Health expert predicts 20% to 30% will be infected, stresses Tamiflu just a drug; vaccine will not be available until 2006

2005-10-25 / Taiwan News, Staff Reporter /

Dr. Su Ih-jen (蘇益仁), the director of the Clinical Division at the National Health Research Institute, is one of the forerunners in

Dr. Su Ih-jen/File photo

Taiwan's fight against the threat of avian flu. Su has been instrumental in the development of a local manufacturing process for Tamiflu, one of the two drugs experts believe could prove effective in treating the virus.
In an interview last week with the Taiwan News' Jenny Hsu, Su discusses preparations being made to fight a disease that could infect 20-30 percent of local residents in the first wave of a possible outbreak.

Taiwan News: Is Taiwan prepared for a possible avian flu epidemic?

Su Ih-jen: I believe we are. Taiwan is the first country to seek authorization from Roche to manufacture our own version of Tamiflu. Taiwanese scientists began research on avian flu shortly after SARS hit. We sent a team to different Southeast Asian countries such as Hong Kong, Vietnam, and Thailand to learn more about the virus. Since Taiwan is not a member of WHO, we have to make an extra effort to protect our people. The three ways to fight the virus are first, we must maintain a high level of hygiene in our public areas. Second, we need to have enough effective anti-viral drugs when the outbreak takes place, and lastly, we need to develop a vaccine against the virus before it spreads.

TN: What is the latest in Taiwan's effort to develop an avian flu vaccine?

Su: Our scientists have been working on a vaccine for a long time. But it will not be available until 2006. A vaccine is developed from the virus strand you are trying to fight. When we have our first case in Taiwan, we can develop a vaccine against the local type of avian flu. We predict the first wave of an outbreak will begin around January to March next year and foresee that 20-30 percent of the population will be infected. Those who make it will have the best line of defense because their bodies would have developed antibodies against the virus. We call it "nature's vaccine."

TN: You mentioned that we will have our first wave in the beginning of next year. Do you predict there will be more than one outbreak?

Su: Of course, the virus will probably be around for the next four-five years. This is why we need to quickly develop a vaccine.

TN: What is the cost of making of the vaccine? When it is developed, will it be very expensive for the public?

Su: Vaccine development is a costly task. I do not have the exact figure. When a vaccine becomes available, it will be more expensive than the regular flu vaccine. However, I think by the time we have a vaccine, the government should give it out for free. The government should consider the burden of disease on this situation. Would it rather pay for the vaccine now and prevent an epidemic or would they prefer to save some money and risk the health of the entire country in the long run?

TN: How does Tamiflu work and how effective is it?

Su: There are two drugs in the world have been proven effective in controlling the H5N1 virus. One is Relenza, the other one is Tamiflu. We must let the public know that Tamiflu is not a vaccine, it is a drug, used to treat patients after they have been infected. What Tamiflu does is to inhibit the virus from replicating and releasing itself to other cells. It is most effective when administered within the first 48 hours when the symptoms appear.

TN: If both Relenza and Tamiflu are effective, then do we only hear about Tamiflu?

Su: Unlike like Tamiflu, Relenza is a nasal spray. It is harder to distribute nasal sprays when a mass quantity is required. Tamiflu is a tablet taken orally. It is easier to ingest and distribute.

TN: One way to prevent the spread of the virus is to stop it in neighboring countries. Since an avian flu related death was confirmed in Thailand, would we consider sending free Tamiflu to Thailand as we did for Vietnam?

Su: No, it is not necessary. Vietnam has an extremely high population density. Most of the cases in Vietnam happened in the countryside where public health is not emphasized. People there are not as aware of avian flu as the people in Thailand. Thailand has been preparing for it. I think they are rich enough to provide medical help for their own people. Another reason to help Vietnam is because we have over 300,000 Taiwanese businessmen there. There is a high frequency of travel between Vietnam and Taiwan.

TN: Since this is also the season for the regular flu, how can people tell the difference between regular flu and avian flu?

Su: There are not a whole lot of differences between the two types of flu. The symptoms are very similar. Generally people will feel feverish, fatigue, body ache, coughing, and sneezing. The best way to differentiate the two is to go see a doctor. Doctors are trained to ask the recent history of the patient. Has he been around poultry lately? Where has he traveled in the last few months? Has he been around any sick people? If the doctor suspects a H5N1 case, he can take a quick culture sample from the throat area. Through our rapid diagnosis system, we can have the results back in less than two hours. I urge the public to have confidence in the medical technology of Taiwan. We have wonderful doctors and world-class facilities. People should learn to trust the doctors.