# 919
The 80% mortality rate from the H5N1 virus in Indonesia has, until now, has been largely attributed to the late treatment that most patients receive. Compared to Egypt, where the mortality rate is only about 40%, obviously something is amiss in Indonesia.
Now we are getting word that researchers testing the newer strains find it is 20 to 30 times less susceptible (or more resistant) to Tamiflu than earlier strains.
There is no other way to describe this other than bad news.
There have been concerns over the liberal dispensing of Tamiflu in Indonesia over the past year, with worries that overuse could result in resistant strains developing. Whether that is in fact the case, is unknown.
We do know the drug has been used to prevent outbreaks in areas where there have been human infections and entire villages have received prophylactic doses. Practically anyone complaining of `pilik', or cold-like symptoms, can get free Tamiflu from a community center.
Tamiflu is currently the best drug we have with the potential to treat H5N1 infections. If a resistant strain should acquire pandemic capability, we will find our treatment options severely limited.
Obviously this bears watching, and more testing is needed to confirm these results.
Indonesian bird flu viruses less susceptible to Tamiflu, scientists report
Canadian Press
Published: Thursday, June 21, 2007
TORONTO (CP) - An Australian researcher says H5N1 avian flu viruses from Indonesia are markedly less susceptible to the antiviral drug Tamiflu than a previous line of the H5N1 family of viruses.
Jennifer McKimm-Breschkin says laboratory testing shows the viruses from Indonesia are 20 to 30 times less susceptible to the drug as compared to H5N1 viruses that circulated in Cambodia a couple of years ago.
McKimm-Breschkin, who's attending a conference on infectious diseases in Toronto, says the findings are not good news.
And she says they may help to explain the high death toll from H5N1 in Indonesia, where 80 of 100 patients have died of the disease.
A scientist from the World Health Organization says it's not clear what the impact of the reduced susceptibility to Tamiflu means for people from that part of the world who become infected with the virus.
Dr. Frederick Hayden says a lot of factors can have an impact on whether oseltamivir treatment of H5N1 patients is successful, including how much time passes between infection and the start of drug therapy.
