Fearing bird flu, some are stockpiling Tamiflu

WASHINGTON – What fallout shelters were to worries about the Bomb, and duct tape and plastic sheeting were to fears of terrorism after Sept. 11, Tamiflu is starting to be for the specter of pandemic influenza.

Across the country, people appear to be building home stockpiles of the prescription antiviral medicine, according to reports by drugstores, benefit managers and physicians.

The run on Tamiflu was apparently spurred by government warnings, here and abroad, that chances for a worldwide flu epidemic are rising, and by news that Southeast Asia’s H5N1 bird flu is moving westward.

For more than a year, demand for the drug, known generically as oseltamivir, has been rising as more than three dozen countries began to lay in millions of doses for national stockpiles. Retail demand took a sharp upturn last month. A five-day course of two pills a day costs $80 to $90.

The trend worries many physicians and public health experts because widespread home stockpiling could undermine international efforts to fight a flu pandemic.

The Centers for Disease Control and Prevention and the Infectious Diseases Society of America are each drawing up advice to practitioners on the issue of home stockpiles, spokesmen said this week. With no vaccine available yet, an abundant supply of Tamiflu is one of the few weapons public health agencies could wield to try to stop an emerging pandemic.

Human infections with the H5N1 strains are extremely rare – but frequently fatal. Since late 2003, 118 people have contracted the disease and 61 have died.

H5N1 is transmitted easily among birds but is not easily passed between people. It may never develop that capacity.

Tamiflu is taken once a day to prevent influenza or twice a day to lessen symptoms once infection has occurred. Ironically, the drug’s surging popularity comes as new research suggests that some of the H5N1 strains that have infected human beings are so virulent that conventional doses may not be effective. How the drug should be used in a pandemic – or whether it would even work – is uncertain.