Frontline defense against the next pandemic: Antivirals for avian flu

S.A. Khan, P.G.M. Rao, P. Kumar, G. Rodrigues

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

A pandemic of the human influenza virus has caused extensive morbidity and mortality around the world. The mechanisms involved in the emergence of new influenza viral strains and the epidemiological factors leading to pandemics are unpredictable. The spread of the virus and the challenges encountered in its management are discussed, along with a review on the antivirals against avian influenza. Till date, neuraminidase inhibitors remain the mainstay of management as they are well tolerated and less likely to promote the development of drug resistance, compared to the conventional adamantanes. Details on the clinical effects of antivirals on the infection, safety profile, status in clinical practice and drug resistance are covered in this paper. Future prospects and research to fight the pandemic are also addressed. An outbreak of this infection in various Asian countries emphasises the need for a collaborative approach from healthcare experts, governments and media, to control and curb the spread of infection worldwide.
Original languageEnglish
Pages (from-to)383-389
Number of pages7
JournalIndian Journal of Pharmacology
Volume38
Issue number6
Publication statusPublished - 2006

Fingerprint

Influenza in Birds
Pandemics
Antiviral Agents
Drug Resistance
Human Influenza
Infection
Adamantane
Neuraminidase
Orthomyxoviridae
Disease Outbreaks
Viruses
Morbidity
Delivery of Health Care
Safety
Mortality
Research

Cite this

Khan, S.A. ; Rao, P.G.M. ; Kumar, P. ; Rodrigues, G. / Frontline defense against the next pandemic: Antivirals for avian flu. In: Indian Journal of Pharmacology. 2006 ; Vol. 38, No. 6. pp. 383-389.
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title = "Frontline defense against the next pandemic: Antivirals for avian flu",
abstract = "A pandemic of the human influenza virus has caused extensive morbidity and mortality around the world. The mechanisms involved in the emergence of new influenza viral strains and the epidemiological factors leading to pandemics are unpredictable. The spread of the virus and the challenges encountered in its management are discussed, along with a review on the antivirals against avian influenza. Till date, neuraminidase inhibitors remain the mainstay of management as they are well tolerated and less likely to promote the development of drug resistance, compared to the conventional adamantanes. Details on the clinical effects of antivirals on the infection, safety profile, status in clinical practice and drug resistance are covered in this paper. Future prospects and research to fight the pandemic are also addressed. An outbreak of this infection in various Asian countries emphasises the need for a collaborative approach from healthcare experts, governments and media, to control and curb the spread of infection worldwide.",
author = "S.A. Khan and P.G.M. Rao and P. Kumar and G. Rodrigues",
note = "Cited By :1 Export Date: 10 November 2017 CODEN: INJPD Correspondence Address: Khan, S.A.; Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal-576 104, India; email: sohailkhan1981@gmail.com Chemicals/CAS: amantadine, 665-66-7, 768-94-5; oseltamivir, 196618-13-0, 204255-09-4, 204255-11-8; rimantadine, 13392-28-4, 1501-84-4; zanamivir, 139110-80-8 Tradenames: fluarix; flumist, Medimmune; fluvirin, Chiron; fluzone, Labaz; relenza, Glaxo SmithKline Manufacturers: Chiron; Glaxo SmithKline; Labaz; Medimmune References: Johnson, N.P., Mueller, J., Updating the account lobal mortality of the 1918-1920 {"}Spanish{"} influenza pandemic (2002) Bull Hist Med, 76, pp. 105-115; Hseih, Y.C., Wu, T.Z., Liu, D.P., Shao, P.L., Chang, L.Y., Lu, C.Y., Influenza pandemics: Past, present and future (2006) J Formos Med Assoc, 105, pp. 1-6; Wong, S.S., Yuen, K.Y., Avian influenza virus infections in humans (2006) Chest, 129, pp. 156-168; Sims, L.D., Domenech, J., Benigno, C., Kahn, S., Kamata, A., Lubroth, J., Origin and evolution of highly pathogenic H5N1 avian influenza in Asia (2005) Vet Rec, 157, pp. 159-164; Tam, J.S., Influenza A (H5N1) in Hong Kong: An overview (2002) Vaccine, 20, pp. 77-81; Shortridge, K.F., Peiris, J.S., Guan, Y., The next influenza pandemic: Lessons from Hong Kong (2003) J Appl Microbiol, 94, pp. 70-79; Koopmans, M., Wilbrink, B., Conyn, M., Natrop, G., Van Der Nat, H., Vennema, H., Transmission of H7N7 avian influenza A virus to human beings during a large outbreak in commercial poultry farms in the Netherlands (2004) Lancet, 363, pp. 587-593; Avian Influenza- Frequently Asked Questions, , http://www.who.int/csr/disease/avian_influenza/avian_faqs/en/index.html, [accessed: 2006 May 2]. Available from; Webster, R.G., Guan, Y., Poon, L., Krauss, S., Webby, R., Govorkovai, E., The spread of the H5N1 bird flu epidemic in Asia in 2004 (2005) Arch Virol Suppl, 19, pp. 117-129; Jameel, S., The birds are coming: Are we ready? (2005) Indian J Med Res, 122, pp. 277-281; Taubenberger, J.K., Morens, D.M., 1918 Influenza: The mother of all pandemics (2006) Emerging Infect Dis, 12, pp. 15-22; Kilbourne, E.D., Influenza pandemics of the 20th century (2006) Emerg Infect Dis, 12, pp. 9-14; Jefferson, T., Demicheli, V., Rivetti, D., Jones, M., Di Pietrantonj, C., Rivetti, A., Antivirals for influenza in healthy adults: Systematic review (2006) Lancet, 367, pp. 303-313; Jefferson, T., Demicheli, V., Rivetti, D., Jones, M., Di Pietrantonj, C., Rivetti, A., Antivirals for influenza in healthy adults: Systematic review (2006) Lancet, 367, pp. 303-313; Oseltamivir, , http://en.wikipedia.org/wiki/oseltamivir, [accessed: 2006 May 3]. Available from; Li, W., Escarpe, P.A., Eisenberg, E.J., Cundy, K.C., Sweet, C., Jakeman, K.J., Identification of GS 4104 as an orally bioavailable prodrug of the influenza virus neuraminidase inhibitor GS 4071 (1998) Antimicrob Agents Chemother, 42, pp. 647-653; Mendel, D.B., Tai, C.Y., Escarpe, P.A., Li, W., Sidwell, R.W., Huffman, J.H., Oral administration of a prodrug of the influenza virus neuraminidase inhibitor GS 4071 protects mice and ferrets against influenza infection (1998) Antimicrob Agents Chemother, 42, pp. 640-646; Leneva, I.A., Roberts, N., Govorkova, E.A., Goloubeva, O.G., Webster, R.G., The neuraminidase inhibitor GS4104 (oseltamivir phosphate) is efficacious against A/ Hong Kong/156/97 (H5N1) and A/Hong Kong/1074/99 (H9N2) influenza viruses (2000) Antiviral Res, 48, pp. 101-115; Govorkova, E.A., Leneva, I.A., Goloubeva, O.G., Bush, K., Webster, R.G., Comparison of efficacies of RWJ-270201, zanamivir and oseltamivir against H5N1, H9N2, and other avian influenza viruses (2001) Antimicrob Agents Chemother, 45, pp. 2723-2732; (2001) Product Information: Tamiflu(R) Oseltamivir Phosphate Capsules and for Oral Suspension, , Nutley, NJ: Roche Pharmaceuticals; Wood, N.D., Aitken, M., Sharp, S., Evison, H., Tolerability and pharmacokinetics of the influenza neuraminidase inhibitor Ro 64-0802 (GS4071) following oral administration of the prodrug Ro 64-0796 (GS4104) to healthy male volunteers (1997) 37th Interscience Conference on Antimicrobial Agents and Chemotherapy, p. 25. , Program and Abstracts of the; 1997 Sep 27-28; Washington, DC; Beigel, J.H., Farrar, J., Han, A.M., Hayden, F.G., Hyer, R., De Jong, M.D., Avian influenza a (H5N1) infection in humans (2005) N Engl J Med, 353, pp. 1374-1385; Aoki, F., Osterhaus, A., Rimmelzwaan, G., Kinnersley, W., Ward, P., Oral GS4104 successfully reduces duration and severity of naturally acquired influenza (1998) Final Program and Exhibition Addendum of the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy: Late Breaker Abstracts, , 1998 Sept 22; Washington; DC. Abstr LB-5; Hayden, F.G., Lobo, M., Treanor, J.J., Efficacy and tolerability of oral GS4104 for early treatment of experimental influenza in humans (1997) 37th ICAAC Program Addendum, , (abstract). Sept 28; Abstr 14; Oseltamivir (2003) Lexi-Comp's Drug Information Handbook. 11th Ed., pp. 1036-1037. , Lacy CF, Armstrong LL, Goldman M, Lance LL, editors. Hudson, Ohio: Lexi-Comp Inc publication; Prevention and control of influenza: Recommendations of the Advisory Committee on Immunization Practices (2002) MMWR, 51, pp. 15-31. , CDC: Centers for Disease Control and Prevention; Waghorn, S.L., Goa, K.L., Zanamivir (1998) Drugs, 55, pp. 721-725; Leneva, I.A., Goloubeva, O., Fenton, R.J., Tisdale, M., Webster, R.G., Efficacy of zanamivir against avian influenza a viruses that possess genes encoding H5N1 internal proteins and are pathogenic in mammals (2001) Antimicrob Agents Chemother, 45, pp. 1216-1224; (2000) Product Information: Relenza(R), Zanamivir for Inhalation, , Glaxo Wellcome, Research Triangle Park, NC; Peng, A.W., Hussey, E.K., Rosolowski, B., Blumer, J.L., Pharmacokinetics and tolerability of a single inhaled dose of zanamivir in children (2000) Curr Ther Res, 61, pp. 36-46; Cass, L.M., Efthymiopoulos, C., Bye, A., Pharmacokinetics of zanamivir after intravenous, oral, inhaled or intranasal administration to healthy volunteers (1999) Clin Pharmacokinet, 36, pp. 1-11; Brady, B., McAuley, L., Shukla, V.K., Economic Evaluation of Zanamivir for the Treatment of Influenza., , http://www.ccohta.ca, Technology report no 13. [cited 2001, Sep 10]. Available from; Randomized trial of efficacy and safety of inhaled zanamivir in treatment of influenza A and B virus infections (1998) Lancet, 353, pp. 1877-1881. , The MIST study group; Drugs for non-HIV viral infections (2002) Med Lett Drugs Ther, 44, pp. 9-16; Murphy, K.R., Eivindson, A., Pauksens, K., William, Tellier, G., Watts, R., Efficacy and safety of inhaled zanamivir for the treatment of influenza in patients with asthma or chronic obstructive pulmonary disease. A double-blind, randomised, placebo-controlled, multicentre study (2000) Clin Drug Invest, 20, pp. 337-349; Williamson, J.C., Pegram, P.S., Respiratory distress associated with zanamivir (2000) N Engl J Med, 342, pp. 661-662; Zanamivir (2003) Lexi-Comp's Drug Information Handbook. 11th Ed., pp. 1463-1464. , Lacy CF, Armstrong LL, Goldman M, Lance LL, editors. Hudson, Ohio: Lexi-Comp Inc publication; Webster, A., Boyce, M., Edmundson, S., Miller, I., Coadministration of orally inhaled zanamivir with inactivated trivalent influenza vaccine does not adversely affect the production of antihaemagglutinin antibodies in the serum of healthy volunteers (1999) Clin Pharmacokinet, 36, pp. 51-58; Mauskopf, J.A., Cates, S.C., Griffin, A.D., Neighbors, D.M., Lamb, S.C., Rutherford, C., Cost effectiveness of zanamivir for the treatment of influenza in a high risk population in Australia (2000) Pharmacoeconomics, 17, pp. 611-620; Moscona, A., Neuraminidase inhibitors for influenza (2005) N Eng J Med, 353, pp. 1363-1373; Avian influenza a (H5N1) infection in humans (2005) N Eng J Med, 353, pp. 1374-1385. , The Writing Committee of the World Health Organization (WHO) Consultation on Human Influenza A/H5; Hayden, F.G., Lobo, M., Hussey, E.K., Efficacy of intranasal GG167 in experimental human influenza A and B virus infection (1996) Options for the Control of Influenza III: Proceedings for the Third International Conference for the Control of Influenza, , Brown LE, Hampson AW, Webster RG, editors. May 4-9.718-25; Varghese, J.N., Smith, P.W., Sollis, S.L., Blick, T.J., Sahasrabudhe, A., McKimm-Breschkin, J.L., Drug design against a shifting target: A structural basis for resistance to inhibitors in a variant of influenza virus neuraminidase (1998) Structure, 6, pp. 735-746; Moscona, A., Oseltamivir Resistance - Disabling our influenza defenses (2005) N Eng J Med, 353, pp. 2633-2636; Palese, P., Making Better Influenza Virus Vaccines (2006) Emerg Infect Dis, 12, pp. 61-65; Influenza vaccine 2005-2006 (2005) The Medical Letter, 47, p. 85; Tables for Influenza: January 2006 (2006) Medscape Infectious Diseases, 8 (1). , www.medscape.com, [accessed: 2006 May 2]. obtained from; Lee, C.W., Suarez, D.L., Avian influenza virus: Prospects for prevention and control by vaccination (2005) Anim Health Res Rev, 1, pp. 1-15; Tollis, M., Di Trani, L., Recent developments in avian influenza research, epidemiology and immunoprophylaxis (2002) Vet J, 164, pp. 202-215; Lee, C.W., Seene, D.A., Suarez, D.L., Generation of reassortant influenza vaccines by reverse genetics that allows utilization of a DIVA (Differentiating Infected from Vaccinated Animals) Strategy for the control of avian influenza (2004) Vaccine, 22, pp. 3175-3181; Neumann, G., Hatta, M., Kawaoka, Y., Reverse genetics for the control of avian influenza Avian Dis, 47, pp. 882-887. , 203; Cass, L.M., Brown, J., Pickford, M., Fayinka, S., Newman, S.P., Johansson, C.J., Pharmacoscintigraphic evaluation of lung deposition of inhaled zanamivir in healthy volunteers (1999) Clin Pharmacokinet, 36, pp. 21-31",
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Frontline defense against the next pandemic: Antivirals for avian flu. / Khan, S.A.; Rao, P.G.M.; Kumar, P.; Rodrigues, G.

In: Indian Journal of Pharmacology, Vol. 38, No. 6, 2006, p. 383-389.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Frontline defense against the next pandemic: Antivirals for avian flu

AU - Khan, S.A.

AU - Rao, P.G.M.

AU - Kumar, P.

AU - Rodrigues, G.

N1 - Cited By :1 Export Date: 10 November 2017 CODEN: INJPD Correspondence Address: Khan, S.A.; Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal-576 104, India; email: sohailkhan1981@gmail.com Chemicals/CAS: amantadine, 665-66-7, 768-94-5; oseltamivir, 196618-13-0, 204255-09-4, 204255-11-8; rimantadine, 13392-28-4, 1501-84-4; zanamivir, 139110-80-8 Tradenames: fluarix; flumist, Medimmune; fluvirin, Chiron; fluzone, Labaz; relenza, Glaxo SmithKline Manufacturers: Chiron; Glaxo SmithKline; Labaz; Medimmune References: Johnson, N.P., Mueller, J., Updating the account lobal mortality of the 1918-1920 "Spanish" influenza pandemic (2002) Bull Hist Med, 76, pp. 105-115; Hseih, Y.C., Wu, T.Z., Liu, D.P., Shao, P.L., Chang, L.Y., Lu, C.Y., Influenza pandemics: Past, present and future (2006) J Formos Med Assoc, 105, pp. 1-6; Wong, S.S., Yuen, K.Y., Avian influenza virus infections in humans (2006) Chest, 129, pp. 156-168; Sims, L.D., Domenech, J., Benigno, C., Kahn, S., Kamata, A., Lubroth, J., Origin and evolution of highly pathogenic H5N1 avian influenza in Asia (2005) Vet Rec, 157, pp. 159-164; Tam, J.S., Influenza A (H5N1) in Hong Kong: An overview (2002) Vaccine, 20, pp. 77-81; Shortridge, K.F., Peiris, J.S., Guan, Y., The next influenza pandemic: Lessons from Hong Kong (2003) J Appl Microbiol, 94, pp. 70-79; Koopmans, M., Wilbrink, B., Conyn, M., Natrop, G., Van Der Nat, H., Vennema, H., Transmission of H7N7 avian influenza A virus to human beings during a large outbreak in commercial poultry farms in the Netherlands (2004) Lancet, 363, pp. 587-593; Avian Influenza- Frequently Asked Questions, , http://www.who.int/csr/disease/avian_influenza/avian_faqs/en/index.html, [accessed: 2006 May 2]. Available from; Webster, R.G., Guan, Y., Poon, L., Krauss, S., Webby, R., Govorkovai, E., The spread of the H5N1 bird flu epidemic in Asia in 2004 (2005) Arch Virol Suppl, 19, pp. 117-129; Jameel, S., The birds are coming: Are we ready? (2005) Indian J Med Res, 122, pp. 277-281; Taubenberger, J.K., Morens, D.M., 1918 Influenza: The mother of all pandemics (2006) Emerging Infect Dis, 12, pp. 15-22; Kilbourne, E.D., Influenza pandemics of the 20th century (2006) Emerg Infect Dis, 12, pp. 9-14; Jefferson, T., Demicheli, V., Rivetti, D., Jones, M., Di Pietrantonj, C., Rivetti, A., Antivirals for influenza in healthy adults: Systematic review (2006) Lancet, 367, pp. 303-313; Jefferson, T., Demicheli, V., Rivetti, D., Jones, M., Di Pietrantonj, C., Rivetti, A., Antivirals for influenza in healthy adults: Systematic review (2006) Lancet, 367, pp. 303-313; Oseltamivir, , http://en.wikipedia.org/wiki/oseltamivir, [accessed: 2006 May 3]. Available from; Li, W., Escarpe, P.A., Eisenberg, E.J., Cundy, K.C., Sweet, C., Jakeman, K.J., Identification of GS 4104 as an orally bioavailable prodrug of the influenza virus neuraminidase inhibitor GS 4071 (1998) Antimicrob Agents Chemother, 42, pp. 647-653; Mendel, D.B., Tai, C.Y., Escarpe, P.A., Li, W., Sidwell, R.W., Huffman, J.H., Oral administration of a prodrug of the influenza virus neuraminidase inhibitor GS 4071 protects mice and ferrets against influenza infection (1998) Antimicrob Agents Chemother, 42, pp. 640-646; Leneva, I.A., Roberts, N., Govorkova, E.A., Goloubeva, O.G., Webster, R.G., The neuraminidase inhibitor GS4104 (oseltamivir phosphate) is efficacious against A/ Hong Kong/156/97 (H5N1) and A/Hong Kong/1074/99 (H9N2) influenza viruses (2000) Antiviral Res, 48, pp. 101-115; Govorkova, E.A., Leneva, I.A., Goloubeva, O.G., Bush, K., Webster, R.G., Comparison of efficacies of RWJ-270201, zanamivir and oseltamivir against H5N1, H9N2, and other avian influenza viruses (2001) Antimicrob Agents Chemother, 45, pp. 2723-2732; (2001) Product Information: Tamiflu(R) Oseltamivir Phosphate Capsules and for Oral Suspension, , Nutley, NJ: Roche Pharmaceuticals; Wood, N.D., Aitken, M., Sharp, S., Evison, H., Tolerability and pharmacokinetics of the influenza neuraminidase inhibitor Ro 64-0802 (GS4071) following oral administration of the prodrug Ro 64-0796 (GS4104) to healthy male volunteers (1997) 37th Interscience Conference on Antimicrobial Agents and Chemotherapy, p. 25. , Program and Abstracts of the; 1997 Sep 27-28; Washington, DC; Beigel, J.H., Farrar, J., Han, A.M., Hayden, F.G., Hyer, R., De Jong, M.D., Avian influenza a (H5N1) infection in humans (2005) N Engl J Med, 353, pp. 1374-1385; Aoki, F., Osterhaus, A., Rimmelzwaan, G., Kinnersley, W., Ward, P., Oral GS4104 successfully reduces duration and severity of naturally acquired influenza (1998) Final Program and Exhibition Addendum of the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy: Late Breaker Abstracts, , 1998 Sept 22; Washington; DC. Abstr LB-5; Hayden, F.G., Lobo, M., Treanor, J.J., Efficacy and tolerability of oral GS4104 for early treatment of experimental influenza in humans (1997) 37th ICAAC Program Addendum, , (abstract). Sept 28; Abstr 14; Oseltamivir (2003) Lexi-Comp's Drug Information Handbook. 11th Ed., pp. 1036-1037. , Lacy CF, Armstrong LL, Goldman M, Lance LL, editors. Hudson, Ohio: Lexi-Comp Inc publication; Prevention and control of influenza: Recommendations of the Advisory Committee on Immunization Practices (2002) MMWR, 51, pp. 15-31. , CDC: Centers for Disease Control and Prevention; Waghorn, S.L., Goa, K.L., Zanamivir (1998) Drugs, 55, pp. 721-725; Leneva, I.A., Goloubeva, O., Fenton, R.J., Tisdale, M., Webster, R.G., Efficacy of zanamivir against avian influenza a viruses that possess genes encoding H5N1 internal proteins and are pathogenic in mammals (2001) Antimicrob Agents Chemother, 45, pp. 1216-1224; (2000) Product Information: Relenza(R), Zanamivir for Inhalation, , Glaxo Wellcome, Research Triangle Park, NC; Peng, A.W., Hussey, E.K., Rosolowski, B., Blumer, J.L., Pharmacokinetics and tolerability of a single inhaled dose of zanamivir in children (2000) Curr Ther Res, 61, pp. 36-46; Cass, L.M., Efthymiopoulos, C., Bye, A., Pharmacokinetics of zanamivir after intravenous, oral, inhaled or intranasal administration to healthy volunteers (1999) Clin Pharmacokinet, 36, pp. 1-11; Brady, B., McAuley, L., Shukla, V.K., Economic Evaluation of Zanamivir for the Treatment of Influenza., , http://www.ccohta.ca, Technology report no 13. [cited 2001, Sep 10]. Available from; Randomized trial of efficacy and safety of inhaled zanamivir in treatment of influenza A and B virus infections (1998) Lancet, 353, pp. 1877-1881. , The MIST study group; Drugs for non-HIV viral infections (2002) Med Lett Drugs Ther, 44, pp. 9-16; Murphy, K.R., Eivindson, A., Pauksens, K., William, Tellier, G., Watts, R., Efficacy and safety of inhaled zanamivir for the treatment of influenza in patients with asthma or chronic obstructive pulmonary disease. A double-blind, randomised, placebo-controlled, multicentre study (2000) Clin Drug Invest, 20, pp. 337-349; Williamson, J.C., Pegram, P.S., Respiratory distress associated with zanamivir (2000) N Engl J Med, 342, pp. 661-662; Zanamivir (2003) Lexi-Comp's Drug Information Handbook. 11th Ed., pp. 1463-1464. , Lacy CF, Armstrong LL, Goldman M, Lance LL, editors. Hudson, Ohio: Lexi-Comp Inc publication; Webster, A., Boyce, M., Edmundson, S., Miller, I., Coadministration of orally inhaled zanamivir with inactivated trivalent influenza vaccine does not adversely affect the production of antihaemagglutinin antibodies in the serum of healthy volunteers (1999) Clin Pharmacokinet, 36, pp. 51-58; Mauskopf, J.A., Cates, S.C., Griffin, A.D., Neighbors, D.M., Lamb, S.C., Rutherford, C., Cost effectiveness of zanamivir for the treatment of influenza in a high risk population in Australia (2000) Pharmacoeconomics, 17, pp. 611-620; Moscona, A., Neuraminidase inhibitors for influenza (2005) N Eng J Med, 353, pp. 1363-1373; Avian influenza a (H5N1) infection in humans (2005) N Eng J Med, 353, pp. 1374-1385. , The Writing Committee of the World Health Organization (WHO) Consultation on Human Influenza A/H5; Hayden, F.G., Lobo, M., Hussey, E.K., Efficacy of intranasal GG167 in experimental human influenza A and B virus infection (1996) Options for the Control of Influenza III: Proceedings for the Third International Conference for the Control of Influenza, , Brown LE, Hampson AW, Webster RG, editors. May 4-9.718-25; Varghese, J.N., Smith, P.W., Sollis, S.L., Blick, T.J., Sahasrabudhe, A., McKimm-Breschkin, J.L., Drug design against a shifting target: A structural basis for resistance to inhibitors in a variant of influenza virus neuraminidase (1998) Structure, 6, pp. 735-746; Moscona, A., Oseltamivir Resistance - Disabling our influenza defenses (2005) N Eng J Med, 353, pp. 2633-2636; Palese, P., Making Better Influenza Virus Vaccines (2006) Emerg Infect Dis, 12, pp. 61-65; Influenza vaccine 2005-2006 (2005) The Medical Letter, 47, p. 85; Tables for Influenza: January 2006 (2006) Medscape Infectious Diseases, 8 (1). , www.medscape.com, [accessed: 2006 May 2]. obtained from; Lee, C.W., Suarez, D.L., Avian influenza virus: Prospects for prevention and control by vaccination (2005) Anim Health Res Rev, 1, pp. 1-15; Tollis, M., Di Trani, L., Recent developments in avian influenza research, epidemiology and immunoprophylaxis (2002) Vet J, 164, pp. 202-215; Lee, C.W., Seene, D.A., Suarez, D.L., Generation of reassortant influenza vaccines by reverse genetics that allows utilization of a DIVA (Differentiating Infected from Vaccinated Animals) Strategy for the control of avian influenza (2004) Vaccine, 22, pp. 3175-3181; Neumann, G., Hatta, M., Kawaoka, Y., Reverse genetics for the control of avian influenza Avian Dis, 47, pp. 882-887. , 203; Cass, L.M., Brown, J., Pickford, M., Fayinka, S., Newman, S.P., Johansson, C.J., Pharmacoscintigraphic evaluation of lung deposition of inhaled zanamivir in healthy volunteers (1999) Clin Pharmacokinet, 36, pp. 21-31

PY - 2006

Y1 - 2006

N2 - A pandemic of the human influenza virus has caused extensive morbidity and mortality around the world. The mechanisms involved in the emergence of new influenza viral strains and the epidemiological factors leading to pandemics are unpredictable. The spread of the virus and the challenges encountered in its management are discussed, along with a review on the antivirals against avian influenza. Till date, neuraminidase inhibitors remain the mainstay of management as they are well tolerated and less likely to promote the development of drug resistance, compared to the conventional adamantanes. Details on the clinical effects of antivirals on the infection, safety profile, status in clinical practice and drug resistance are covered in this paper. Future prospects and research to fight the pandemic are also addressed. An outbreak of this infection in various Asian countries emphasises the need for a collaborative approach from healthcare experts, governments and media, to control and curb the spread of infection worldwide.

AB - A pandemic of the human influenza virus has caused extensive morbidity and mortality around the world. The mechanisms involved in the emergence of new influenza viral strains and the epidemiological factors leading to pandemics are unpredictable. The spread of the virus and the challenges encountered in its management are discussed, along with a review on the antivirals against avian influenza. Till date, neuraminidase inhibitors remain the mainstay of management as they are well tolerated and less likely to promote the development of drug resistance, compared to the conventional adamantanes. Details on the clinical effects of antivirals on the infection, safety profile, status in clinical practice and drug resistance are covered in this paper. Future prospects and research to fight the pandemic are also addressed. An outbreak of this infection in various Asian countries emphasises the need for a collaborative approach from healthcare experts, governments and media, to control and curb the spread of infection worldwide.

M3 - Article

VL - 38

SP - 383

EP - 389

JO - Indian Journal of Pharmacology

JF - Indian Journal of Pharmacology

SN - 0253-7613

IS - 6

ER -