H1N1 vs. Tamiflu

Let's talk about some news. I have done my first trial with paper surveys, so far things are going well. I need to clean up some of the language and try to make it a little more clear, and to try and make the font smaller or maybe print both sided. Right now the paper surveys work out to about 5 pages, which is a deterrent for some people I have talked to. It is funny how it is hard to talk people into doing surveys for even simple OTC anti-inflammatory meds. I don't personally take many drugs, but if I need to pound some Ibuprofen - like when I had Strep Throat around Valentines Day (see previous blog post on Ibuprofen) - I don't really have a problem telling people about it. I need to work on how I present the survey maybe; better explanation is always a useful thing.

We are nearing the end of the internship. This has been a lot of hard work, but I am glad that I did it. I have learned a lot of stuff about medications, a lot of stuff about research and a lot of stuff about communication.

Since we are so near the end - and since every blog deserves one REALLY long post - I think that this week I will be featuring a drug that has come to the forefront of a lot of people's minds right now: Tamiflu.
The Swine Flu, or H1N1 has received a lot of press lately. Inevitebly we as people will find something to panic about. This 'new' flu virus has caused a lot of uproar. Recently at work I was talking with the man who is in charge of education on my unit and he asked what I thought of the Swing Flu. Working in healthcare we are poised to be taking care of the children who are diagnosed with Swine Flu, this is especially true of the fact that we give very specialized care at my hospital. I told him that I thought that we might see a few cases - half-a-dozen at best - but that would be the extent of it. I could be wrong, but I doubt it.
According to: http://www.theblogofrecord.com/tag/jama-influenza-flu-death-mortality-studies/ nearly 36,000 Americans die every year from the 'normal' influenza virus and cnn.com reports that 615 people are currently infected with Swine Flu worldwide and out of all the the worldwide infections, 16 persons have died.
While the loss of human-life is not good on any scale, the number of deaths is not consistent with the panic. At least, not in my opinon.

So, what is Swine Flu? The Swine Flu, or H1N1 is a type A flu virus that is usually transmitted to individuals who spend a lot of time around pigs, but it can be transmitted from person to person. The symptoms are usually the same as the 'normal' flu, but in children there have been some reports of dirhea and vomitting associated with the virus. Like any other influenza virus the H1N1 Swine Flu virus any underlying medical conditions are exacerbated by the virus.

The news is, of course, not all bad. It seems that the Swine Flu virus is susceptible to the standard anti-viral medications. One such medication that is important in this fight is Tamiflu.
(http://www.cdc.gov/h1n1flu/eua/pdf/tamiflu-patients.pdf)

There are A LOT of online resources about Tamiflu. I am not going to take the time to look it up, but I bet the number of hits is pretty high right now.

So, let's begin the discussion with an' old favorite; the organic molecule:

I also found an image that details all of the steps required to convert Shikimic Acid - the botanical starting product that is eventually converted to Tamiflu - into Tamiflu. This is obviously a multi-step synthesis. The diagram is probably a bit too complicated for the casual reader - myself included! - but it was too cool to pass up the picture of how the make the stuff.

For best result Tamiflu must be taken within the first 48 hours of symptoms.

Tamiflu acts as a neuraminidase inhibitor meaning, among other things, that it inhibits infected cells from transmitting virions to other parts of the body. Neuraminidase is used to cleave the bond between an infected cell and a virion, when that process is inhibited by introduction of Tamiflu, the infection is slowed or even halted totally allowing the body to fight the infection.
(http://www.fluwikie.com/index.php?n=Consequences.NeuraminidaseInhibitors)

Time will tell if I am wrong, or if I am right. But, if you think of the times when people have been agitated or panicky about some worldwide problem - think of Y2K here - it has proved to be minor and in some cases nonexistent.