Black Triangle

many of those prescribed Tamiflu are stockpiling it to be sure of having access to the powerful drug

Independent 10th of August

Doctors should stop giving Tamiflu to children as a routine treatment for swine flu, researchers concluded after finding the drug can cause more harm than good.

Independent 11th of August

To be fair, no wonder people are confused with the BMJ and Liam Donaldson having a disagreement over oseltamivir.

All you need to know about Tamiflu (oseltamivir).

1. Evidence that it is effective in children is limited, the BMJ study actually adds very little to what we knew before the pandemic started.
2. However, oseltamivir may have some effect, and you might consider that important if you judge the influenza infection a serious risk to your child’s health.
3. If you don’t judge currently judge the risks of the disease to be great (your judgement may vary compared to others), then be aware that a child suffering relatively mild symptoms of influenza may well develop nausea and vomiting if they take osetamivir (about 1 in 20). Nightmares have also been reported.
4. These adverse effects are reversible and not life-threatening (whereas some have died from Swine flu).
5. Your decision may change based on your perceived risk of the influenza – which could change if the virus mutates.

The government are taking a safety first approach to oseltamivir’s use, and I have some sympathy. One can imagine how the media would react if a child died from Swine flu after being denied oseltamivir. They’d be crucified. On the other hand, nausea and vomiting may be unpleasant, but there won’t be the same media outcry.

One could compare oseltamivir with a bathing ring.

Standing on a beach with one foot high waves coming into shore you might be pretty confident that you and your child can cope without the bathing ring. However the life guards are handing them out for free, because the odd rogue wave has taken people out to sea. Most kids tolerate having the bathing ring anyway. That’s probably comparable to the current H1N1 influenza outbreak, which currently has relatively mild symptoms in most people.

With a more severe influenza outbreak (either a mutation of the existing influenza pandemic, or a more serious Avian influenza) you are stood on the beach looking at 30 foot wave heading towards you. You are going to grab anything that might make you float regardless of the strength of the evidence. Bathing rings float, they might help.

The problem we appear to have is that the government planned for, and prepared the public for, an outbreak of influenza that was much more severe. This was noted in the Radio 4 programme The Report. We can be thankful that is the case, but there may well be a substantial argument for revisiting the prescribing of oseltamivir to those with mild symptoms.

More on Oseltamivir’s adverse effects, including the controversial neuropsychiatric problems, here.