Dr. Dominick Iacuzio, Medical Director, Roche Pharmaceuticals

Tamiflu®, from Roche Pharmaceuticals

Dr. Dominick Iacuzio is the Medical Director at Hoffmann-La Roche Inc. (Roche), based in Nutley, N.J., the U.S. prescription drug unit of the Roche Group, based in Basel, Switzerland.

Dr. Iacuzio spoke today for almost an hour with Etopia Media Medical News Network, explaining the medical and public health aspects of Roche's Tamiflu® brand of oseltamivir, the most powerful and the most popular of the new "anti-virals" that can offer a medical defense against viruses that is superior to that offered through a strategy that relies on vaccination to protect a susceptible population.

As discussed in "Etopia Media Medical News Network #30: Could the bird flu virus H5N1 cause a 1918-class global influenza pandemic?", epidemiologists now fear, and public health officials around the world are now discussing how best to defend against, a global pandemic of avian influenza that could equal or exceed the impact of the 1918 influenza pandemic that killed at least 20 million and possibly as many as 40 million people worldwide, including 675,000 Americans.

Because avian influenza virus, like all viruses, has the ability to mutate and evolve very rapidly, it's a moving target against which it is difficult to direct the weapon of vaccination, which creates in those vaccinated an artificially-acquired immunity only to the specific variety of virus being targeted by that vaccine.

Add to this problem the production difficulties and long time frames involved in producing the vaccine and it's easy to see that protecting tens or hundreds of millions of people against a rapidly-moving and rapidly-mutating strain of virus, such as the avian flu, by means of the vaccination route would in no way be a sure thing.

Also, as in case of the British Medicines and Health Products Regulatory Agency (MHRA)'s de-certification of the Chiron Corporation flu vaccine factory in Liverpool, England, U.K., a failure to protect the sanitation of the flu production process, which involves the use of millions of chicken eggs that need to be kept sterile, can render tens of millions of flu doses useless and throw a country depending upon these doses into medical turmoil.

For all these reasons, it may take a completely different public health strategy to meet the challenge of defending against a possible avian flu pandemic, like the one that is potentially brewing now in Asia. Wild birds spread the avian influenza virus to domestic fowl, which spread it to pigs, which, by harboring both avian and human viruses, can provide a "mixing pot" for crossover mutations that produce a strain that can infect humans. After additional changes in the virus, it may become transmissible on a human-to-human basis. Once the virus has started to infect humans, as it already has in tens of cases in Asia, most of whom have died, it sets the stage, in this age of globalism and easy and common international travel, for a global pandemic.

Tamiflu®, an "anti-viral" drug from Roche Pharmaceuticals, works entirely different from the way vaccines do when they confer an artificially-induced immune system enhancement against a specific type of influenza virus.

Tamiflu, Roche's brand of oseltamivir, works against the flu by interfering in the intimate bio-chemical processes by which a virus, once it has penetrated, infected, and replicated itself inside a human cell, then pours out of that cell to carry on these activities in additional cells. By blocking the action of a particular enzyme, Tamiflu prevents this stage of the infection cycle from occurring, thereby preventing the spread of the virus more widely throughout the body.

As Dr. Iacuzio explains in this interview, the aches, pains, and other symptoms typically associated with a case of flu are largely the result of physiological reactions in the body triggered by the viral infection. These changes are a sort of "alarm" that alerts and turns on the powerful human immune response that comes into play to seek out and destroy the invading microbes. Unfortunately for victims of the flu, these "alarm" signals can make them, as the person in the body, quite uncomfortable.

But by interfering in the process by which the virus spreads, Tamiflu eliminates the need for these alarms to sound quite so loudly. This means that, when taken within the first 48 hours after infection, Tamiflu reduces the severity of symptoms and shortens the period of illness.

In addition, if taken on a prophylactic, or preventive basis, Tamiflu can block even the initial onset of virus replication and resulting symptoms in a high percentage of instances.

Due to the comparative advantage of an anti-viral such as Tamiflu as compared with a vaccination strategy, public health officials worldwide and Roche experts are now meeting to talk about producing and storing stockpiles of Tamiflu to be held in readiness against the eventuality of an incipient avian influenza pandemic.

You can hear Dr. Iacuzio discuss all these matters, as well as talk in detail about the way Tamiflu works inside the body at the cellular level, by clicking here.

To read a press release dated October 31, 2004, announcing "New Data Proves Oseltamivir Effective Against Human H5N1 and Avian H5N1 Influenza Virus--Study confirms need to stockpile oseltamivir as a management strategy for the next pandemic, click here.

To read an earlier press release, dated October 19, 2004, titled "HHS Cites Tamiflu® in New Antiviral Guidelines for Preventing, Treating Influenza—Antivirals to Play Greater Role with Vaccine Shortage, click here.

You can visit the Tamiflu home page on the Roche web site by clicking here.