This blog often covers my own first-person experiences. The most recent was a bit of a surprise. After covering the H1N1 flu from a distance as a blogger, the virus has hit home. This week, one of my family members was diagnosed with H1N1. She’s already feeling better, and the rest of the family is not sick. Though it was not a clear cut decision, my doctor suggested I should go on Tamiflu (in large part because I recently finished chemotherapy).
Today’s New York Times had a colorful article on H1N1 at kids’ summer camps in Maine which illustrated a debate about the use of Tamiflu as a prophylactic. It seems to have worked at the camps, however, some officials worry that the large-scale distribution of Tamiflu may be, in the words of Maine’s Public Health Director, “start breeding resistance.” It raises the prickly issue that can come up in other emergency preparedness and response contexts as well: that sometimes what is best for the individual is not necessarily best for the society as a whole.
A couple of other interesting H1N1 articles I wanted to highlight: an interview with author John Barry (The Great Influenza) about the lessons of the 1918 pandemic for the present situation in the current issue of “Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science”, and a helpful piece today in WebMD.com offering a likely time-line for implementation of a H1N1 vaccine during the rest of the year.
UPDATE (7/25): The New York Times reports that a top CDC official is asking summer camps to stop handing out Tamiflu to healthy campers to stop camp flu outbreaks.
The official, Dr. Anne Schuchat, director of the National Center on Immunization and Respiratory Diseases, said she “strongly recommended” giving the drug only to people already seriously ill, or to their family members who are pregnant, have asthma or have other conditions that could be life-threatening if they caught the flu.
Giving the drug to healthy people wastes the world’s limited supplies of Tamiflu and increases the chances of drug-resistant strains developing, Dr. Schuchat said, and the disease centers are working with camp associations and local health departments to discourage the practice…The practice is controversial because public health authorities consider it selfish and dangerous. Although there is a national stockpile of 50 million courses of Tamiflu, it will not last into the coming flu season if many healthy Americans start taking the drug.
What’s particular interesting is how this illustrates a potential conflict between what is best for the greater society and what is best for an individual or a particular community, such as a camp.
2 responses so far ↓
1 Katie Danziger // Jul 23, 2009 at 10:31 pm
I’m sorry to hear that H1N1 hit your house, but I have heard that should it mutate, those who have had it are in better shape.
2 Give Tamiflu Prophylactically Or Not? When Personal & National Preparedness Can Conflict // Jul 25, 2009 at 11:24 am
[...] As I mentioned in a post earlier this week, “H1N1 Hits Home, I’m On Tamiflu,” I (along with my oncologist) had to decide a course of action after someone in my family was diagnosed with H1N1. Because I am recovering from Leukemia and have just finished chemotherapy, she recommended that I take Tamiflu (which follows the CDC’s guidance for people with underlying illnesses). But giving the antiviral to healthy kids this summer raises a more difficult issue, particularly since the camps have found it to be a successful way of stopping the flu’s spread. In his article, which covers the press briefing given yesterday by Dr. Anne Schuchat, director of the National Center on Immunization and Respiratory Diseases, McNeil writes: Giving the drug to healthy people wastes the world’s limited supplies of Tamiflu and increases the chances of drug-resistant strains developing, Dr. Schuchat said, and the disease centers are working with camp associations and local health departments to discourage the practice. Dozens of camps have had swine flu outbreaks this summer. Some closed, others set up infirmaries, and some have had camp doctors write Tamiflu prescriptions or asked parents to send children with the drug. [...]
Leave a Comment