I take Valtrex for cold sores. Just taking 2, twice a day for one day, and the next day it is gone. It is really a life saver. Anyone who has ever had a cold sore should really talk to your doctor about keeping Valtrex on hand.
I went to the doctor with a bottom lip full of cold sores. I was swollen beyond anything (anyone remember Bubba from Forest Gump?). The doctor prescribed Valtrex 1 gram, 3 times a day (every 8 hours). Well, 24 hours have passed, my swelling is down to almost normal, and I'm already in the scab stage. AMAZING! I will be keeping this on hand all the time. By the way, I have been suffering with cold sores for 20 years, and have used everything from Abreva to L-Lysine to other homeopathic remedies. These are the quickest results EVER. Definitely worth the money.
This drug is a miracle! I woke up with a full blown cold sore and went to the Doctor who gave me Valtrex. I was very skeptical because the cold sore was pretty big already, but 12 hours after my first dose, it looks much better and the pain is gone. Will never again waste my time or money on OTC cold sore treatments. This stuff really works!
poniedziałek, 5 listopada 2012
Reviews for Valtrex
Valtrex (valacyclovir) for Cold Sores: My face started tingling while I was at work and I had a couple of little pustules starting to form. I put denavir on my cold sore until I could make it to the doctor. 9 hours later my cold sore was more full and I went to the doctor and received a prescription for valtrex. I took my first dose and went to sleep. Later that day I took my second dose and I noticed after my second dose the pustules started to dry up. I read a lot of material saying that you need to take Valtrex before the cold sore actually appears for it to be most effective, but I can truly say that it still works even if the cold sore is visible. I never new that I could get rid of a cold sore so fast. Definitely try Valtrex.
Valtrex (valacyclovir) for Herpes Simplex, Suppression: I take Valtrex for suppressive therapy. My daily life is so much more manageable emotionally and physically since taking Valtrex as a suppressive treatment. For those who suffer with this virus, you will understand how our lows are very low when experiencing regular outbreaks. Valtrex allows my condition to be a minor inconvenience and no longer a dark lonely place. I now experience an outbreak twice yearly.
Valtrex (valacyclovir) for Herpes Simplex, Suppression: I take Valtrex for suppressive therapy. My daily life is so much more manageable emotionally and physically since taking Valtrex as a suppressive treatment. For those who suffer with this virus, you will understand how our lows are very low when experiencing regular outbreaks. Valtrex allows my condition to be a minor inconvenience and no longer a dark lonely place. I now experience an outbreak twice yearly.
Tamiflu and Relenza
Controversy continues over the use of antivirals for treating seasonal influenza. According to a new report, none of the four newer antivirals routinely prescribed for seasonal influenza is entirely suitable.
The study by Tom Jefferson and colleagues of Cochrane Vaccines Field, a collaborative evaluation group based in Italy, was published by The Lancet (early online publication) and reported by MedPage Today on January 19, 2006.
Tamiflu (oseltamavir) and Relenza (zanamivir) have recently been found to be ineffective in treating seasonal influenza. However, just last week the Centers for Disease Control and Prevention (CDC) recommended that Tamiflu and Relenza be prescribed in place of the more established antiviral agents, Symmetrel (amantadine) and Flumadine (rimantadine).
The CDC disagrees with Dr Jefferson et al's report's recommendations about the newer drugs, and has recently issued an advisory to doctors to prescribe Tamiflu and Relenza for seasonal flu. However, the CDC advises against prescribing rimantadine or amantadine, because the dominant influenza A strain rapidly becomes resistant to these drugs.
While the Cochrane group agreed with the CDC that "the use of amantadine and rimantadine should be discouraged," they went one step further, recommending that Tamiflu and Relenza also be reserved to fight a global influenza pandemic:
"Because of their low effectiveness, neuraminidase inhibitors [Tamiflu and Relenza] should not be used in seasonal influenza control and should only be used in a serious epidemic or pandemic alongside other public-health measures such as use of masks, gowns, gloves, quarantine, and hand washing."
In September 2005, the CDC reported that about 12% of influenza A strains worldwide are now resistant to amantadine and rimantadine-including avian flu strains in Asia that occur in poultry and people. The CDC and the Cochrane group agree that the older antiviral agents, amantadine and rimantadine, are not only ineffective against influenza, but can also cause unpleasant side effects, such as nausea, insomnia and hallucinations.
The study by Dr Jefferson and colleagues found that Tamiflu and Relenza offer moderate relief from symptomatic influenza but do not relieve either asymptomatic influenza or on influenza-like illnesses. Moreover, these drugs reduce but do not completely stop viral shedding from the nose.
Despite these negative findings, the CDC still backs its recommendations.
"Our guidelines and our recommendations are pretty clear," said a CDC spokesperson, according to MedPage Today. "Tamiflu and Relenza have proven to be highly effective in laboratory studies that we've done, and when they are administered at the appropriate time, namely 24 to 48 hours after the onset of influenza symptoms, they have also proven to be effective."
Dr Jefferson and colleagues conducted a meta-analysis that included data from 52 randomized trials of amantadine and rimantadine, and Tamiflu and Relenza. The analysis examined the preventative effects of these drugs as a percentage of relative risk.
The results showed that amantadine prevented 61% of influenza A cases and 25% of influenza-like illnesses. It caused nausea, insomnia and hallucinations, and withdrawals due to adverse events.
"In treatment, amantadine significantly shortened duration of fever compared with placebo but had no effect on nasal shedding of influenza A viruses," the researchers wrote.
The study included fewer data for rimantadine, but these data showed its effects to be comparable to those of amantadine.
Trials comparing the efficacy of Tamiflu and Relenza with placebo showed that these drugs did not affect influenza-like illness, even at higher doses. Moreover, neither drug was effective against asymptomatic influenza. Relative efficacies for Tamiflu 75 mg daily and 150 mg daily were 61% and 73%, respectively, and efficacy of Relenza 10 mg daily was 62%.
Tamiflu proved about 50% effective in preventing post-infection transmission within households, and both Tamiflu and Relenza hastened symptom relief by about 30%, compared with placebo, if taken within 48 hours after symptom onset.
"We cannot explain how neuraminidase inhibitors can affect respiratory complications of seasonal influenza, such as bronchitis and pneumonia, while not preventing infection, and this effect should be further studied," the researchers wrote.
The study by Tom Jefferson and colleagues of Cochrane Vaccines Field, a collaborative evaluation group based in Italy, was published by The Lancet (early online publication) and reported by MedPage Today on January 19, 2006.
Tamiflu (oseltamavir) and Relenza (zanamivir) have recently been found to be ineffective in treating seasonal influenza. However, just last week the Centers for Disease Control and Prevention (CDC) recommended that Tamiflu and Relenza be prescribed in place of the more established antiviral agents, Symmetrel (amantadine) and Flumadine (rimantadine).
The CDC disagrees with Dr Jefferson et al's report's recommendations about the newer drugs, and has recently issued an advisory to doctors to prescribe Tamiflu and Relenza for seasonal flu. However, the CDC advises against prescribing rimantadine or amantadine, because the dominant influenza A strain rapidly becomes resistant to these drugs.
While the Cochrane group agreed with the CDC that "the use of amantadine and rimantadine should be discouraged," they went one step further, recommending that Tamiflu and Relenza also be reserved to fight a global influenza pandemic:
"Because of their low effectiveness, neuraminidase inhibitors [Tamiflu and Relenza] should not be used in seasonal influenza control and should only be used in a serious epidemic or pandemic alongside other public-health measures such as use of masks, gowns, gloves, quarantine, and hand washing."
In September 2005, the CDC reported that about 12% of influenza A strains worldwide are now resistant to amantadine and rimantadine-including avian flu strains in Asia that occur in poultry and people. The CDC and the Cochrane group agree that the older antiviral agents, amantadine and rimantadine, are not only ineffective against influenza, but can also cause unpleasant side effects, such as nausea, insomnia and hallucinations.
The study by Dr Jefferson and colleagues found that Tamiflu and Relenza offer moderate relief from symptomatic influenza but do not relieve either asymptomatic influenza or on influenza-like illnesses. Moreover, these drugs reduce but do not completely stop viral shedding from the nose.
Despite these negative findings, the CDC still backs its recommendations.
"Our guidelines and our recommendations are pretty clear," said a CDC spokesperson, according to MedPage Today. "Tamiflu and Relenza have proven to be highly effective in laboratory studies that we've done, and when they are administered at the appropriate time, namely 24 to 48 hours after the onset of influenza symptoms, they have also proven to be effective."
Dr Jefferson and colleagues conducted a meta-analysis that included data from 52 randomized trials of amantadine and rimantadine, and Tamiflu and Relenza. The analysis examined the preventative effects of these drugs as a percentage of relative risk.
The results showed that amantadine prevented 61% of influenza A cases and 25% of influenza-like illnesses. It caused nausea, insomnia and hallucinations, and withdrawals due to adverse events.
"In treatment, amantadine significantly shortened duration of fever compared with placebo but had no effect on nasal shedding of influenza A viruses," the researchers wrote.
The study included fewer data for rimantadine, but these data showed its effects to be comparable to those of amantadine.
Trials comparing the efficacy of Tamiflu and Relenza with placebo showed that these drugs did not affect influenza-like illness, even at higher doses. Moreover, neither drug was effective against asymptomatic influenza. Relative efficacies for Tamiflu 75 mg daily and 150 mg daily were 61% and 73%, respectively, and efficacy of Relenza 10 mg daily was 62%.
Tamiflu proved about 50% effective in preventing post-infection transmission within households, and both Tamiflu and Relenza hastened symptom relief by about 30%, compared with placebo, if taken within 48 hours after symptom onset.
"We cannot explain how neuraminidase inhibitors can affect respiratory complications of seasonal influenza, such as bronchitis and pneumonia, while not preventing infection, and this effect should be further studied," the researchers wrote.
Amantadine and Rimandatine Not Recommended for Influenza
While the primary strategy for preventing complications of influenza infections is annual vaccination, antiviral medications with activity against influenza viruses can be effective for the prophylaxis and treatment of influenza. Two classes of antivirals are currently available-the M2 ion channel inhibitors (i.e., the two adamantanes amantadine and rimantadine) and the neuraminidase inhibitors (i.e., oseltamivir and zanamivir). The neuraminidase inhibitors are effective for the treatment and prophylaxis of influenza A and B, while the adamantanes are only active against influenza A viruses. This alert provides new information about the resistance of influenza viruses currently circulating in the United States to the adamantanes, and it makes an interim recommendation that these drugs not be used during the 2005-06 influenza season. Amantadine is also used to treat the symptoms of Parkinson's disease, and should continue to be used for this indication.
Viral resistance to adamantanes can emerge rapidly during treatment because a single point mutation at amino acid positions 26, 27, 30, 31, or 34 of the M2 protein can confer cross-resistance to both amantadine and rimantadine. The transmissibility of adamantane-resistant viruses is not impaired by any of these amino acid changes. A recent report on the global prevalence of adamantane-resistant influenza viruses showed a significant increase (from 1.9% to 12.3%) in drug resistance over the past 3 years. In the United States, the frequency of drug resistance increased from 1.9% in 2004 to 14.5% during the first 6 months of the 2004-05 influenza season.
For the 2005-06 season, 120 influenza A (H3N2) viruses isolated from patients in 23 states have been tested at CDC through January 12, 2006; 109 of the isolates (91%) contain an amino acid change at position 31 of the M2 protein, which confers resistance to amantadine and rimantadine. Three influenza A(H1N1) viruses have been tested and demonstrated susceptibility to these drugs. All influenza viruses from the United States that have been screened for antiviral resistance at CDC have demonstrated susceptibility to the neuraminidase inhibitors.
On the basis of available antiviral testing results, CDC is providing an interim recommendation that neither amantadine nor rimandatine be used for the treatment or prophylaxis of influenza A in the United States for the remainder of the 2005-06 influenza season. During this period, oseltamivir or zanamivir should be selected if an antiviral medication is used for the treatment and prophylaxis of influenza. Testing of influenza isolates for resistance to antivirals will continue throughout the 2005-06 influenza season, and recommendations will be updated as needed. Annual influenza vaccination remains the primary means of preventing morbidity and mortality associated with influenza.
Viral resistance to adamantanes can emerge rapidly during treatment because a single point mutation at amino acid positions 26, 27, 30, 31, or 34 of the M2 protein can confer cross-resistance to both amantadine and rimantadine. The transmissibility of adamantane-resistant viruses is not impaired by any of these amino acid changes. A recent report on the global prevalence of adamantane-resistant influenza viruses showed a significant increase (from 1.9% to 12.3%) in drug resistance over the past 3 years. In the United States, the frequency of drug resistance increased from 1.9% in 2004 to 14.5% during the first 6 months of the 2004-05 influenza season.
For the 2005-06 season, 120 influenza A (H3N2) viruses isolated from patients in 23 states have been tested at CDC through January 12, 2006; 109 of the isolates (91%) contain an amino acid change at position 31 of the M2 protein, which confers resistance to amantadine and rimantadine. Three influenza A(H1N1) viruses have been tested and demonstrated susceptibility to these drugs. All influenza viruses from the United States that have been screened for antiviral resistance at CDC have demonstrated susceptibility to the neuraminidase inhibitors.
On the basis of available antiviral testing results, CDC is providing an interim recommendation that neither amantadine nor rimandatine be used for the treatment or prophylaxis of influenza A in the United States for the remainder of the 2005-06 influenza season. During this period, oseltamivir or zanamivir should be selected if an antiviral medication is used for the treatment and prophylaxis of influenza. Testing of influenza isolates for resistance to antivirals will continue throughout the 2005-06 influenza season, and recommendations will be updated as needed. Annual influenza vaccination remains the primary means of preventing morbidity and mortality associated with influenza.
Antiviral Drugs Should Be Used Cautiously to Fight Flu
Antiviral medications such as Tamiflu and Relenza, which are effective in treating the H1N1 swine flu, should be taken only by people hospitalized with the flu or those at high risk for complications from the disease, U.S. health officials said Tuesday.
Those at risk include people with underlying health conditions, such as asthma or diabetes, as well as the very young, the elderly, and pregnant women, officials said.
Because the H1N1 swine flu remains mild for the vast majority of people who get it, most people won't need these medications at all, according to new guidelines for antiviral drug use issued by the U.S. Centers for Disease Control and Prevention.
"Antiviral medicines are a critical part of our tool kit in countering influenza, both the 2009 H1N1 influenza virus and seasonal flu strains," Dr. Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases, said during an afternoon news conference.
But, Schuchat added, "most children, adolescents and adults who have influenza-like illness do not need antiviral medicine."
One reason why: If too many people take antiviral medicines it could increase the risk that the virus would become resistant to these drugs, Schuchat said.
"We have seen a bit of antiviral resistance already with the 2009 H1N1 strain, and we hope this won't take off," she said. "A critical feature is to use these antivirals very carefully so they can have benefit and not lead to problems."
Because most people who get the flu -- whether H1N1 swine flu or seasonal flu -- will not be tested to see what type of flu they have, the new guidelines are based on symptoms, not a particular flu strain, Schuchat said.
"A key point of the antiviral guidance is that hospitalized patients who are suspected to have influenza need prompt treatment with antiviral medicines," she said. "That can be a very important way to reduce the severity of illness. We don't want providers to wait until test results are available, but we want them to start antivirals when you suspect influenza."
The new guidelines also recommend that, when high-risk people have been in contact with someone who has the H1N1 swine flu, doctors should wait to see if flu symptoms develop before starting treatment with antivirals.
"Instead of starting antivirals, we give providers an option we call 'watchful waiting,' and wait and see if fever develops," Schuchat said. "And, when fever or respiratory problems develop, give antivirals then."
Another key to the best use of antivirals in people at risk for complications is to start the drugs as soon as flu symptoms appear, Schuchat said.
She stressed, however, that the new guidelines leave room for judgment and discretion on the part of doctors. "Every patient is different, and we want clinicians to have that opportunity to customize care for each patient," she said.
The recommendations include:
Treatment with antivirals is recommended for people at higher risk for complications. These include children younger than 5 years old, adults 65 and older, pregnant women, people with chronic medical or immunosuppressive conditions, such as patients on chemotherapy, and people younger than 19 years of age who are receiving long-term aspirin therapy.
Treatment should not wait for lab tests because testing can delay treatment and a negative rapid test for flu does not rule out influenza.
For some high-risk patients, doctors may choose to give them antiviral prescriptions that can be filled should symptoms appear.
Schuchat noted that cases of H1N1 swine flu -- now the predominant flu strain in the United States -- have already started to increase, especially in southeastern states. "The H1N1 flu never went away this summer," she said. "It is not surprising that we are seeing this uptick in cases."
The good news is that the H1N1 virus still hasn't mutated into a more dangerous form, which means that the vaccine currently being tested should be a good match, she said.
The first 45 million doses of the vaccine are expected by mid-October.
Those at risk include people with underlying health conditions, such as asthma or diabetes, as well as the very young, the elderly, and pregnant women, officials said.
Because the H1N1 swine flu remains mild for the vast majority of people who get it, most people won't need these medications at all, according to new guidelines for antiviral drug use issued by the U.S. Centers for Disease Control and Prevention.
"Antiviral medicines are a critical part of our tool kit in countering influenza, both the 2009 H1N1 influenza virus and seasonal flu strains," Dr. Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases, said during an afternoon news conference.
But, Schuchat added, "most children, adolescents and adults who have influenza-like illness do not need antiviral medicine."
One reason why: If too many people take antiviral medicines it could increase the risk that the virus would become resistant to these drugs, Schuchat said.
"We have seen a bit of antiviral resistance already with the 2009 H1N1 strain, and we hope this won't take off," she said. "A critical feature is to use these antivirals very carefully so they can have benefit and not lead to problems."
Because most people who get the flu -- whether H1N1 swine flu or seasonal flu -- will not be tested to see what type of flu they have, the new guidelines are based on symptoms, not a particular flu strain, Schuchat said.
"A key point of the antiviral guidance is that hospitalized patients who are suspected to have influenza need prompt treatment with antiviral medicines," she said. "That can be a very important way to reduce the severity of illness. We don't want providers to wait until test results are available, but we want them to start antivirals when you suspect influenza."
The new guidelines also recommend that, when high-risk people have been in contact with someone who has the H1N1 swine flu, doctors should wait to see if flu symptoms develop before starting treatment with antivirals.
"Instead of starting antivirals, we give providers an option we call 'watchful waiting,' and wait and see if fever develops," Schuchat said. "And, when fever or respiratory problems develop, give antivirals then."
Another key to the best use of antivirals in people at risk for complications is to start the drugs as soon as flu symptoms appear, Schuchat said.
She stressed, however, that the new guidelines leave room for judgment and discretion on the part of doctors. "Every patient is different, and we want clinicians to have that opportunity to customize care for each patient," she said.
The recommendations include:
Treatment with antivirals is recommended for people at higher risk for complications. These include children younger than 5 years old, adults 65 and older, pregnant women, people with chronic medical or immunosuppressive conditions, such as patients on chemotherapy, and people younger than 19 years of age who are receiving long-term aspirin therapy.
Treatment should not wait for lab tests because testing can delay treatment and a negative rapid test for flu does not rule out influenza.
For some high-risk patients, doctors may choose to give them antiviral prescriptions that can be filled should symptoms appear.
Schuchat noted that cases of H1N1 swine flu -- now the predominant flu strain in the United States -- have already started to increase, especially in southeastern states. "The H1N1 flu never went away this summer," she said. "It is not surprising that we are seeing this uptick in cases."
The good news is that the H1N1 virus still hasn't mutated into a more dangerous form, which means that the vaccine currently being tested should be a good match, she said.
The first 45 million doses of the vaccine are expected by mid-October.
Antibiotics and Alcohol
It is common to see “Avoid Alcohol” labels on prescription bottles. Many patients are concerned about mixing antibiotics with alcohol contained in beverages or other medications. In general, most antibiotics can be taken safely with small amounts of alcohol. Drinking excessive amounts of alcohol while fighting an infection may not be wise, can lead to dehydration, and may hinder the body’s natural ability to heal itself, as well.
In general, alcohol should be avoided when taking these antibiotics. Many over-the-counter medications (OTCs), such as cough or cold syrups may also contain alcohol in the formulation. The inactive ingredient listing can be checked to determine if alcohol is present, the label on the OTC bottle can be checked, or ask your physician or pharmacist. Prescription medications may also contain alcohol. Patients should check with their physician or pharmacist each time they receive a new prescription to determine if there are important drug interactions. A drug interaction checker to review drug combinations can give additional information.
One of the most common alcohol-antibiotic interactions is with the antimicrobial agent metronidazole (Flagyl). Metronidazole is used for a variety of infections, including gastrointestinal, skin, joint and respiratory tract infections. Taking metronidazole with alcohol may result in a reaction called a “disulfiram-like reaction”. A “disulfiram-like reaction” may include nausea, flushing of the skin, stomach cramps, vomiting, headaches, rapid heart rate, and difficulty breathing.[1] A similar reaction may occur with other antibiotics.
Certain antibiotics may also lead to central nervous system (CNS) side effects, such drowsiness, sedation, dizziness or confusion. Alcohol is also considered a CNS depressant. When alcohol is combined with antibiotics that also have a CNS depressant effect, additive effects may occur. These effects can be serious if driving, in the elderly, and in patients who may take other CNS depressant medications, such as opioid pain relievers, anxiety or seizures medications, among others.
Alcohol is metabolized (broken down) in the liver by an enzyme called cytochrome P450 2C9. Some drugs are also metabolized by the 2C9 enzyme. Depending upon how often and how much alcohol is consumed, this enzyme may affect how drugs are metabolized. When an intoxicating, acute amount of alcohol is consumed, the 2C9 enzyme is “inhibited”, meaning that it cannot metabolize drugs that require this enzyme as efficiently as normal. The levels of the drug in the body may increase because it is not fully metabolized and excreted. This could lead to drug toxicity and side effects. Alternatively, when alcohol is abused chronically, as may occur with an alcoholic, levels of the 2C9 enzyme may become “induced”, meaning that metabolizing is occurring at a more efficient rate, and drug levels may decrease. The therapeutic effect that is desired may not occur with lowered drug levels in the body.
In general, alcohol should be avoided when taking these antibiotics. Many over-the-counter medications (OTCs), such as cough or cold syrups may also contain alcohol in the formulation. The inactive ingredient listing can be checked to determine if alcohol is present, the label on the OTC bottle can be checked, or ask your physician or pharmacist. Prescription medications may also contain alcohol. Patients should check with their physician or pharmacist each time they receive a new prescription to determine if there are important drug interactions. A drug interaction checker to review drug combinations can give additional information.
One of the most common alcohol-antibiotic interactions is with the antimicrobial agent metronidazole (Flagyl). Metronidazole is used for a variety of infections, including gastrointestinal, skin, joint and respiratory tract infections. Taking metronidazole with alcohol may result in a reaction called a “disulfiram-like reaction”. A “disulfiram-like reaction” may include nausea, flushing of the skin, stomach cramps, vomiting, headaches, rapid heart rate, and difficulty breathing.[1] A similar reaction may occur with other antibiotics.
Certain antibiotics may also lead to central nervous system (CNS) side effects, such drowsiness, sedation, dizziness or confusion. Alcohol is also considered a CNS depressant. When alcohol is combined with antibiotics that also have a CNS depressant effect, additive effects may occur. These effects can be serious if driving, in the elderly, and in patients who may take other CNS depressant medications, such as opioid pain relievers, anxiety or seizures medications, among others.
Alcohol is metabolized (broken down) in the liver by an enzyme called cytochrome P450 2C9. Some drugs are also metabolized by the 2C9 enzyme. Depending upon how often and how much alcohol is consumed, this enzyme may affect how drugs are metabolized. When an intoxicating, acute amount of alcohol is consumed, the 2C9 enzyme is “inhibited”, meaning that it cannot metabolize drugs that require this enzyme as efficiently as normal. The levels of the drug in the body may increase because it is not fully metabolized and excreted. This could lead to drug toxicity and side effects. Alternatively, when alcohol is abused chronically, as may occur with an alcoholic, levels of the 2C9 enzyme may become “induced”, meaning that metabolizing is occurring at a more efficient rate, and drug levels may decrease. The therapeutic effect that is desired may not occur with lowered drug levels in the body.
Genital Herpes. What Is It?
Genital herpes is a sexually transmitted infection that can cause blisters and skin ulcers in the genital and anal area. It can be caused by either of two types of herpes simplex virus, HSV-1 or HSV-2. HSV-2 is the more common cause. HSV-1 more commonly causes sores on the face and mouth.
HSV spreads from person to person through kissing and skin-to-skin contact, as well as through vaginal, oral or anal intercourse. An infected person often transmits the virus when skin blisters or ulcers are visible, but the virus also can be spread when there are no symptoms or skin sores at all. Herpes virus can be transmitted by people who don't know they are infected.
In a pregnant woman with HSV infection (usually HSV-2), the virus can pass to the baby during delivery, causing infections of the newborn's skin, mouth, lungs or eyes. If the herpes virus spreads through the baby's bloodstream, it can cause serious infections of the brain and other vital organs.
Many people with genital herpes infection have no symptoms. When symptoms appear, they can include:
Itching, burning, soreness and small blisters in the genital or anal area
Small ulcers (skin sores) when the blisters break
Local pain if urine touches the genital ulcers
Enlarged or painful lymph nodes (swollen glands) in the groin
Headache, fever, muscle aches and a generally sick feeling
Less common problems related to genial herpes include:
Urinary retention. Difficulty urinating when the virus affects the nerves to the bladder
Encephalitis. Herpes infection that has spread to the brain causing headache, fever, confusion and sometimes seizures.
Meningitis. Inflammation of the lining around the brain. It can be recurrent, a condition known as Mollaret's meningitis.
Proctitis. Inflammation of the rectum or anus that can involve pain, bleeding, fever and chills, usually related to unprotected anal sex.
The first episode of herpes symptoms usually has the worst symptoms. When symptoms develop, they can occur from a few days to a few weeks after contact with an infected person, but sometimes an infected person might not have any symptoms for years. Almost everyone with symptomatic genital herpes will have at least one recurrence. In people who have repeated herpes episodes, symptoms can be triggered by physical or emotional stress.
Newborns infected with herpes around the time of delivery usually develop symptoms 5 to 9 days after birth. Symptoms can include blisters on the skin, eyes and mouth. If the virus spreads through the baby's bloodstream to the brain, there can be sleepiness or irritability, and seizures. The virus can also spread to the baby's liver, lungs and other organs, causing disseminated (wide-spread) disease. Herpes in a newborn can be from either HSV-1 or HSV-2, but HSV-2 tends to cause more severe disease.
HSV spreads from person to person through kissing and skin-to-skin contact, as well as through vaginal, oral or anal intercourse. An infected person often transmits the virus when skin blisters or ulcers are visible, but the virus also can be spread when there are no symptoms or skin sores at all. Herpes virus can be transmitted by people who don't know they are infected.
In a pregnant woman with HSV infection (usually HSV-2), the virus can pass to the baby during delivery, causing infections of the newborn's skin, mouth, lungs or eyes. If the herpes virus spreads through the baby's bloodstream, it can cause serious infections of the brain and other vital organs.
Many people with genital herpes infection have no symptoms. When symptoms appear, they can include:
Itching, burning, soreness and small blisters in the genital or anal area
Small ulcers (skin sores) when the blisters break
Local pain if urine touches the genital ulcers
Enlarged or painful lymph nodes (swollen glands) in the groin
Headache, fever, muscle aches and a generally sick feeling
Less common problems related to genial herpes include:
Urinary retention. Difficulty urinating when the virus affects the nerves to the bladder
Encephalitis. Herpes infection that has spread to the brain causing headache, fever, confusion and sometimes seizures.
Meningitis. Inflammation of the lining around the brain. It can be recurrent, a condition known as Mollaret's meningitis.
Proctitis. Inflammation of the rectum or anus that can involve pain, bleeding, fever and chills, usually related to unprotected anal sex.
The first episode of herpes symptoms usually has the worst symptoms. When symptoms develop, they can occur from a few days to a few weeks after contact with an infected person, but sometimes an infected person might not have any symptoms for years. Almost everyone with symptomatic genital herpes will have at least one recurrence. In people who have repeated herpes episodes, symptoms can be triggered by physical or emotional stress.
Newborns infected with herpes around the time of delivery usually develop symptoms 5 to 9 days after birth. Symptoms can include blisters on the skin, eyes and mouth. If the virus spreads through the baby's bloodstream to the brain, there can be sleepiness or irritability, and seizures. The virus can also spread to the baby's liver, lungs and other organs, causing disseminated (wide-spread) disease. Herpes in a newborn can be from either HSV-1 or HSV-2, but HSV-2 tends to cause more severe disease.
Tthe use of antivirals in patients with H5N1
According to the WHO, the H5N1 virus has already killed 234 people in 12 countries. In the most recent clinical management guidelines issued by the WHO, TAMIFLU remains the primary antiviral agent of choice for the treatment of H5N1 virus infections.
Symposium findings
In Indonesia, of the total of 119 H5N1 human cases reported, 22 survived - an 18 per cent survival rate overall. Of the 119, 33 patients received no TAMIFLU, all of whom died. TAMIFLU was administered to the other 86 patients, with a 26 per cent survival rate overall. Time from onset of illness to initiation of treatment appeared to influence survival. Of the two patients who received TAMIFLU within 24 hours of illness onset, both survived. If given the drug within four days, 55 per cent survived (6/11), and 35 per cent survived if given TAMIFLU within six days (13/37). The survival rate of those receiving it later than six days after illness onset was 18 per cent (9/49). Recent information about eight Vietnamese patients infected with H5N1 was also presented. All eight patients received TAMIFLU, however, all eight patients presented to the hospital later than five days after onset of illness. Only three of the eight patients survived reinforcing that treatment benefit is reduced for patients that receive the drug later in the course of illness. In two patients who were unable to take the drug orally due to the severity of their illness, physicians administered the drug by nasogastric tube and found it was well absorbed and there was a reduction in H5N1 virus in these patients.
Susceptibility of circulating H5N1 strains to TAMIFLU
These clinical findings are supported by animal data, also presented at ISRVI, which shows that oseltamivir treatment was effective against H5N1 influenza viruses representing different clades/subclades. However, higher doses were required for the more pathogenic H5N1 viruses. "Multiple factors can affect the susceptibility of antiviral therapy with highly pathogenic H5N1 influenza viruses and it is reassuring that oseltamivir, in mouse models, demonstrates activity even to the most pathogenic circulating strains," comments study author Dr. Elena Govorkova, St. Jude Children's Research Hospital, Memphis, US. "Antiviral drugs are an essential component for the early control of an influenza pandemic." Data also confirms the low level of resistance reported to-date with TAMIFLU to H5N1 avian influenza in the field; there are only five cases of published reports of H5N1 resistance or reduced susceptibility to TAMIFLU to date. Laboratory results have shown 96 per cent of H5N1 strains (53 out of 55) tested in the laboratory were sensitive to TAMIFLU.
This compares to the around 14 per cent of isolates tested this year of the seasonal influenza A H1N1 virus showing resistance to TAMIFLU, reported at the conference. It is important to note that these increased levels of resistance have only been reported spontaneously in this year's H1N1 (Solomon Islands) seasonal strain, and not an avian strain such as H5N1, and not in patients who have been administered TAMIFLU.
"Currently, we are seeing that TAMIFLU has been used as part of the clinical management of patients infected with H5N1 with only isolated cases of resistance being reported," comments Dr. David Reddy, Global Pandemic Task Force Leader at Roche. "This is reassuring for governments that have stockpiled TAMIFLU for pandemic use. It is, however, critical that both Roche and the medical community remain vigilant so that we can understand this mutating virus and be best prepared for defence against a potential pandemic strain."
Roche has undertaken several research initiatives to study the use of TAMIFLU against the evolving H5N1 avian influenza virus, including collaborations with the National Institutes of Health (NIH), the Southeast Asia Influenza Clinical Trials Research Network, and other research institutions.
Note to editors:
Difference between a pandemic strain of influenza and seasonal influenza
A pandemic strain of influenza is always of the A variety and is a completely new strain to which there will be no immunity. A seasonal strain of influenza is one that has previously been circulating, which may have changed slightly (antigenic drift) and to which a level of immunity exists.
About pandemic influenza
An influenza pandemic occurs when a new strain of influenza A virus appears, against which the human population has no immunity resulting in several, simultaneous epidemics worldwide with enormous numbers of deaths and illness. The most severe influenza pandemics to date include: 'Spanish flu' A (H1N1): 1918 caused in excess of 30 million deaths worldwide; 'Asian flu' A (H2N2): 1958 caused one million deaths worldwide; 'Hong Kong flu' A (H3N2): 1968 caused 800,000 deaths worldwide in six weeks. The WHO believes that we are as close to the next pandemic as we have been at any time in the past 37 years, with two of the three widely-recognized prerequisites for a human pandemic met to date in the avian influenza outbreak in East Asia. Firstly, a new influenza virus strain has emerged (H5N1), and secondly, the virus has spread to humans. The final barrier will be the effective transmission of the virus from human to human.
About TAMIFLU
TAMIFLU is designed to be active against all clinically relevant influenza viruses and works by blocking the action of the neuraminidase (NA) enzyme on the surface of the virus. When neuraminidase is inhibited, the spread of the virus to other cells in the body is inhibited. It is licensed for the treatment and prophylaxis of influenza in children aged one year and above and in adults. The most frequently reported adverse events in clinical studies were nausea, vomiting, and diarrhea. TAMIFLU is available for the treatment of influenza in more than 80 countries worldwide. TAMIFLU was approved based on studies in seasonal influenza. The magnitude of effect of TAMIFLU in treating and preventing novel strains of influenza (such as those that may be involved in a pandemic or associated with avian flu) cannot be predicted. The WHO has recommended that higher doses and longer duration may be required.
Roche and Gilead
TAMIFLU was invented by Gilead Sciences and licensed to Roche in 1996. Roche and Gilead partnered on clinical development, with Roche leading efforts to produce, register and bring the product to the markets. Under the terms of the companies' agreement, amended in November 2005, Gilead participates with Roche in the consideration of sub-licenses for the pandemic supply of TAMIFLU in resource-limited countries. To ensure broader access to TAMIFLU for all patients in need, Gilead has agreed to waive its right to full royalty payments for product sold under these sub-licenses.
About Roche
Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As the world's biggest biotech company and an innovator of products and services for the early detection, prevention, diagnosis and treatment of diseases, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is the world leader in in-vitro diagnostics and drugs for cancer and transplantation, a market leader in virology and active in other major therapeutic areas such as autoimmune diseases, inflammation, metabolism and central nervous system.
Symposium findings
In Indonesia, of the total of 119 H5N1 human cases reported, 22 survived - an 18 per cent survival rate overall. Of the 119, 33 patients received no TAMIFLU, all of whom died. TAMIFLU was administered to the other 86 patients, with a 26 per cent survival rate overall. Time from onset of illness to initiation of treatment appeared to influence survival. Of the two patients who received TAMIFLU within 24 hours of illness onset, both survived. If given the drug within four days, 55 per cent survived (6/11), and 35 per cent survived if given TAMIFLU within six days (13/37). The survival rate of those receiving it later than six days after illness onset was 18 per cent (9/49). Recent information about eight Vietnamese patients infected with H5N1 was also presented. All eight patients received TAMIFLU, however, all eight patients presented to the hospital later than five days after onset of illness. Only three of the eight patients survived reinforcing that treatment benefit is reduced for patients that receive the drug later in the course of illness. In two patients who were unable to take the drug orally due to the severity of their illness, physicians administered the drug by nasogastric tube and found it was well absorbed and there was a reduction in H5N1 virus in these patients.
Susceptibility of circulating H5N1 strains to TAMIFLU
These clinical findings are supported by animal data, also presented at ISRVI, which shows that oseltamivir treatment was effective against H5N1 influenza viruses representing different clades/subclades. However, higher doses were required for the more pathogenic H5N1 viruses. "Multiple factors can affect the susceptibility of antiviral therapy with highly pathogenic H5N1 influenza viruses and it is reassuring that oseltamivir, in mouse models, demonstrates activity even to the most pathogenic circulating strains," comments study author Dr. Elena Govorkova, St. Jude Children's Research Hospital, Memphis, US. "Antiviral drugs are an essential component for the early control of an influenza pandemic." Data also confirms the low level of resistance reported to-date with TAMIFLU to H5N1 avian influenza in the field; there are only five cases of published reports of H5N1 resistance or reduced susceptibility to TAMIFLU to date. Laboratory results have shown 96 per cent of H5N1 strains (53 out of 55) tested in the laboratory were sensitive to TAMIFLU.
This compares to the around 14 per cent of isolates tested this year of the seasonal influenza A H1N1 virus showing resistance to TAMIFLU, reported at the conference. It is important to note that these increased levels of resistance have only been reported spontaneously in this year's H1N1 (Solomon Islands) seasonal strain, and not an avian strain such as H5N1, and not in patients who have been administered TAMIFLU.
"Currently, we are seeing that TAMIFLU has been used as part of the clinical management of patients infected with H5N1 with only isolated cases of resistance being reported," comments Dr. David Reddy, Global Pandemic Task Force Leader at Roche. "This is reassuring for governments that have stockpiled TAMIFLU for pandemic use. It is, however, critical that both Roche and the medical community remain vigilant so that we can understand this mutating virus and be best prepared for defence against a potential pandemic strain."
Roche has undertaken several research initiatives to study the use of TAMIFLU against the evolving H5N1 avian influenza virus, including collaborations with the National Institutes of Health (NIH), the Southeast Asia Influenza Clinical Trials Research Network, and other research institutions.
Note to editors:
Difference between a pandemic strain of influenza and seasonal influenza
A pandemic strain of influenza is always of the A variety and is a completely new strain to which there will be no immunity. A seasonal strain of influenza is one that has previously been circulating, which may have changed slightly (antigenic drift) and to which a level of immunity exists.
About pandemic influenza
An influenza pandemic occurs when a new strain of influenza A virus appears, against which the human population has no immunity resulting in several, simultaneous epidemics worldwide with enormous numbers of deaths and illness. The most severe influenza pandemics to date include: 'Spanish flu' A (H1N1): 1918 caused in excess of 30 million deaths worldwide; 'Asian flu' A (H2N2): 1958 caused one million deaths worldwide; 'Hong Kong flu' A (H3N2): 1968 caused 800,000 deaths worldwide in six weeks. The WHO believes that we are as close to the next pandemic as we have been at any time in the past 37 years, with two of the three widely-recognized prerequisites for a human pandemic met to date in the avian influenza outbreak in East Asia. Firstly, a new influenza virus strain has emerged (H5N1), and secondly, the virus has spread to humans. The final barrier will be the effective transmission of the virus from human to human.
About TAMIFLU
TAMIFLU is designed to be active against all clinically relevant influenza viruses and works by blocking the action of the neuraminidase (NA) enzyme on the surface of the virus. When neuraminidase is inhibited, the spread of the virus to other cells in the body is inhibited. It is licensed for the treatment and prophylaxis of influenza in children aged one year and above and in adults. The most frequently reported adverse events in clinical studies were nausea, vomiting, and diarrhea. TAMIFLU is available for the treatment of influenza in more than 80 countries worldwide. TAMIFLU was approved based on studies in seasonal influenza. The magnitude of effect of TAMIFLU in treating and preventing novel strains of influenza (such as those that may be involved in a pandemic or associated with avian flu) cannot be predicted. The WHO has recommended that higher doses and longer duration may be required.
Roche and Gilead
TAMIFLU was invented by Gilead Sciences and licensed to Roche in 1996. Roche and Gilead partnered on clinical development, with Roche leading efforts to produce, register and bring the product to the markets. Under the terms of the companies' agreement, amended in November 2005, Gilead participates with Roche in the consideration of sub-licenses for the pandemic supply of TAMIFLU in resource-limited countries. To ensure broader access to TAMIFLU for all patients in need, Gilead has agreed to waive its right to full royalty payments for product sold under these sub-licenses.
About Roche
Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As the world's biggest biotech company and an innovator of products and services for the early detection, prevention, diagnosis and treatment of diseases, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is the world leader in in-vitro diagnostics and drugs for cancer and transplantation, a market leader in virology and active in other major therapeutic areas such as autoimmune diseases, inflammation, metabolism and central nervous system.
Health Emergency in Response to Swine Flu
U.S. health officials declared a public health emergency Sunday in response to the swine flu outbreak, as the number of confirmed cases nationwide rose to 20.
The viruses found in the United States are susceptible to the antivirals oseltamivir (Tamiflu) and zanamivir (Relenza) according to the CDC.
Homeland Security Secretary Janet Napolitano said the declaration was a precautionary measure, and did not mean that the threat posed by the outbreak was worsening. But, the move allows federal and state governments easier access to flu tests and medications, she said.
"That [a public health emergency] sounds more severe than it really is. This is standard operating procedure, and allows us to free up federal, state and local agencies and their resources for prevention and mitigation. It allows us to use medication and diagnostic tests that we might not otherwise be able to use, and it releases funds for the acquisition of additional antivirals," Napolitano said during a press conference at the White House.
Napolitano said the federal government had 50 million doses of the antiviral flu medication Tamiflu, and a quarter of those doses were being released to states, if needed, "particularly prioritizing the states where we already have confirmed incidence of the flu."
All 20 U.S. patients -- eight in New York, seven in California, two in Texas, two in Kansas and one in Ohio -- have recovered, Dr. Richard Besser, acting director of the U.S. Centers for Disease Control and Prevention, said at the news conference.
In a separate Sunday afternoon press conference, Dr. Anne Schuchat, the CDC's Interim Deputy Director for Science and Public Health Program, said that it's still too early to say that the flu outbreak in the U.S. will be less severe than the one occurring in Mexico.
"Right now it's premature to say the disease in Mexico is different than here. We don't have that many infected people at this point and we don't have great information from Mexico yet," Schuchat said. "Certainly, we have deaths in Mexico and we have not -- fortunately -- seen them yet here, but we fear that we may. We need to prepare for the idea that we will have additional cases, additional affected states and I do fear that we will have deaths here."
Meanwhile, in Mexico, believed to be the source of the outbreak, authorities continued to take dramatic steps over the weekend -- including suspending public gatherings -- to try to contain the swine flu outbreak that officials say has killed as many as 103 people, and sickened more than 1,600 others in that country.
On Monday, the European Union advised against nonessential travel to the United States or Mexico, CBS News reported.
In the United States, eight more cases of swine flu, all involving school students, were confirmed Sunday by New York City health officials, while another case was reported in Ohio. Two cases were reported in Kansas on Saturday, plus another in California. That brings the national total of confirmed swine flu cases to 20. All of the cases have so far been mild.
Some of the U.S. cases involved people who had recently returned from trips to Mexico, Schuchat noted in the Sunday press conference. The two cases reported in Kansas involved a husband and wife who had recently been to that country, she said. And The New York Times reported that some of the students at St. Francis Preparatory School, in Queens, had recently come back from Mexico as well.
Also on Sunday, Canadian officials confirmed four "very mild" cases of swine flu at a school in Nova Scotia, and two other cases in British Columbia. According to the Associated Press, a provincial health official said that the infection that sickened the students in Nova Scotia "was acquired in Mexico, brought home and spread."
The CDC's Besser said that as the number of cases of swine flu continues to grow in Mexico, his agency expects to see more cases in the United States. "As we look for cases of swine flu, we are seeing more cases of swine flu, and we would expect to see more cases of swine flu," he said.
"We have ramped up our surveillance around the country to try and understand better what is the scope, what is the magnitude of this outbreak," Besser said.
Although all the reported cases in the United States have so far been mild, there are bound to be more severe cases, Besser said. "Given the reports out of Mexico, I would expect that over time we are going to see more severe disease in this country," he said.
Napolitano said the Department of Homeland Security has started "passive surveillance protocols to screen people coming into the country."
"All persons entering the United States from a location of human infection of swine flu will be processed by appropriate CDC protocols," she said. "Right now these are passive. They are looking for people and asking about: 'Are you sick? Have you been sick?' and the like. And if so, they can be referred over for further examination. Travelers who do present with symptoms will be isolated."
Despite the outbreak the U.S. government has not told people not to travel to Mexico or other counties where flu has been found. "To date the State Department had not issued official travel advisories, for particularly Mexico, but these situations are very fluid," Napolitano said.
There are steps people can take to help prevent catching and spreading the flu, including frequent hand-washing, Besser said. "If you are sick it is very important that people stay at home. If your children are sick, have a fever and flu-like illness, they shouldn't go to school. And if you are ill you shouldn't get on an airplane or another public transport. Those things are part of personal responsibility in trying to reduce the impact," he said.
In a Saturday news conference, Schuchat told reporters that, because of the wide geographic spread of the virus so far, the outbreak was already "beyond containment."
But she added that U.S. health officials had numerous tools to fight the illness' spread and protect the health of Americans. The viruses found in the United States are resistant to two antiviral medications -- amantadine and rimantadine -- but are susceptible to the antivirals oseltamivir (Tamiflu) and zanamivir (Relenza), Schuchat said.
Schuchat said steps were already being taken to devise a vaccine against this strain of swine flu, although the process takes time. "We are taking the initial steps in terms of preparing the seed virus to hand off to the industry partners, to produce large quantities. But you know it takes months to produce a vaccine," she said.
In response to the developments in North America, countries around the world planned quarantines and tested airline passengers for fevers as global health officials tried Sunday to come up with uniform ways to battle the outbreak. Nations from New Zealand to France reported new suspected cases and some warned citizens against travel to North America, the AP said.
World Health Organization Director-General Margaret Chan held teleconferences with staff and flu experts around the world but stopped short of recommending specific measures to halt the disease beyond urging governments to step up their surveillance of suspicious outbreaks, the news service said.
In Mexico, the government has ordered schools closed and all public events have been suspended for the time being, including more than 500 concerts and other gatherings in the city of 20 million residents. Even churches stood empty Sunday, the AP said.
While Mexico's flu season is usually over by now, health officials noticed a sizeable uptick in flu cases in recent weeks. According to a report published in The New York Times on Friday, World Health Organization experts said that most deaths among Mexican patients with swine flu have involved healthy young adults.
That could be worrisome, experts say. Seasonal flus usually strike hardest at infants and the elderly, but pandemic flus -- such as the 1918-19 Spanish flu, which killed an estimated 20 million to 40 million people worldwide -- often strike young, healthy people, the newspaper reported.
Swine flu is a respiratory disease of pigs caused by type A influenza. Swine flu does not normally infect humans. However, human infections do occur, usually after exposure to pigs. Symptoms resemble those of the regular flu, including sore throat, coughing and fever.
The viruses found in the United States are susceptible to the antivirals oseltamivir (Tamiflu) and zanamivir (Relenza) according to the CDC.
Homeland Security Secretary Janet Napolitano said the declaration was a precautionary measure, and did not mean that the threat posed by the outbreak was worsening. But, the move allows federal and state governments easier access to flu tests and medications, she said.
"That [a public health emergency] sounds more severe than it really is. This is standard operating procedure, and allows us to free up federal, state and local agencies and their resources for prevention and mitigation. It allows us to use medication and diagnostic tests that we might not otherwise be able to use, and it releases funds for the acquisition of additional antivirals," Napolitano said during a press conference at the White House.
Napolitano said the federal government had 50 million doses of the antiviral flu medication Tamiflu, and a quarter of those doses were being released to states, if needed, "particularly prioritizing the states where we already have confirmed incidence of the flu."
All 20 U.S. patients -- eight in New York, seven in California, two in Texas, two in Kansas and one in Ohio -- have recovered, Dr. Richard Besser, acting director of the U.S. Centers for Disease Control and Prevention, said at the news conference.
In a separate Sunday afternoon press conference, Dr. Anne Schuchat, the CDC's Interim Deputy Director for Science and Public Health Program, said that it's still too early to say that the flu outbreak in the U.S. will be less severe than the one occurring in Mexico.
"Right now it's premature to say the disease in Mexico is different than here. We don't have that many infected people at this point and we don't have great information from Mexico yet," Schuchat said. "Certainly, we have deaths in Mexico and we have not -- fortunately -- seen them yet here, but we fear that we may. We need to prepare for the idea that we will have additional cases, additional affected states and I do fear that we will have deaths here."
Meanwhile, in Mexico, believed to be the source of the outbreak, authorities continued to take dramatic steps over the weekend -- including suspending public gatherings -- to try to contain the swine flu outbreak that officials say has killed as many as 103 people, and sickened more than 1,600 others in that country.
On Monday, the European Union advised against nonessential travel to the United States or Mexico, CBS News reported.
In the United States, eight more cases of swine flu, all involving school students, were confirmed Sunday by New York City health officials, while another case was reported in Ohio. Two cases were reported in Kansas on Saturday, plus another in California. That brings the national total of confirmed swine flu cases to 20. All of the cases have so far been mild.
Some of the U.S. cases involved people who had recently returned from trips to Mexico, Schuchat noted in the Sunday press conference. The two cases reported in Kansas involved a husband and wife who had recently been to that country, she said. And The New York Times reported that some of the students at St. Francis Preparatory School, in Queens, had recently come back from Mexico as well.
Also on Sunday, Canadian officials confirmed four "very mild" cases of swine flu at a school in Nova Scotia, and two other cases in British Columbia. According to the Associated Press, a provincial health official said that the infection that sickened the students in Nova Scotia "was acquired in Mexico, brought home and spread."
The CDC's Besser said that as the number of cases of swine flu continues to grow in Mexico, his agency expects to see more cases in the United States. "As we look for cases of swine flu, we are seeing more cases of swine flu, and we would expect to see more cases of swine flu," he said.
"We have ramped up our surveillance around the country to try and understand better what is the scope, what is the magnitude of this outbreak," Besser said.
Although all the reported cases in the United States have so far been mild, there are bound to be more severe cases, Besser said. "Given the reports out of Mexico, I would expect that over time we are going to see more severe disease in this country," he said.
Napolitano said the Department of Homeland Security has started "passive surveillance protocols to screen people coming into the country."
"All persons entering the United States from a location of human infection of swine flu will be processed by appropriate CDC protocols," she said. "Right now these are passive. They are looking for people and asking about: 'Are you sick? Have you been sick?' and the like. And if so, they can be referred over for further examination. Travelers who do present with symptoms will be isolated."
Despite the outbreak the U.S. government has not told people not to travel to Mexico or other counties where flu has been found. "To date the State Department had not issued official travel advisories, for particularly Mexico, but these situations are very fluid," Napolitano said.
There are steps people can take to help prevent catching and spreading the flu, including frequent hand-washing, Besser said. "If you are sick it is very important that people stay at home. If your children are sick, have a fever and flu-like illness, they shouldn't go to school. And if you are ill you shouldn't get on an airplane or another public transport. Those things are part of personal responsibility in trying to reduce the impact," he said.
In a Saturday news conference, Schuchat told reporters that, because of the wide geographic spread of the virus so far, the outbreak was already "beyond containment."
But she added that U.S. health officials had numerous tools to fight the illness' spread and protect the health of Americans. The viruses found in the United States are resistant to two antiviral medications -- amantadine and rimantadine -- but are susceptible to the antivirals oseltamivir (Tamiflu) and zanamivir (Relenza), Schuchat said.
Schuchat said steps were already being taken to devise a vaccine against this strain of swine flu, although the process takes time. "We are taking the initial steps in terms of preparing the seed virus to hand off to the industry partners, to produce large quantities. But you know it takes months to produce a vaccine," she said.
In response to the developments in North America, countries around the world planned quarantines and tested airline passengers for fevers as global health officials tried Sunday to come up with uniform ways to battle the outbreak. Nations from New Zealand to France reported new suspected cases and some warned citizens against travel to North America, the AP said.
World Health Organization Director-General Margaret Chan held teleconferences with staff and flu experts around the world but stopped short of recommending specific measures to halt the disease beyond urging governments to step up their surveillance of suspicious outbreaks, the news service said.
In Mexico, the government has ordered schools closed and all public events have been suspended for the time being, including more than 500 concerts and other gatherings in the city of 20 million residents. Even churches stood empty Sunday, the AP said.
While Mexico's flu season is usually over by now, health officials noticed a sizeable uptick in flu cases in recent weeks. According to a report published in The New York Times on Friday, World Health Organization experts said that most deaths among Mexican patients with swine flu have involved healthy young adults.
That could be worrisome, experts say. Seasonal flus usually strike hardest at infants and the elderly, but pandemic flus -- such as the 1918-19 Spanish flu, which killed an estimated 20 million to 40 million people worldwide -- often strike young, healthy people, the newspaper reported.
Swine flu is a respiratory disease of pigs caused by type A influenza. Swine flu does not normally infect humans. However, human infections do occur, usually after exposure to pigs. Symptoms resemble those of the regular flu, including sore throat, coughing and fever.
Infectious Diseases Threats and Strategies for Containment
An update on the government's avian and pandemic influenza preparedness efforts was given today by leading infectious disease experts from around the country at a news conference at the National Press Club in Washington, D.C. The news conference, sponsored by the National Foundation for Infectious Diseases (NFID), addressed key issues and developments in the control and prevention of emerging infectious diseases, as well as highlighted global health risks of foodborne and water-related illnesses and the threat of multi-drug resistant tuberculosis.
"Emerging, and in some cases re-emerging, infectious diseases, notably avian and pandemic influenza, pose a very serious threat to the nation's public health," said Susan J. Rehm, MD, NFID Medical Director and Vice Chair, Department of Infectious Disease, at the Cleveland Clinic. "As health care professionals, we need to continue to identify these threats and take the necessary steps to respond quickly and effectively."
Addressing the prospect of an influenza pandemic, Carole A. Heilman, PhD, director, division of microbiology and infectious diseases, at the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH) and the Department of Health and Human Services discussed how NIAID is leading efforts to help bolster the nation's pandemic influenza preparedness, including activities exploring cell-based vaccines; expanding the domestic capacity for influenza vaccines; developing point-of-care diagnostics; supporting influenza antivirals; and advancing surge capacity for producing H5N1 vaccines. "NIAID is exploring all avenues to ensure that the infrastructure is in place to act on an influenza pandemic in this country," stated Dr. Heilman. NIAID is the lead NIH institute for pandemic influenza preparedness efforts.
Additional topics discussed at the 12th Richard J. Duma/NFID Annual News Conference and Symposium on Infectious Diseases included:
-- New Therapeutic Regimens in the Fight Against Multi-drug Resistant
Tuberculosis: Michael D. Iseman, MD, professor of medicine, National
Jewish Medical Center and Research Center in Denver, Colorado,
discussed the threat of multi-drug resistant tuberculosis and new
therapeutic strategies to help address the growing need to control
tuberculosis and reduce barriers to accessing these regimens.
"Since the introduction of the fluorquinolones in the 1980's there have been no significant advances in the treatment of tuberculosis," stated Dr. Iseman. "With the emergence of multi-drug resistant tuberculosis, this is a critical juncture in our efforts to control this disease."
-- Vaccine Financing Issues: Jerome O. Klein, MD, professor of pediatrics
at School of Medicine, discussed the rising costs of
vaccines in this country and concerns regarding continued access to
safe and effective vaccines.
-- Foodborne and Water-related Diseases: A National and Global Update:
James M. Hughes, MD, professor of medicine and public health, Rollins
School of Public Health at Emory University, the director of the Emory
Program in Global Infectious Diseases and the Emory Center for Global
Safe Water, provided an overview of the increasing prevalence and
public health risks of foodborne illnesses caused by a variety of
bacteria, viruses and parasites, and water-related diseases associated
with drinking water, water not intended for drinking, and recreational
water.
"Emerging, and in some cases re-emerging, infectious diseases, notably avian and pandemic influenza, pose a very serious threat to the nation's public health," said Susan J. Rehm, MD, NFID Medical Director and Vice Chair, Department of Infectious Disease, at the Cleveland Clinic. "As health care professionals, we need to continue to identify these threats and take the necessary steps to respond quickly and effectively."
Addressing the prospect of an influenza pandemic, Carole A. Heilman, PhD, director, division of microbiology and infectious diseases, at the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH) and the Department of Health and Human Services discussed how NIAID is leading efforts to help bolster the nation's pandemic influenza preparedness, including activities exploring cell-based vaccines; expanding the domestic capacity for influenza vaccines; developing point-of-care diagnostics; supporting influenza antivirals; and advancing surge capacity for producing H5N1 vaccines. "NIAID is exploring all avenues to ensure that the infrastructure is in place to act on an influenza pandemic in this country," stated Dr. Heilman. NIAID is the lead NIH institute for pandemic influenza preparedness efforts.
Additional topics discussed at the 12th Richard J. Duma/NFID Annual News Conference and Symposium on Infectious Diseases included:
-- New Therapeutic Regimens in the Fight Against Multi-drug Resistant
Tuberculosis: Michael D. Iseman, MD, professor of medicine, National
Jewish Medical Center and Research Center in Denver, Colorado,
discussed the threat of multi-drug resistant tuberculosis and new
therapeutic strategies to help address the growing need to control
tuberculosis and reduce barriers to accessing these regimens.
"Since the introduction of the fluorquinolones in the 1980's there have been no significant advances in the treatment of tuberculosis," stated Dr. Iseman. "With the emergence of multi-drug resistant tuberculosis, this is a critical juncture in our efforts to control this disease."
-- Vaccine Financing Issues: Jerome O. Klein, MD, professor of pediatrics
at School of Medicine, discussed the rising costs of
vaccines in this country and concerns regarding continued access to
safe and effective vaccines.
-- Foodborne and Water-related Diseases: A National and Global Update:
James M. Hughes, MD, professor of medicine and public health, Rollins
School of Public Health at Emory University, the director of the Emory
Program in Global Infectious Diseases and the Emory Center for Global
Safe Water, provided an overview of the increasing prevalence and
public health risks of foodborne illnesses caused by a variety of
bacteria, viruses and parasites, and water-related diseases associated
with drinking water, water not intended for drinking, and recreational
water.
Antiviral agents
Antiviral agents are used to inhibit production of viruses that cause disease. Most antiviral agents are only effective while the virus is replicating.
It is difficult to find medicines that are selective for the virus as viruses share most of the metabolic processes of the host cell. However, some enzymes are only present in viruses and these are potential targets for antiviral drugs.
Agents that inhibit the transcription of the viral genome are DNA polymerase inhibitors and reverse transcriptase inhibitors. Protease inhibitors inhibit the post-translational events. Other antiviral agents inhibit the virus from attaching to or penetrating the host cell. Immunomodulators induce production of host cell enzymes, which stop viral reproduction. Integrase strand transfer inhibitors prevent integration of the viral DNA into the host DNA by inhibiting the viral enzyme integrase. Neuraminidase inhibitors block viral enzymes and inhibit reproduction of the viruses.
It is difficult to find medicines that are selective for the virus as viruses share most of the metabolic processes of the host cell. However, some enzymes are only present in viruses and these are potential targets for antiviral drugs.
Agents that inhibit the transcription of the viral genome are DNA polymerase inhibitors and reverse transcriptase inhibitors. Protease inhibitors inhibit the post-translational events. Other antiviral agents inhibit the virus from attaching to or penetrating the host cell. Immunomodulators induce production of host cell enzymes, which stop viral reproduction. Integrase strand transfer inhibitors prevent integration of the viral DNA into the host DNA by inhibiting the viral enzyme integrase. Neuraminidase inhibitors block viral enzymes and inhibit reproduction of the viruses.
Antivirals and Antibiotics Based on Boron Chemistry
PALO ALTO, Calif. and LONDON, October 08, 2007 /PRNewswire/ -- Anacor Pharmaceuticals and GlaxoSmithKline today announced that they have entered into a worldwide strategic alliance for the discovery, development and commercialization of novel medicines for viral and bacterial diseases. The collaboration provides GlaxoSmithKline access to Anacor's proprietary boron-based chemistry for use against selected targets.
GlaxoSmithKline will participate in the alliance through its Infectious Diseases Centre of Excellence for Drug Discovery (ID CEDD). Under the terms of the agreement, Anacor will grant GlaxoSmithKline options to select product candidates developed under the collaboration that are directed to up to four discovery targets and with the potential for at least eight product options. Anacor will primarily be responsible for the discovery and development of boron-containing small molecule drug candidates through clinical proof of concept, at which point GlaxoSmithKline will have an exclusive option to license each compound for further development and commercialization on a worldwide basis. Anacor will have the right to further develop and commercialize compounds for which GlaxoSmithKline does not exercise its option. Anacor will receive a $12 million upfront payment and a $10 million equity financing commitment from GlaxoSmithKline. Contingent on achieving certain milestones, Anacor is eligible to receive discovery, development, regulatory and commercial milestones ranging up to $252 million and $331 million for each product candidate. If GlaxoSmithKline exercises its option at the proof of concept stage, Anacor will receive tiered double digit royalties, which are dependent on sales achieved.
Boron has been a relatively underutilized element in pharmaceutical products, in part due to a lack of naturally occurring boron-containing molecules to guide rational drug design. As a consequence of boron's unique properties, boron containing molecules may access different chemical space than traditional anti-infectives, providing opportunities for structural and biological novelty. Anacor's proprietary technological advances in the synthesis of boron-based compounds coupled with its rational drug design expertise, has enabled the company to rapidly create diverse families of boron-based compounds.
"We are pleased that GlaxoSmithKline, an industry leader in the development and commercialization of anti-infective drugs has acknowledged the potential of our boron-based chemistry for systemic applications," said David Perry, President and Chief Executive Officer. "This agreement with GlaxoSmithKline is consistent with our strategy to maximize the value of our technology platform by forming early collaborations for systemic applications of our boron technology, while developing topical products on our own to a more advanced stage."
"GlaxoSmithKline recently created a single Centre of Excellence for Drug Discovery dedicated to Infectious Diseases," said Zhi Hong, Senior Vice President and Head of GlaxoSmithKline's ID CEDD. "We recognize the issues created by resistance to available medicines and are determined to take advantage of novel approaches that offer new prospects for treatments across a range of infectious diseases. Anacor's boron-based chemistry has shown promise in inhibiting targets that are difficult to address with traditional carbon-based molecules and we look forward to further exploring its potential to provide new antiviral and antibiotic options."
About Anacor Pharmaceuticals
Anacor is a biopharmaceutical company developing novel small molecule therapeutics derived from its boron chemistry platform. Anacor has focused initially on developing topical applications of its compounds to treat fungal, bacterial and inflammatory diseases. Anacor's most advanced product candidate is AN2690, a novel topical antifungal in development for the treatment of toenail onychomycosis, which is a fungal infection of the nail and nail bed. Anacor entered into a worldwide license, development and commercialization agreement for AN2690 with Schering-Plough for all indications including the treatment of onychomycosis. In addition, Anacor has a portfolio of other topical product candidates in development for the treatment of psoriasis, gingivitis, acne, vaginal candidiasis and tinea pedis.
About GlaxoSmithKline
GlaxoSmithKline, one of the world's leading research-based pharmaceutical and healthcare companies, is committed to improving the quality of human life by enabling people to do more, feel better and live longer. For information about GlaxoSmithKline visit the company website.
About The ID CEDD
The ID CEDD is a global research unit within GlaxoSmithKline Drug Discovery dedicated to discovering therapies for infectious diseases. It is designed to integrate and better coordinate the progression of infectious diseases medicines from therapeutic hypothesis to clinical proof of concept. While drawing from the broader resources of GlaxoSmithKline's R&D organization, the ID CEDD bridges the conventional gap between discovery and development, brings scientists and physicians together in an environment and size of small biotechnology companies. It focuses on building an innovative pipeline through both internal efforts and external alliances with other companies and research institutions. Its Centre of Excellence for External Drug Discovery (ID CEEDD) will focus on 'virtualising' a portion of the infectious diseases pipeline by forming multiple risk-sharing/reward-sharing alliances.
GSK cautionary statement regarding forward-looking statements
Under the safe harbour provisions of the U.S. Private Securities Litigation Reform Act of 1995, the company cautions investors that any forward-looking statements or projections made by the company, including those made in this Announcement, are subject to risks and uncertainties that may cause actual results to differ materially from those projected. Factors that may affect the Group's operations are described under 'Risk Factors' in the 'Business Review' in the company's Annual Report on Form 20-F for 2006.
Anacor Forward-Looking Statements
This press release contains forward-looking statements, including statements regarding the expected closing of the collaboration agreement, GlaxoSmithKline's financing commitment to Anacor, the discovery, development and commercialization of novel medicines pursuant to the collaboration, future payments of milestone and royalty amounts to Anacor and the potential of Anacor's boron-based chemistry to inhibit targets that are difficult to address with traditional carbon-based molecules or have developed resistance to currently available treatments. These statements relate to future events and involve known and unknown risks, uncertainties and other factors that could cause actual levels of activity, performance or achievement to differ materially from those expressed or implied by these forward-looking statements. Some factors that may affect these forward-looking statements include, but are not limited to, the ability of the parties to collaborate successfully to develop drug candidates, the results of future drug discovery, development and commercialization efforts, including proof of safety and efficacy in clinical trials, the ability to obtain regulatory approvals for drug candidates identified through the collaboration, and the introduction of competing therapies by other companies. These statements reflect the views of Anacor as of the date of this press release with respect to future events and, except as required by law, it undertakes no obligation to update or revise publicly any forward-looking statements, whether as a result of new information, future events or otherwise after the date of this press release.
GlaxoSmithKline will participate in the alliance through its Infectious Diseases Centre of Excellence for Drug Discovery (ID CEDD). Under the terms of the agreement, Anacor will grant GlaxoSmithKline options to select product candidates developed under the collaboration that are directed to up to four discovery targets and with the potential for at least eight product options. Anacor will primarily be responsible for the discovery and development of boron-containing small molecule drug candidates through clinical proof of concept, at which point GlaxoSmithKline will have an exclusive option to license each compound for further development and commercialization on a worldwide basis. Anacor will have the right to further develop and commercialize compounds for which GlaxoSmithKline does not exercise its option. Anacor will receive a $12 million upfront payment and a $10 million equity financing commitment from GlaxoSmithKline. Contingent on achieving certain milestones, Anacor is eligible to receive discovery, development, regulatory and commercial milestones ranging up to $252 million and $331 million for each product candidate. If GlaxoSmithKline exercises its option at the proof of concept stage, Anacor will receive tiered double digit royalties, which are dependent on sales achieved.
Boron has been a relatively underutilized element in pharmaceutical products, in part due to a lack of naturally occurring boron-containing molecules to guide rational drug design. As a consequence of boron's unique properties, boron containing molecules may access different chemical space than traditional anti-infectives, providing opportunities for structural and biological novelty. Anacor's proprietary technological advances in the synthesis of boron-based compounds coupled with its rational drug design expertise, has enabled the company to rapidly create diverse families of boron-based compounds.
"We are pleased that GlaxoSmithKline, an industry leader in the development and commercialization of anti-infective drugs has acknowledged the potential of our boron-based chemistry for systemic applications," said David Perry, President and Chief Executive Officer. "This agreement with GlaxoSmithKline is consistent with our strategy to maximize the value of our technology platform by forming early collaborations for systemic applications of our boron technology, while developing topical products on our own to a more advanced stage."
"GlaxoSmithKline recently created a single Centre of Excellence for Drug Discovery dedicated to Infectious Diseases," said Zhi Hong, Senior Vice President and Head of GlaxoSmithKline's ID CEDD. "We recognize the issues created by resistance to available medicines and are determined to take advantage of novel approaches that offer new prospects for treatments across a range of infectious diseases. Anacor's boron-based chemistry has shown promise in inhibiting targets that are difficult to address with traditional carbon-based molecules and we look forward to further exploring its potential to provide new antiviral and antibiotic options."
About Anacor Pharmaceuticals
Anacor is a biopharmaceutical company developing novel small molecule therapeutics derived from its boron chemistry platform. Anacor has focused initially on developing topical applications of its compounds to treat fungal, bacterial and inflammatory diseases. Anacor's most advanced product candidate is AN2690, a novel topical antifungal in development for the treatment of toenail onychomycosis, which is a fungal infection of the nail and nail bed. Anacor entered into a worldwide license, development and commercialization agreement for AN2690 with Schering-Plough for all indications including the treatment of onychomycosis. In addition, Anacor has a portfolio of other topical product candidates in development for the treatment of psoriasis, gingivitis, acne, vaginal candidiasis and tinea pedis.
About GlaxoSmithKline
GlaxoSmithKline, one of the world's leading research-based pharmaceutical and healthcare companies, is committed to improving the quality of human life by enabling people to do more, feel better and live longer. For information about GlaxoSmithKline visit the company website.
About The ID CEDD
The ID CEDD is a global research unit within GlaxoSmithKline Drug Discovery dedicated to discovering therapies for infectious diseases. It is designed to integrate and better coordinate the progression of infectious diseases medicines from therapeutic hypothesis to clinical proof of concept. While drawing from the broader resources of GlaxoSmithKline's R&D organization, the ID CEDD bridges the conventional gap between discovery and development, brings scientists and physicians together in an environment and size of small biotechnology companies. It focuses on building an innovative pipeline through both internal efforts and external alliances with other companies and research institutions. Its Centre of Excellence for External Drug Discovery (ID CEEDD) will focus on 'virtualising' a portion of the infectious diseases pipeline by forming multiple risk-sharing/reward-sharing alliances.
GSK cautionary statement regarding forward-looking statements
Under the safe harbour provisions of the U.S. Private Securities Litigation Reform Act of 1995, the company cautions investors that any forward-looking statements or projections made by the company, including those made in this Announcement, are subject to risks and uncertainties that may cause actual results to differ materially from those projected. Factors that may affect the Group's operations are described under 'Risk Factors' in the 'Business Review' in the company's Annual Report on Form 20-F for 2006.
Anacor Forward-Looking Statements
This press release contains forward-looking statements, including statements regarding the expected closing of the collaboration agreement, GlaxoSmithKline's financing commitment to Anacor, the discovery, development and commercialization of novel medicines pursuant to the collaboration, future payments of milestone and royalty amounts to Anacor and the potential of Anacor's boron-based chemistry to inhibit targets that are difficult to address with traditional carbon-based molecules or have developed resistance to currently available treatments. These statements relate to future events and involve known and unknown risks, uncertainties and other factors that could cause actual levels of activity, performance or achievement to differ materially from those expressed or implied by these forward-looking statements. Some factors that may affect these forward-looking statements include, but are not limited to, the ability of the parties to collaborate successfully to develop drug candidates, the results of future drug discovery, development and commercialization efforts, including proof of safety and efficacy in clinical trials, the ability to obtain regulatory approvals for drug candidates identified through the collaboration, and the introduction of competing therapies by other companies. These statements reflect the views of Anacor as of the date of this press release with respect to future events and, except as required by law, it undertakes no obligation to update or revise publicly any forward-looking statements, whether as a result of new information, future events or otherwise after the date of this press release.
Subskrybuj:
Posty (Atom)