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Sunday, May 24 2009 This Morning 10°C This Afternoon 21°C 5-Day
Forecast
Tamiflu might not work against swine flu, Government's own scientists
warn
By David Rose
Last updated at 10:45 PM on 23rd May 2009
* Comments (0)
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Swine flu could soon become resistant to Tamiflu, the drug being
stockpiled to fight it, say Government scientists.
A strain of seasonal flu closely related to the swine virus has
already mutated so that Tamiflu is virtually useless against it.
But the Government is spending more than £100million to bring
Britain's stockpile of Tamiflu up to 50million doses – enough for 80
per cent of the population.
swine flu
Stockpile: But swine flu could soon mutate to become resistant to
Tamiflu
Dr Steve Gamblin, the joint head of molecular structure at the
National Institute for Medical Research, told The Mail on Sunday that
the mutation renders Tamiflu about 250 times less effective than it
should be.
'Our research suggests that if Tamiflu is used extensively, mutant
swine flu viruses that are resistant to the drug may well arise,' said
Dr Gamblin.
'Instead of relying on Tamiflu alone, it would be better to use a
cocktail of Tamiflu and Relenza,' – another anti-viral drug to which,
so far, flu viruses have not developed resistance.
However, the Government has stockpiled only about ten million doses of
Relenza and it is more difficult to take. While Tamiflu can be
swallowed as a pill at home, Relenza is a powder that must be
administered with an inhaler, normally under medical supervision.
The NIMR in Mill Hill, North London, is one of four World Health
Organisation centres spearheading research into developing a swine flu
vaccine. But a Health Department spokesman admitted that this is
unlikely to be available in large quantities until the end of
December. If swine flu starts to spread rapidly during the autumn,
Tamiflu and Relenza will be the only lines of defence.
Because swine flu is a new strain no one has inbuilt immunity, which
increases the risk of a pandemic. Two more cases were confirmed in
Britain yesterday, bringing the total to 122.
Dr John McCauley, one of three flu research directors at the NIMR,
said the timing of the start of the annual flu season will be
critical. He said that in 1918, when a pandemic killed more than
50million worldwide, the virus responsible first appeared in the
northern hemisphere in spring, just as swine flu has, then
'disappeared' for the summer.
In recent years, seasonal flu has not started to spread widely until
December or January. But in 1918, the virus re-emerged in September.
'If swine flu comes back in December, it probably won't be too bad,'
said Dr McCauley. 'Much earlier, and we could be in trouble.'
So far, research suggests that swine flu is not exceptionally
virulent. According to the WHO, it is likely to kill about 0.4 per
cent of those who get it.
However, if it did quickly infect millions of people, the death toll
would be substantial, while the strain on the health service and the
wider economy would be immense.
Both swine flu and the Tamiflu-resistant seasonal flu are descendants
of the 1918 pandemic virus, and are classified as H1N1 viruses because
of the distinctive proteins that form their coating.
Tamiflu works by attacking the N1 protein. If taken early, it ensures
that symptoms are mild and reduces the chance of a victim giving the
illness to someone else. But according to Dr Gamblin, it takes only a
'point mutation' – a change to a single amino acid in a virus's DNA –
to render Tamiflu ineffective.
By the winter of 2007-08, he and his colleagues had identified this
problem, while their hopes that the mutation would also make the virus
weaker were later dashed. Worse, the mutation appeared to be an
inherent characteristic of the N1 virus protein, making it likely that
other strains – such as swine flu – would in time undergo it.
The laws of natural selection mean that if swine flu does mutate, the
new strain would quickly become dominant , Dr Gamblin added.
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