While the H12N1 Swine Flu continues to spread in the UK the government continues floundering in it’s response. There appears to be complete confusion on the issue of Tamiflu, the antiviral drug used to “treat the flu.”  Chief Medical Officer Sir Liam Donaldson appears ready to distribute vouchers to anyone off the Internet or otherwise, just days after giving doctors permission to not prescribe Tamiflu if their phone rings too much.

Because patients must be treated with 48 hours after the onset of symptoms there is limited usefulness for the drug. It also does not cure the flu, it only shortens the duration by 1-2 days. While some projections are that widespread distribution of Tamiflu to the general population would save millions of lives, the reality is no one knows if Tamiflu would be effective at all  with this type of distribution. It is more likely to create widespread resistance and render Tamiflu a useless drug.  Tamiflu is a tremendous asset for a pandemic but it should be reserved for susceptible populations and specific situations and remain under the control of doctors, not the government. Isolation and preventative measures are our front line defense against the pandemic, not handing out Tamiflu to everyone.

A case in point is the Air Force Academy outbreak of Swine Flu. It is early and Tamiflu could be administered to the entire population since they live in close quarters and could be sequestered short term in the contained environment of the Academy. Or they could be more conservative and administer Tamiflu to anyone with a history of respiratory or immune problems making them a higher risk for serious complications, and restrict the campus short term. Letting everyone in Colorado Springs have a free voucher for Tamiflu would be irresponsible.

Tamiflu is not a panacea and using it as one will probably render it useless for the people who need it most. Lets hope the UK does not create a resitant strain of flu via massive distribution of vouchers.

Reduction of Risk of Introduction of Novel H1N1 Virus into the Camp Setting

• Provide camp attendees, staff and volunteers with materials prior to arrival at the camp to notify them that they are not allowed to attend camp if they have had an ILI in the 7 days prior to the start of the camp.  In addition, they should be reminded that if they have been exposed to a person with novel H1N1 or ILI in the 7 days prior to the start of camp, they may attend camp but should closely self-monitor and report development of ILI symptoms immediately.
• Consider active screening of ALL newly arriving camp attendees, staff and volunteers by asking if they have had any symptoms of ILI in the previous 7 days. Provide education to individual campers about reporting ILI.  A careful health history of each arriving camper should be taken. Note any conditions that may place them at high risk for complications of influenza.
• Camp attendees, staff and volunteers should be instructed to immediately inform camp management if they currently have or have had an influenza-like illness (ILI) in the 7 days prior to arrival.
• Persons who currently have or have had ILI in the previous 7 days should not attend camp for 7 days after their symptoms began or until they have been symptom-free for 24 hours, whichever is longer.

See the CDC website for complete information