For your information, the problem with inhalable Relenza for the treatment of bird flu is that the H5N1 virus replicates very deep in the lung, in the pneumocyte, and there is evidence it spreads to other organs as well. I discussed this issue at length with a respiratory intensivist in the US. The particle size of Relenza unfortunately is not likely to deposit well to the pneumocyte; it works best at the upper respiratory epithelium that the common flu infects. It is possible, even probable that a pandemic flu will have to replicate in the upper respiratory epithelium in order to efficiently spread, however if much replication occurs too deeply then unfortunately Relenza in it's current form will not be an effective TREATMENT. Nebulised Relenza may be able to achieve the very tiny particle size required, or it may not. That is why we need systemic treatments like intravenous Relenza.
Note that I say treatment. I believe that if a real pandemic hit, the major role of antivirals would be prophylaxis, which Relenza in it's current form is excellent, much better than Tamiflu, due to it's resisitance profile. Virus has to spread down the respiratory passages and epithelium, and Relenza has been shown to protect against H5N1 infection in the animal model. (There are currently no human volunteers for a human study, naturally)
My child the guinea pig? That's a bit rich. Wouldn't you do anything possible to save your child's life in an extreme crisis? Lactose can be administered intravenously and all the inhaler powder is is only lactose and zanamivir. Well, ok i'd do a test dose on myself first. As a doctor you can decide what risks to take and not to take.
In a pandemic hospitals would be emptied of many surgical and elective patients and replaced with flu patients. You would see hundreds of thousands, if not millions of doses of IV Relenza administered daily if it was available.
It needs to be available.
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