China fights the bird flu; Tamiflu investigated

The Chinese government wants its citizens and the world to know what it’s doing to prevent the bird flu from spreading. Criticized for the lack of transparency during the SARS epidemic, this time China is publicizing its intensive anti-flu program, which will cost China the equivalent of $248 million:

  • Making government officials sign contracts “of responsibility, compulsory vaccination of poultry, and proper handling of dead poultry and poultry died of unknown reasons.” Their responsibilities also require immediate reporting of any bird deaths. (I couldn’t find any information on what consequences any failures might bring.)
  • Broadcasting mandatory public information announcements explaining how to prevent human infection, as well as requiring more frequent updates of information on any outbreaks
  • Monitoring any domestic and wild birds within a three-kilometer radius of an outbreak sites or places where infected humans may have visited
  • Requiring animal health departments to coordinate more closely with human health departments
  • Preventing people from entering and leaving “residential courtyards” without permits. (I couldn’t determine what “residential courtyards” are.)
  • Dispersing 60 million doses of poultry vaccine, 10 tons of disinfectant, 2,000 “exposure suits” and equipment in anticipation of future outbreaks
  • Establishing hotlines for hospital consultation as well as assigning certain hospitals to only deal with bird flu victims. These special hospitals can “establish special wards with 60 beds within four hours,” as well as have special teams organized “for treating human infection, disinfection, report of epidemic situation, and supply of medical materials”
  • Requiring all medical institutions to report any patients with “body temperature higher than 38 degrees Centigrade” (approximately 100.4 degrees Fahrenheit) “and cough”
  • Continuing to observe bird flu survivors as well as any workers who culled infected birds
  • Requiring all schools to report student fevers
  • Boosting public morale by cutting taxes on poultry businesses, creating subsidies for vaccinating and culling poultry, as well as subsidies to build modern breeding farms “to prevent poultry from living side by side with humans”
  • Tightening inspections at entry and exit ports
  • Producing a human vaccine

China isn’t the only country pursuing a bird flu vaccine but it’s good to know they’re working on it, too, especially since the FDA is investigating Tamiflu for some nasty side effects, or adverse events, as the FDA refers to them:

In the safety review mandated by the BPCA, a number of adverse event reports were identified associated with the use of Tamiflu in children 16 years of age or younger. These adverse event reports were primarily related to unusual neurologic or psychiatric events such as delirium, hallucinations, confusion, abnormal behavior, convulsions, and encephalitis. These events were reported almost entirely in children from Japan who received Tamiflu according to Japanese treatment guidelines (very similar but not identical to U.S. treatment guidelines). The review identified a total of 12 deaths in pediatric patients since Tamiflu’s approval. All of the pediatric deaths were reported in Japanese children. In many of these cases, a relationship to Tamiflu was difficult to assess because of the use of other medications, presence of other medical conditions, and/or lack of adequate detail in the reports.

The review also identified severe skin reactions (like allergic reactions) in some pediatric patients. These events were not all reported in Japanese children and have also been reported in adults. Severe skin reactions in all age groups are currently being reviewed in more detail.

Tamiflu Pediatric Adverse Events: Questions and Answers,” FDA, downloaded Nov. 18, 2005

More information on those “adverse events” is found here:

According to the data, 12 children–all in Japan–died after taking Tamiflu.

Four of the children died hours after taking the drug, while four others died of cardiopulmonary arrest, according to the data.

The causes of death for the remaining four were a consciousness disorder, pneumonia, suffocation and cardiopulmonary arrest caused by acute pancreatitis.

[SNIP]

Earlier in the week, Chugai Pharmaceutical said it told the government that two teenage boys exhibited abnormal behavior that led to their deaths after taking Tamiflu

A 17-year-old high school student jumped in front of a truck in February last year, shortly after taking the medicine, while a junior high school student fell from the ninth floor of his apartment building in February this year.(IHT/Asahi: November 18,2005)

FDA investigating 12 deaths of Japanese children who took Tamiflu,” The Asahi Shimbun, Nov. 18, 2005

Japan’s Ministry of Health, Labor and Welfare has concluded it wasn’t Tamiflu that caused the deaths, but the FDA wants to make sure.

All the more reason to remember the best ways to prevent the flu: frequent hand-washing, living a healthy lifestyle, getting plenty of rest and exercise, and avoiding people who don’t know enough to cover their mouths when coughing and sneezing.

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