Sunday, December 16, 2007

That Crazy Flu Bug

From the country that brought us video game induced seizures, now comes flu-induced delirium.
Japanese children are running around like crazed lunatics and exhibiting self-destructive behavior. Now, I've never been to Japan, but I can tell you that as the father of a 2 year old, this does not strike me as particularly unusual. Nonetheless, the evidence from Japan seems to implicate the use of Tamiflu (oseltamivir) in flu patients with neuropsychiatric disturbances that include seizures, delirium and mysterious falls from tall buildings.
Four Japanese children under 16 have died from falls and this has the FDA looking into 55 incidents (no deaths) of abnormal behavior in U.S. patients taking Tamiflu since it was approved in 1999.
Apparently, and this was news to me, the use of Tamiflu is considered standard of care in Japan for patients with the flu (75% of the 48 million prescriptions written have been for Japanese patients). This is odd, because the drug is really not all that effective - it is only helpful if given early in the course of illness and only able to diminish the duration of symptoms by 24 hours or so. Roche, the maker of Tamiflu, has brushed off these incidents - arguing that they are the product of the viral (flu) infection rather than the medication.
Regardless of the cause, however, it seems prudent to limit the use of Tamiflu to a select group of patients: those with significant underlying diseases at high risk for complications who present early in the course of their flu bug. Everyone else should consider getting vaccinated (if you haven't done it, now would be a good time) and remember that there's nothing crazy about the notion that good hygiene can help control the spread of disease.

From the New York Times: