends. “I don’t think there is good data right now that supports its use prophylactically,” says Francesca Torriani, medical director of infection prevention and clinical epidemiology at UC San Diego Health. “In my experience as an infectious disease physician, that is a recipe to basically develop resistance.”
…..lots more
:tiphat:
https://fortune.com/2024/06/24/us-strategic-drug-stockpile-inadequate-bird-flu-outbreak/?abc123