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Using a small stockpile of a secondary antiviral drug in a flu pandemic
Date:4/30/2009

In a global influenza pandemic, small stockpiles of a secondary flu medication if used early in local outbreaks could extend the effectiveness of primary drug stockpiles, according to research made available today ahead of publication in PLoS Medicine.

Many countries are investing in large stockpiles of a single drug, oseltamivir (Tamiflu). But influenza viruses can become resistant to antiviral drugs, and the widespread use of a single drug is likely to increase the risk that a resistant strain will emerge. If such a strain were to spread widely, the effectiveness of antiviral drugs in treating infected patients, as well as their ability to slow the spread of a pandemic, would be greatly reduced.

Using a mathematical model to represent the global spread of pandemic influenza, an international team of researchers led by Joseph Wu of the University of Hong Kong, and including collaborators in the UK and the US, found that treating as few as only the first 1% of the population in a local epidemic with a secondary drug rather than with oseltamivir, could substantially delay the development of resistance to oseltamivir. This reduction in resistance was predicted to benefit not only local populations, but also those in distant parts of the world where the pandemic would subsequently spread through air travel.

In the context of the currently emerging swine flu, the secondary drug could be zanamivir (Relenza), the only other approved drug to which the new H1N1 strain has been found to be susceptible.

This strategy is predicted to be effective because it delays use of the primary stockpiled drug until a certain proportion of the local population (about 1.5% according to the model) has been infected with virus that remains susceptible to the primary drug. With drug-sensitive virus in the majority as people recover from infection and develop immunity, only a minority of further infections are likely to be resistant to the p
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Contact: Andrew Hyde
press@plos.org
44-122-346-3330
Public Library of Science
Source:Eurekalert

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