a letter from a senior usa medico
We must have multiple options for dealing with avian flu
Regarding the Dec. 22 story "Bird Flu Kills Two Who Took Tamiflu": Regardless of whether the H5N1 virus does indeed develop resistance to the antiviral drug Tamiflu (oseltamivir) in the face of an avian influenza pandemic, it is always preferable to have multiple therapeutic options available to deal with potentially lethal infections.
The stockpiling of a variety of drugs by public health authorities is clearly the wisest course of action to offer us the greatest degree of protection. This point is illustrated in the Dec. 22 New England Journal of Medicine, which reports that H5N1 resistance to Tamiflu is far more likely than to a related antiviral drug, Relenza (zanamivir).
So why is our government stockpiling 4.3 million treatment courses of Tamiflu, but only 84,000 treatment courses of Relenza? It may be somewhat more convenient to stockpile and administer Tamiflu, which is taken in pill form, compared to Relenza, which is inhaled. But these are insufficient grounds for neglecting a potent therapy against bird flu.
GILBERT ROSS, M.D. Medical Director AUBREY NOELLE STIMOLA Assistant Director of Public Health The American Council on Science and Health New York, N.Y.
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