Wednesday, July 22, 2009

The Swine Flu and seizures?

A worrisome report was released today indicating that the swine flu virus can cause infection deep in the lungs, much like the flu virus responsible for the 1918 pandemic that killed at least 40 million people. This means it's more likely than typical seasonal flu to cause stubborn cases of pneumonia, which is one of the leading causes of death in flu cases. But another facet of the outbreak isn't getting the attention it ought to.

The British Medical Journal reported that the British government is seeking public feedback on side effects from Tamiflu and other antiviral medications. Britain is currently in the throes of an H1N1 outbreak, one that even affected "Harry Potter" actor Rupert Grint.

Tamiflu, the name brand of oseltamivir phosphate, and Relenza (also known as zanamivir) are currently the go-to drugs for prevention and treatment of H1N1 flu. They're both recommended for use in patients or family members of patients who have underlying health conditions, such as asthma or heart disease, which could lead to serious complications from a flu infection. Tamiflu is recommended for patients as young as 1 year of age, while Relenza is approved for those 5 and older.

Skin rash, nausea, and vomiting are the most commonly reported side effects from these antivirals. However, the Food and Drug Administration warned as early as 2006 that Tamiflu and similar treatments were linked with "self-injury and delirium" in patients in Japan.

The Tamiflu Web site puts it this way: "People with the flu, particularly children and adolescents, may be at an increased risk of self injury and confusion shortly after taking TAMIFLU and should be closely monitored for signs of unusal [sic] behavior. A healthcare professional should be contacted immediately if the patient taking TAMIFLU shows any signs of unusual behavior." The governments are looking for help monitoring these serious side effects.

As if the public didn't have enough to worry about. President Obama warned the public and health-care providers to continue being vigilant about the virus and its potential for resurgence.

These public-feedback databases are nothing new; perhaps the most well known one is the VAERS, or Vaccine Adverse Event Reporting System, which is administered by the Department of Health and Human Services. It receives input from thousands of parents and patients a year, on everything from irritation experienced at injection sites to seizures and other neurological problems experienced soon following a vaccine's being administered.

The 1918 flu outbreak orphaned my grandmother. Personally, the initial knowledge that the antivirals were often effective in reducing the severity of swine flu cases helped made me relax a little. But it's looking more and more like we have another awfully erratic and harmful virus on our hands—one whose main treatment isn't as uncomplicated as we could hope. The creation of these antiviral side-effect reporting systems ought to make the public more wary of the flu season ahead instead of blindly depending on these medications.

For more information, visit the Centers for Disease Control and Information's "Antiviral Drugs and H1N1 Flu" information page, or search for more information about the medications, or the, the new HHS-created Web site dedicated to news about the outbreak. For more information about the U.S. Adverse Event Reporting System, or AERS, click here.


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