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H5N1 virus harder to detect in Humans

Siamese

Senior Member
<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR><TD colSpan=2><HR></TD></TR><TR><TD colSpan=2>AVAIAN FLU
H5N1 virus now harder to detect in humans
http://www.nationmultimedia.com/2006/08/18/national/national_30011374.php

Health officials say changes caused by flu drug oseltamivir might be why tests on two recent cases were negative at first


The bird-flu virus H5N1 has become more complex, probably as a result of the antiviral drug oseltamivir, and that has caused complications in detecting it in the laboratory, the Public Health Ministry said yesterday.


Dr Paijit Warachit, director-general of the Department of Medical Sciences, said there had been laboratory failures in detecting the lethal virus during the first tests of the two most recent cases of bird flu this year.


"It's been more difficult to test [the virus] this year," he said. Both cases were confirmed as H5N1 in a subsequent test.


"It may be because the progress of the disease [in humans] has become more complicated," Paijit said.


One factor could be the effect of oseltamivir, or tamiflu, which is believed to be the only effective defence against bird flu in humans.


The drug, Paijit said, was only able to prevent the virus from replicating and did not destroy it. That meant little of the virus was excreted into that part of the respiratory tract where specimens are taken for testing.


"[Medical staff] took swabs in that area, yet as it turned out there was not enough of the virus to enable them to detect it," he said. "The virus was deeper in the respiratory passage."


It had also just been learnt that with these two cases it was found the bird-flu virus had been buried even further into the respiratory tract than the influenza virus, Paijit said. In order to get a complete specimen for testing, health workers were told to probe deeper with their equipment.


Since 2004 when bird flu emerged in Thailand, the ministry has tested more than 4,000 people for the virus and the failure rate due to incomplete specimens had been only 3 per cent, he said.


But that figure had risen to 20 per cent this year, Paijit said.


"We need to continue our studies to see whether the virus will become more and more difficult [to detect] in the future," he said.


In response to findings by Chulalongkorn University scientists that a new form of the virus had been detected in Nakhon Phanom, Paijit said the strain had yet to infect humans.


The virus was found in poultry and it would probably be more virulent than the old one, he said.


Meanwhile, caretaker Public Health Minister Pinij Charusombat yesterday called a meeting with about 500 private hospitals and clinics to seek their cooperation on bird-flu surveillance and reporting of patients suspected of having bird flu.


"It's a concern that some private hospitals may be failing to report a suspected case for fear it could scare their patients," Pinij said. Any health facility that failed to report a case would face harsh punishment.


The Public Health Ministry had also joined with the Bangkok Metropolitan Administration and the Drug Stores Club of Thailand in stepping up screening of patients with suspected bird-flu symptoms.


Bangkok Governor Apirak Kosayodhin said he had ordered poultry checks to be increased and had set a limit on the movement of poultry into Bangkok in order to prevent avian flu being spread in the capital.


Arthit Khwankhom
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Re: H5N1 virus harder to detect in Humans

Well the article above partially answers my question posed last week, about how far a particular strain has to change to make it less easy to detect.
 
Concerns raised over wider oseltamivir use

Concerns raised over wider oseltamivir use

Concerns raised over wider oseltamivir use
[SIZE=-1]Expert: Bird flu virus may become resistant[/SIZE]

[SIZE=-1]APIRADEE TREERUTKUARKUL[/SIZE]
<!--img--><!--/img-->Increasing use of oseltamivir, one of the only drugs known to be effective in treating bird flu in humans, has prompted concerns about H5N1 resistance to the remedy. The Public Health Ministry and the Bangkok Metropolitan Administration recently allowed hospitals to treat people with influenza and bird flu-like symptoms with oseltamivir, even if they had not been in contact with fowls.

Previously, patients with bird-flu like symptoms had to be transferred to state hospitals for quarantine and in-depth disease investigation.

However, private hospitals are now allowed to treat suspected bird flu cases with oseltamivir and build up their own oseltamivir stockpiles.

An additional 100,000 doses of oseltamivir would be reserved for treating people contracting influenza, including avian influenza, since the outbreak in humans and poultry was severe this year, said Paijit Warachit, Medical Sciences Department director-general.

At present, oseltamivir, better known by its trade name of Tamiflu, is the best defence against the lethal H5N1 strain of bird flu and other types of human flu. The closely related zanamivir drug is also effective, but has to be inhaled, almost impossible for patients with severe lung damage caused by the virus.

Yong Poovorawan, a virologist at Chulalongkorn University's faculty of medicine, said continuous and wide use of oseltamivir was likely to trigger viral resistance.

''Although there are no reports of oseltamivir resistance in humans in Thailand so far, we have to be aware that it could happen,'' he said.

Doctors should think carefully before giving the drug to patients.

Dr Yong said H5N1 resistance to oseltamivir had been confirmed in four bird flu patients in Vietnam, three of whom died last year.
Although virus mutations leading to drug resistance were rare, the Vietnam cases raised the possibility that oseltamivir might be less effective than anticipated, particularly as resistant strains of H5N1 become more prevalent, he said.
http://www.bangkokpost.com/News/18Aug2006_news15.php<!--/Content-->
 
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