Tran Dinh Thanh Lam
HO CHI MINH CITY, Dec 21 2005 (IPS) – Although it has been partly successful at controlling the spread of bird flu, Vietnam is stepping up its fight against the frightening disease, starting with more cautious use of antiviral drugs.
News from the country s Pasteur Institute, the national centre of bird flu research, that the deadly flu strain H5N1 has developed resistance to the drug Tamiflu has caused officials to rethink their approach.
They are now developing a national anti-bird flu strategy that includes manufacturing and stockpiling vaccines and antiviral drugs. The fact that H5N1 could develop resistance to Tamiflu makes us revise our anti-bird flu strategy based mostly on that anti-viral drug. We must have other preventive plans in case the resistant strain spreads out, said Dr Cao Bao Van, director of the Molecule Biology Department at the Pasteur Institute.
The team recently discovered evidence that the deadly virus has mutated into a form easily transmitted among mammals. Although their study came to no conclusion on the virus s ability to move easily between people, it said H5N1 had developed resistance to Tamiflu.
A 13-year-old girl infected with bird flu in the southern province of Dong Thap died in January although she was given a strong dose of Tamiflu, Van told IPS. We should not believe totally in the preventive capacity of Tamiflu because a bird-flu virus could resist the drug faster than expected, he added.
Tamiflu only reduces the severity of illness if taken within 48 hours after symptoms appear, said the expert.
Vietnam has recorded fewer bird flu outbreaks in recent days. The number of affected provinces and cities has been reduced to 12 compared to 21 in late November, and the country has not reported any new outbreaks since Dec. 19, reported the Animal Health Department on Dec. 20.
Seven provinces have to date finished two rounds of poultry vaccination, and second injections are in process in 24 others. The number of vaccinated poultry has reached 168 million.
More than 3.5 million birds have been killed nationwide since Oct. 1, boosting the total number of slaughtered birds to more than 59 million.
Centred in Vietnam and other South east Asian countries, bird flu has prompted a global health response, with medical experts warning that if it mutates to permit human-to- human transmission, an outbreak could trigger a worldwide pandemic killing millions of people.
Forty-two people have died in Vietnam but no one in the past two months and no new cases of human infection with the H5N1 virus have been detected in that time.
Despite the recent good news, the spectre of bird flu hangs over this country, prompting people to rush to buy Tamiflu, lauded as one of two drugs effective in reducing the severity of illness in people affected by H5N1. The drug can reduce the severity of influenza and could slow the spread of a pandemic.
The run on stores selling the drug prompted the Ministry of Health (MoH) to tighten Tamiflu supply. Director of the MoH s Pharmaceutical Control Department (PCD), Cao Minh Quang, said that because of limited imported supplies, Tamiflu would be reserved, first for the National Drug Reserve, then for hospitals with bird flu victims and health officials working with bird flu.
Once these demands have been met, the drug will be available on the market, Quang said, adding that Vietnam has ordered 25 million doses of Tamiflu but Swiss pharmaceutical giant Roche said it could only supply the country with two million now.
As another part of its national strategy, in early November Vietnam obtained from Roche the right to manufacture Tamiflu locally. The country also plans to stockpile enough Tamiflu tablets to give freely to the population in case of a pandemic.
Vietnam has a stock of 600,000 Tamiflu capsules donated by Taiwan; the country could also have 30 million tablets that the World Health Organisation (WHO) has pledged to make available to any Asian nation affected by a large-scale outbreak.
But this stock remains too small for a population of nearly 90 million.
Now that H5N1 s resistance to Tamiflu has been detected, the supervision of Tamiflu s resistance and the stockpiling of effective anti-viral drug are necessary and urgent, Van said.
He believes a national strategy should combines diverse measures, including prevention with vaccine, early detection and treatment with effective antiviral drugs.
Facing rapid outbreaks, the National Institute for Hygiene and Epidemiology announced the country would begin producing vaccines from Nov. 10. Cooperation with China to manufacture vaccines has also been suggested. Vietnam would import the ingredients from its neighbour and then, with technology transferred by Chinese experts, produce vaccines locally.
Vaccines offer the best protection against bird flu. But they must be tailored to match any new strain of influenza when it emerges, said Van. Our vaccine, based on samples taken from Nam Dinh Province in 2003, is now too old.
The fight against bird-flu, especially the prevention of a pandemic among humans, has become the most pressing task for all of society, said Prime Minister Phan Van Khai during his visit last month to Ha Tay and Ha Nam provinces, two major suppliers of poultry to Hanoi.
Khai listed a number of actions to be taken immediately, including vaccinating poultry and establishing monitoring systems in all villages nationwide.
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