[e-drug] Drugs, vaccines: will they work for bird flu? (2)

E-drug: Drugs, vaccines: will they work for bird flu? (2)
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Dear colleagues,

It is worth mentioning that a leading Belgian epidemiologist,
Prof. Bonneux. was recently interviewed by the Dutch radio, and he
made a plea for moderation. He accused the Dutch virologist Osterhaus
of panic mongering, and he said that anyhow Tamiflu was only
marginally effective once the illness breaks out, and will shorten
the duration of disease symptoms by only one day. He confirmed that
tamiflu is effective as a prophylactic drug, but that would mean
advising the WHOLE population to daily take the drug for the duration
of the epidemic, i.e. 4-6 weeks. Neither the drug nor the money is
available to achieve that purpose. Anyhow, he rightly said that both
in 1918 and in 1957-58 patients did not die from the virus alone, but
from superinfections by pneumococci or staphylococci, which should be
recognized early and accordingly treated with the appropriate
antibiotics. He called the stockpiling of tamiflu "a waste of money".
As Osterhaus said on TV and radio there was a "host of publications
confirming the activity of Tamiflu" - as the Belgians couldn't find
any good evidence they asked for copies or reprints but did not receive any.

Personally I would like to add that announcements in the media that
"bird flu has reached the EU" are highly exaggerated, because the
case concerned ONE turkey on a small Greek island (Inousses), a few
miles from the Turkish coast.

Let's keep our heads cool. At some time there will probably another
flu pandemic as in 1919 and 1958 and we have to be prepared for that.

Best wishes,

Leo Offerhaus, Netherlands.
offerhausl@euronet.nl

[I have not had time to go through the documentation, but Roche said on Norwegian TV last night that they did not know if Tamiflu would work for the virus they expect to be transferred between humans. As you know, this mutation has not yet happened. So Tamiflu is being stockpiled under the assumption that a medicines that works (with limited effect) on 'normal' flu will work on the mutated bird flu. In Norway too the journalists are concerned that we are only stockpiling for a 3rd of the population and accusing the government of putting people's life on risk!! KM, moderator]

E-drug: Conflicts of interests in guidelines - biased advice?
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Dear e-druggers,

The journal Nature studied more than 200 guidelines on drug prescribing and
found worrying links between guideline authors and the pharmaceutical
industry.

Nature 437, 1070-1071 & 1065-1066 (20 October 2005)
http://www.nature.com/nature/journal/v437/n7062/full/4371070a.html
http://www.nature.com/nature/journal/v437/n7062/full/4371065b.html

Some highlights/quotes:

"Only 90 of the 200 guidelines contained details about individual authors'
conflicts of interest. Of those, just 31 were free of industry influence -
around 70% of panels were affected. In one case, every member of the panel
had been paid by the company responsible for the drug that was ultimately
recommended.

35% of the 685 authors involved declared conflicting industry links. Experts say that this is likely to be an underestimate, however, because it relies on authors' own declarations.

About 10% of all guideline panels include an author who holds stock in a
relevant company.

Public-health experts say that the results of the survey, which is the
largest of its kind, suggest that drug companies are distorting decisions
about how their products are being prescribed.

Drug-company sponsors see guideline-issuing bodies as perfect places to
exert influence."

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