Saturday, 14 November 2009

Better late than never: WHO correction

Earlier one group of WHO experts only recommend Tamilflu after 3 days
by which time the effectiveness of Tamilflu is proven to be almost
zero based on manufacturers' tests.

It has caused more deaths than those who don't get any Tamilflu at
all, and most probably responsible for the increase in the number of
Tamilflu resistant swine flu.

Soon all the expensive Tamilflu stocks will be useless as a result of
that stupid WHO recommendation when the number of Tamilflu resistant
cases overwhelm the normal swine flu.

You may argue that WHO never recommend the administration of Tamilflu
after 48 hours but giving a directive that ONLY THOSE WITH PROVEN
SERIOUS CASES BE GIVEN TAMILFLU is the same as saying that, because
serious cases can only be proven more than 48 hours of flu symptoms.

With the introduction of vaccination, it is now time to finish all the
Tamilflu stocks in order to save as many lives as possible.

Despite all the meaningless deaths caused by the earlier WHO
recommendation, stupidly implemented by thoughtless doctors, this new
recommendation should be welcomed.

It does not mean the most doctors are thoughtless. In fact most of
them have ignored this earlier directive as shown by various medical
advises given by successful doctors who managed to save lives.

WHO Urges Doctors To Use Antiviral Drugs Sooner To Prevent Swine Flu

The recommendation to administer antivirals such as Tamiflu much
earlier represents a dramatic turnaround.
November 13, 2009
By Charles Recknagel
The World Health Organization (WHO) is urging doctors to administer
antiviral drugs sooner to patients suffering from swine flu.

At the same time, it says it is sending emergency supplies of
antivirals -- such as Tamiflu and Relenza -- to developing countries
hardest hit by the pandemic, including Afghanistan, Azerbaijan,
Belarus, Kyrgyzstan, Ukraine, and Mongolia.

The WHO recommendation to administer antivirals early is a dramatic
turnaround from the UN agency's earlier guidelines.

Previously, the WHO had urged doctors to use laboratory tests to
confirm that patients have the H1N1 virus before administering
antiviral drugs.

But the organization said on November 12 that as medical workers have
gained experience with swine flu, they have learned that waiting for
lab tests can be a fatal delay.

"People in at-risk groups need to be treated with antivirals as soon
as possible when they have flu symptoms," Dr. Nikki Shindo, a medical
officer with the WHO's global influenza program, told reporters in
Geneva. "This includes pregnant women, children under 2 years old, and
people with underlying conditions such as respiratory problems."

She said that people who are not in high-risk groups can wait a little

"People who are not from at-risk groups but who have persistent or
rapidly worsening symptoms should also be treated with antivirals,"
she said. "These symptoms include difficulty breathing and a high
fever that last beyond three days."

But Shindo said the vast majority of patients who contract swine flu
will not have symptoms lasting long enough to require antivirals.

"I want to stress that people who are not from the at-risk group and
have only a typical cold need not take antivirals," Shindo said. "We
are not recommending taking antivirals if otherwise healthy people are
experiencing only mild illness, or as a preventive in healthy people."

Rapid Deterioration

The change in the WHO's guidelines comes as doctors in pandemic areas
find that the H1N1 virus can cause a very rapid deterioration of
health in some patients, usually on the fifth or sixth day following
the onset of symptoms.

The deterioration is characterized by primary viral pneumonia, which
destroys the lung tissue and does not respond to antibiotics. Even
when such patients are placed under intensive care in hospitals, it
can be too late to prevent death.

A plane full of antiviral drugs is unloaded in Ukraine earlier this
Shindo said that the UN health agency asked doctors what they could
have done differently to avoid the fatalities, and that all had said
"without exception" that the outcomes would have been different if the
patients had been treated with an antiviral drug earlier.

The hardest-hit countries since the influenza season began in the
Northern Hemisphere are countries with medical systems that even in
normal times have to cope with shortages of funding and medicines.
Those fragile systems now have been overwhelmed with flu patients and
have limited stocks of antivirals to cope with the pandemic.

Shindo said the WHO is rushing additional supplies of antivirals to
six countries.

"Recently, we sent supplies to Afghanistan, Mongolia, Belarus, and
Ukraine," she said, "and we will send antivirals to Azerbaijan and

Rapid Distribution

She called on all the countries to rapidly distribute the new supplies
to local areas so that patients who need them do not have to travel to
central hospitals.

"A further recommendation we make is that countries decentralize the
distribution of antivirals and insure that general practitioners have
access to these medicines for their patients. Patients should not need
to visit a hospital in order to get antivirals prescribed," Shindo

Since the H1N1 virus was first identified early this year, it has
swept worldwide and is now the dominant form of flu in circulation.

The WHO says that in areas where there is widespread influenza,
doctors should assume that patients with flulike symptoms are infected
with H1N1.

The flu is unlike normal seasonal influenza in that it appears to
particularly affect younger and healthy people. Worldwide, around 40
percent of severe cases are now occurring in previously healthy
children and adults under the age of 50.

By contrast, normal seasonal influenza usually targets older people,
with 90 percent of deaths occurring in people over 65 years of age.

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