Thesun 2009-05-04 Page04 Use Antivirals Wisely Says Expert

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Pandemic may still occur: WHO

Use antivirals wisely, says expert

KUALA LUMPUR: A virologist has expressed the fear that if antivirals for influenza A (H1N1) are readily available over the counter, they could be abused. Emeritus Prof Datuk Dr Lam Sai Kit, who is with Universiti Malaya’s Institute of Research Management and Monitoring, said that if any medication is overused and abused and not prescribed by doctors, the chances of the virus developing resistance are high. With the decision by the World Health Organisation (WHO) to raise the global alert for influenza A(H1N1) to Stage 5, pharmacies are stocking up on such medicines as Tamiflu and Relenza, and there has yet to be irrefutable evidence Once the public want to know where they can of pigs spreading the virus. we can’t obtain them. “So far, there has been no concrete use Tamiflu “There are people who think that by evidence of the involvement of pigs taking Tamiflu, they can prevent the onspreading the virus, yet undue attention or Relenza, set of flu but that is using the medication is paid to pigs,” he said, questioning the what are wrongly,” Lam told Bernama. proposal to spend millions to vaccinate we going to He said there are also people who pigs with the old swine flu vaccine. quickly pop a Tamiflu into their mouths “In Malaysia, it was mentioned that use? We will when they have ordinary flu, and by around RM7 million would be spent to have nothing doing so, they might be diminishing the vaccinate pigs against swine flu. The much as potency of the drugs. question is, why? Hopefully, the govern- armoury “Once we can’t use Tamiflu or Rement will review this. lenza, what are we going to use? We will “In any case, the old swine flu vac- against have nothing much as armoury against cine to be used in pigs is unlikely to severe severe influenza,” he said. protect against the present A (H1N1) influenza.” Lam, a former director of WHO’s strain, much like the seasonal flu comNational Influenza Centre (Malaysia), posite vaccine for use in humans. Scarce said Tamiflu works by killing the virus resources should be used to prevent the before it could go through its entire life spread of human infections since it is a he said. cycle, thus preventing it from replicating fact that it is human-to-human transmis“The pig farming industry has alor growing. sion which is all important now.” ready been hit because of the labelling Furthermore, the majority of influFurthermore, Lam said the WHO did of the virus as swine flu and, hopefully, enza infections do not require treatment not recommend any steps to prevent the this renaming of the virus will switch the with antivirals since they are mild and movement of pigs, unlike during the attention back to human transmission confined to the upper respiratory tract Nipah virus outbreak. and prevention.” and do not go down to the lungs. “There is scant evidence of pig inLam headed the research team that “Tamiflu should only be used if volvement in the present pandemic so studied the Nipah virus when it was first there is evidence that the influenza a we should leave the pigs alone for now,” discovered. – Bernama patient has is caused by something lifethreatening, such as pneumonia or lung infection. The more virulent types of flu usually go down to the lungs L/THESUN and require an antiviral like ZULKIFLI ERSA Tamiflu,” he said. Asked if Tamiflu is still safe to be prescribed for children after recent reports of psychiatric disturbances, heart and lung disorders and deaths among 12 children, Lam said the benefits outweigh the complications. “The WHO is still recommending its usage. The evidence is obviously not strong enough and the benefit far outweighs any rare complication. In any case, other studies have not reported such adverse events. Dosage should be according to recommendations,” he said. In 2008, the US Food and Drug Administration changed the drug’s label to acknowledge reports of “delirium and abnormal behaviour leading to injury and, in some cases, resulting in fatal outcomes,” among flu patients taking Tamiflu. On its website, it states that the reasons the adverse neuro-psychiatric events and deaths are reported almost entirely in Japanese children Health MInister Datuk Seri Liow Tiong Lai visits the biowere still unclear but it is unusual hazard containment laboratory at the Institute for Medical enough to prompt further evaluation. Research in Kuala Lumpur where tests on blood samples are Lam welcomed WHO’s move to recarried out to see whether they are infected with the influenza A (H1N1). name swine flu as influenza A (H1N1) as He is accompanied by IMR director-general Dr Shahnaz Murad.

ADB: Asia must retool to boost domestic demand pg 13

Caution ...

Holidaymakers check travel safety to Hongkong KUALA LUMPUR: Agencies with impending tours to Hongkong have been flooded with calls from clients following reports of the first confirmed influenza A (H1N1) case in the Special Administrative Region of China, China Press reported yesterday. Giacomo Travel & Tours Sdn Bhd managing director Datuk Ho See Sin told the daily he received a number of phone calls on Saturday morning from clients who wanted to know the latest flu situation in Hongkong. Local Chinese dailies on Sat-

urday highlighted the Hongkong government’s move to place 300 people in a hotel under quarantine for seven days, after a guest from Mexico became the first confirmed A (H1N1) case in the city. Ho said some clients have asked for a postponement of their trips for fear of contracting the deadly flu in Hongkong. However, he said others expressed confidence in the strict preventative measures being taken by the Hongkong government, and wanted the tours to stick to the scheduled departure dates. “In general, tours which are im-

pending will not be cancelled as the agencies have already finalised the trips, paid deposits for hotel rooms and food. If the trips are cancelled, tour organisers will incur heavy losses,” he said. But tours scheduled for departures months later can be postponed or cancelled, he said. His company has cancelled a September tour to Mexico because of the outbreak of the A (H1N1) flu. Ho said the outbreak has caused a 30% drop in business for the company and appealed to the government to be cautious with the wording of their press releases to

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avoid dampening the confidence of tourists. Malaysian Chinese Tourism Association president Chay Ng said the association is taking a serious view of the flu reports in Hongkong but urged Hongkong-bound tourists not to be unduly worried. He said there is only one confirmed case in Hongkong and believed its government has taken stringent measures to prevent the spread of the flu. “We have yet to receive any report of our clients asking for cancellation of their trips to Hongkong,” said Chay.

MEXICO CITY: Mexico’s swine flu outbreak appeared to be easing with a decrease in serious cases, the government said, but world health officials warned the unpredictable virus could still become a pandemic. “Each day there are fewer serious cases and the mortality has been decreasing,” Health Minister Jose Angel Cordova told a news conference in Mexico City, where millions were heeding government advice to stay at home. Of the more than 100 suspected deaths from the new influenza A (H1N1) virus that have emerged in the Latin American nation, 19 had been confirmed, Cordova said. Mexico had already scaled back from its original estimate of 176 suspected deaths. However, new cases of the mongrel virus, which mixes swine, avian and human flu strains, were still being tracked across the world. Colombia became the latest country to report a confirmed case of the disease, which has now been found in 19 countries. In Geneva, the World Health Organisation said influenza A (H1N1) had not spread in a sustained way outside North America, as required before the pandemic alert is raised to its highest level. But it said that would probably happen soon. “I would still propose that a pandemic is imminent because we are seeing the disease spread,” Michael Ryan, WHO director of Global Alert and Response, told a briefing. Few are ready to take chances with the new virus, widely dubbed swine flu. In Hongkong, police quarantined a hotel for one week after a Mexican guest was found to have the virus and Mexicans were also being confined in Beijing, Shanghai and elsewhere. Mexican Foreign Minister Patricia Espinosa criticised China, saying Mexican citizens who showed no signs of illness at all were being “isolated, under unacceptable conditions”. Authorities in Mexico, the hardest-hit nation, said earlier they believed the situation is stabilising as fewer patients with severe flu symptoms were checking into hospitals. The WHO said its laboratories had identified a total of 787 infections in 17 countries, including one case in Ireland, The United States, the second hardest-hit nation, has confirmed 226 cases in 30 states. Public hospitals in Mexico have noted a steady drop in patients turning up with fevers, suggesting the infection rate may be declining as people use hand gel and avoid crowds. – Agencies

No new permits to import pork CHANGLOON: The Agriculture and Agrobased Industry Ministry will no longer issue new permits to import pork following the influenza A (H1N1) epidemic, its deputy minister Datuk Wira Mohd Johari Baharom said yesterday. This would be effective immediately as a precautionary measure although findings had shown that the animal was not the cause of the disease. “Clinical research on samples of mucus, saliva and faeces of the animal taken from 14 farms in Selangor and five in Malacca have tested negative,” he told reporters after launching a Ujian Penilaian Sekolah Rendah (UPSR) seminar here. Mohd Johari said the Veterinary Services Department would monitor other animals that might be responsible for the A (H1N1) virus. He said the permits issued to companies importing pork from China, Europe, Australia and Vietnam will also be revoked if the epidemic worsened. Research was also conducted on imported pork to ensure that they were not contaminated with the A (H1N1) virus. He said applications for import permits would be relaxed once the situation improved, but only to cater to the country’s needs. “The Veterinary Department has monitored developments on the epidemic daily since it surfaced, while pig farms are monitored throughout the year and not just when epidemics threaten our lives,” he said. He said the said authorities visited 202 farms nationwide and had not found any report of the A (H1N1) virus.