News - Bird Flu Drug Resistance Fears

Indonesia's confirmed bird flu death toll has risen to 11 as new disturbing evidence emerges that the virus may be developing resistance to Tamiflu, the only drug known to be effective against the virus.

A 39-year-old man and an eight-year-old boy were Indonesia?s latest victims of the H5N1 strain of the virus, a hospital spokesman said.

"It's been confirmed. We were informed of the results this morning," Ilham Patu, a spokesman for Sulianti Saroso hospital, Indonesia's main centre for the treatment of bird flu said.

Routine samples

Indonesia, the world's fourth most populous nation, routinely sends samples of cases that test positive locally abroad for verification.

The man, a resident of South Jakarta, died on December 13, a day after being admitted to the hospital. The boy died two days later at a private hospital in Jakarta.

Health ministry official Hariyadi Wibisono said the test results were from the Centers for Disease Control in the US and not from a World Health Organisation-linked laboratory in Hong Kong, as Dr Patu said earlier.

Asked about the contradictory information, Dr Patu said: "My information was obtained from the health ministry's research and development center. But in any case, it's confirmed."

Most victims in Indonesia have come from densely-populated Jakarta, where many people still live in close proximity to poultry, providing ideal conditions for the virus to pass to humans.

Hundreds of officials and veterinary students began visiting houses across the capital, looking for sick poultry as part of a nationwide campaign to fight the disease.

"The surveillance is aimed at monitoring poultry that may be infected with bird flu," said agriculture ministry official Makmur.

He said that the students were trained last month by experts from the UN Food and Agriculture Organisation.

Tamiflu resistance

In Vietnam, bird flu had become resistant to the anti-viral drug Tamiflu in two fatal cases, a doctor said in what he called a worrying development.

Tamiflu is considered a frontline defence against bird flu and the most effective treatment available to counter the H5N1 strain.

Menno de Jong, from the Institute of Tropical Diseases in southern
Vietnam's Ho Chi Minh City, said Tamiflu was ineffective in fighting the virus in two girls who died despite being given full doses of the drug.

"Our two patients became resistant despite a full dose of treatment. Both died and in one patient there are some suggestions that the therapeutic failure and ultimately her death may have been caused by the development of resistance," he said.

This patient was a 13-year-old, who died eight days after showing the first symptoms. The other, 18, died three weeks after the onset of symptoms.

"What will be important is to try to learn as much as possible from the next patients. We need to improve treatment of bird flu in this region," he said.

Vietnam has been the country hardest hit by bird flu, which has killed more than 70 people across Asia.

In China state media reported that human trials of a bird flu vaccine had begun this week, with six volunteers being given shots.

The experiments, which will be carried out on 120 volunteers in Beijing, will last nine months but preliminary conclusions are expected in around three months.

Various companies around the world are trying to develop a vaccine against the virus.

But the WHO's top official in China has said that they might be useless in the event of a pandemic because the virus would have mutated.

Scientists fear that H5N1 may mutate into a form that could be easily passed between humans, sparking a pandemic with a potential global death toll of millions.

Increase doses

Swiss pharmaceutical group Roche says increased doses of Tamiflu may be needed to treat human cases of virulent bird flu because of the virus?s growing resistance.

The company says in a statement it may also be necessary to combine the drug with other antiviral agents to treat H5N1.

It says other treatments for the virus need to be explored including higher dose and/or longer duration of treatment with Tamiflu or a combination of antiviral agents.

"Roche agrees that other treatment regimens for the H5N1 virus need to be explored, including higher dose and/or longer duration of treatment with Tamiflu, or a combination of antiviral agents."

Roche said that safety data supported the use of higher doses.

Clinical research was already underway with the World Health Organisation (WHO) and the US National Institutes of Health to assess the effectiveness of a higher dose, before the study on drug resistance was published, Roche spokeswoman Martina Rupp said.

SBS - The World News