Mar 29, 2012
Oseltamivir shown to cross placental barrier to newborn
Significant levels of oseltamivir (Tamiflu) were detected in umbilical cord blood after a woman with a severe case of pandemic 2009 H1N1 (pH1N1) flu received high doses of the drug, suggesting the drug can cross the placental barrier in humans, according to a letter yesterday in Clinical Infectious Diseases. Dutch physicians reported that the 29-year-old woman, 29 weeks pregnant, was treated in an intensive care unit (ICU) for respiratory failure requiring artificial respiration. Polymerase chain reaction was positive for pH1N1, and the patient also had pneumonia. She received antibiotics and 75 mg of oseltamivir twice a day, which was then doubled after 3 days. She gave birth via cesarean section to a 1,640-gram girl 6 days after ICU admission after her condition had not improved and a nasopharyngeal swab was still positive for pH1N1. Test results showed levels of oseltamvir and oseltamivir carboxylate exceeding 90% inhibitory concentration in cord blood taken after cord clamping. The authors write that, because of unknown effects of oseltamivir on fetuses, "We recommend that oseltamivir should only be administered to critically ill pregnant women."
Mar 28 Clin Infect Dis letter
Psychological as well as physical ill health may raise risk of severe H1N1
Underlying medical conditions, including psychological issues, and delayed treatment with oseltamivir appeared to be risk factors during the 2009 H1N1 flu pandemic, according to a Chinese study in PLoS One. Researchers analyzed 230 mild and 230 severe pH1N1 cases in Zhejiang province and found that patients with severe cases received oseltamivir on average 5 days after symptom onset, compared with 3 days for mild cases. They found that both chronic underlying disease and poor psychological health were associated with an increased risk of developing severe disease, with odds ratios (ORs) of 2.39 and 5.85, respectively. They also found that timely oseltamivir treatment was protective against severe pH1N1 disease (OR = 0.35).
Mar 28 PLoS One study
Expert recommends dual-use framework
To move forward on assessing and addressing issues of dual use in the life sciences, the US government must implement an oversight framework similar to what the National Science Advisory Board for Biosecurity (NSABB) recommended almost 5 years ago, a biosecurity expert wrote yesterday in Biosecurity and Bioterrorism. Gerald L. Epstein, PhD, former director of the Center for Science, Technology, and Security Policy of the American Association for the Advancement of Science, made his remarks in light of two recent unpublished studies involving a mutated H5N1 avian flu virus by Dutch researchers and an H5N1-H1N1 hybrid produced by University of Wisconsin scientists. He said such a framework should build on existing processes, be able to gain buy-in from the scientific community, and be capable of implementation at modest cost. He wrote that, while it may be impossible to know how well such a system might work, "maintaining the public trust will require a system to be established in which reasonably foreseeable dual-use consequences of life science research are anticipated, evaluated, and addressed." The NSABB recommended in December that details of the two studies not be published in full.
Mar 28 Clin Infect Dis letter