Backup options need to be tried, experts contend

Drugs such as Tamiflu are limited and won't be in place for years, a team says.
Chicago Tribune
CHICAGO -- Despite recent moves by the federal government to build drug stockpiles for a possible outbreak of avian flu, some experts say the plans so far have neglected a key possibility: What if a pandemic strikes before the stockpiles are in place?
Lung researchers at the University of Chicago think doctors put in that difficult position could turn to experimental therapies designed to prevent an infection from destroying the lungs. Rather than fight the virus itself, the drugs would dampen the immune system's aggressive -- and ultimately self-destructive -- response to such viruses.
The approach would address what the University of Chicago team sees as potential weaknesses in the Bush administration's proposal to buy billions of dollars' worth of flu vaccines and anti-flu medications such as Tamiflu. Those supplies will not be in place for several years, and the drugs may have limitations.
Other plans needed
Last week, researchers from Vietnam reported that two bird flu patients had developed rapid resistance to Tamiflu and died.
The development underscored the need for other options in case anti-flu drugs such as Tamiflu and Relenza don't work or the drugs are in short supply, said Dr. Steven Dudek, a pulmonary researcher at the University of Chicago.
"The drugs in our armament may not be as effective as people are hoping," Dr. Dudek said. "It would be nice to have some other way of treating people who get sick."
Bird flu cannot spread among humans. But scientists fear it could mutate to acquire that ability and spiral into a worldwide pandemic. If that happened, lung experts say they could be at ground zero of a massive explosion of patients, with no reliable way of treating their deadly disease.
One solution may be drugs already being studied to treat other conditions that result in massive lung injury. Experts estimate that 80,000 people die each year from ailments that injure the lungs -- most often infections with pneumonia, staph and other types of bacteria and viruses.
Stopping such lung injury in its tracks could reduce the pressing health threat posed by ordinary infections, in addition to addressing the still-theoretical risk of a flu pandemic, said Dr. Skip Garcia, chairman of the department of medicine at the University of Chicago.
"Right now all we can do for most of these patients is give them supportive care," Dr. Garcia said. "We're not stopping what's causing the injury."
As with bird flu, infections with pneumonia and other bugs often kill patients indirectly, by unleashing an immune response that winds up tearing into the patient's own tissue.