Robyn Klein sent me a fascinating article Tamiflu® (oseltamivir phosphate) resistance and suggested that it would make an interesting blog. It was indeed an interesting article. The active antiviral metabolite of Tamiflu passes through us unchanged, is not altered by our water treatments, and ultimately will be picked up by the bird population in their drinking water. This will give avian viruses an excellent opportunity to build resistance to Tamiflu.
Frankly, the influenza virus does not seem to need this latest advantage. Even in the relatively small population of human avian flu victims treated with Tamiflu, one has already had a resistant strain. And resistance was seen early on in the test tube and test animals. When the next epidemic/pandemic influenza rages across the world, there is no doubt that resistance will build rapidly. This means that the drug would be virtually ineffective. Although, I do not think it was all that effective to begin with. Certainly, avian flu victims are not surviving very well, even though they get Tamiflu. This is blamed on the length of time that often passes between the onset of symptoms and treatment. Still.
Worst of all, though, is that there is virtually no discussion of the side effects of Tamiflu. Its ability to cause psychosis and suicide received a flurry of attention and led to some additional warning labels on the drug. But a deafening silence reigns when it comes to its potential ability to cause birth defects. In the approval process, Tamiflu in pregnancy did cause birth defects. “There were a variety of defects detected in developing [rabbit] fetuses. Most of the observations were an increased incidence of minor skeletal abnormalities and variants. The sponsor has argued that most of the incidence values were within normal range and were not considered real. However,… coupled with the ossification problem in rats and mortalities associated with bone problem in marmosets it is suggested that [Tamiflu] may have effects on bone.” This dilemma was fixed by language on the label saying that pregnant women should not take Tamiflu – unless the benefits outweigh the risks. Whatever that means.
I have not found any additional research on Tamiflu and birth defects. I did read, however, that the drug was being dispensed to pregnant women in South East Asia, so perhaps we will learn more eventually.
There are indications that Tamiflu may cause bone problems in adult animals but, in testing, these were attributed to genetic defects in the lab animals. The government did not require additional testing. And Tamiflu is much more toxic to newborns and is passed through breast milk. Again that problem was solved by labeling: The drug should not be taken by women who are nursing children – unless the benefits outweigh the risks. Whatever that means.
My advice: Forget Tamiflu and stockpile the herbal remedies the Eclectic physicians used in the 1918 pandemic instead.
About the spread of Tamiflu into our water ways: http://www.ehponline.org/realfiles/docs/2007/115-1/ss.html
Documents submitted in support of FDA approval of Tamiflu