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Will use this thread to track similar reports. Such behaviors could be due to the influenza, medical complications of influenza (eg pneumonia nd hypoxia) or unusual medication side effects. Data is incomplete at this point.
Nevertheless will be an important factor to consider when providing assistance.
JT
Thought has a dual purpose in ethics: to affirm life, and to lead from ethical impulses to a rational course of action - Teaching Reverence for Life -Albert Schweitzer. JT
JAPANESE health authorities are investigating a flu medicine that is also available in Australia after a teenager jumped 11 storeys to his death after taking the drug. It
This area is currently in the realm of risk communications vs questionable journalism. The content of the article is balanced but the headline confuses vaccine with medication, focuses on children and neglects the overall prevalance of suicide in Japan. It will be helfpul if we can get to the complete data summaries the authorities are citing on the overall prevalence of suicide by age groups and the rates for general population versus the number on medications versus the number of suicides assoicated with influenza alone.
JT
Thought has a dual purpose in ethics: to affirm life, and to lead from ethical impulses to a rational course of action - Teaching Reverence for Life -Albert Schweitzer. JT
This area is currently in the realm of risk communications vs questionable journalism. The content of the article is balanced but the headline confuses vaccine with medication, focuses on children and neglects the overall prevalance of suicide in Japan. JT
Good morning,
Should we then, consider a policy for the mods to correct or change the headlines in order to avoid such wrong impressions ??
Should we consider the titles of threads in relation and with the light of our Mission ??
For posts maybe. The headline referred to in this post I believe was the actual news article.
JT
Thought has a dual purpose in ethics: to affirm life, and to lead from ethical impulses to a rational course of action - Teaching Reverence for Life -Albert Schweitzer. JT
I just merged and changed the title of 2 threads on this subject in Today's Headlines. The title was changed to better reflect the articles' content. I'll defer to others on the title change.
Last edited by Niko; March 1, 2007, 09:36 AM.
Reason: added link
"In the beginning of change, the patriot is a scarce man (or womanhttps://flutrackers.com/forum/core/i...ilies/wink.png), and brave, and hated and scorned. When his cause succeeds, the timid join him, for it then costs nothing to be a patriot."- Mark TwainReason obeys itself; and ignorance submits to whatever is dictated to it. -Thomas Paine
"In the beginning of change, the patriot is a scarce man (or womanhttps://flutrackers.com/forum/core/i...ilies/wink.png), and brave, and hated and scorned. When his cause succeeds, the timid join him, for it then costs nothing to be a patriot."- Mark TwainReason obeys itself; and ignorance submits to whatever is dictated to it. -Thomas Paine
I reviewed the La Roche links above. A lot of data presented. They reached a more definitive conclusion that Tamiflu is safe than did the FDA, which felt further vigilance is warranted.
I found this FDA information sheet from Nov 2005 helpful.
Excerpt from FDA Q&A Tamiflu Pediatric Adverse Events: Questions and Answers
...
Was it possible that Japanese patients metabolize Tamiflu differently than American or European patients or have higher levels of the drug in their bodies? There is no scientific evidence that this is true and Japanese dosing recommendations are very similar to U.S. and European recommendations.
Was it possible that these events were an unusual manifestation of influenza infection? There is good evidence that neuropsychiatric events can occur with influenza, in the absence of Tamiflu or other treatment. Beginning in the mid-1990s, there have been many reports in the pediatric scientific literature describing a syndrome of influenza-associated encephalitis (inflammation of the brain) or encephalopathy. These reports originated primarily from Japan where pediatricians described a pattern of rapid onset of fever, accompanied by convulsions and altered level of consciousness, progressing to coma within a few days of the onset of flu symptoms. This syndrome frequently resulted in death or significant neurologic sequelae. These reports prompted nationwide surveillance of influenza-associated encephalopathy in Japan. This syndrome was described and the surveillance in Japan was in progress before Tamiflu was approved for the treatment of influenza.
Was it possible that the large number of adverse events from Japan was because the Japanese use more Tamiflu? Is it possible that we may see more U.S. cases as use of Tamiflu increases in this country? Partly because of the awareness in Japan of influenza-associated encephalopathy, the Japanese health service will pay for rapid diagnostic testing for influenza in children and subsequent treatment. Japan currently uses the majority of the world's supply of Tamiflu distributed for seasonal influenza. It is possible that some of these events might be observed in the U.S. population if the use of Tamiflu increases substantially.
Finally, was it possible that the neuropsychiatric events reported from Japan reflect different methods and requirements for adverse event reporting? Both the Japanese Ministry of Health, Labor and Welfare and Roche confirmed that Japanese regulators require an intensive period of active adverse event reporting for 6 months after a product is approved. When Tamiflu was approved for prophylaxis of influenza in Japan, Roche and its Japanese pharmaceutical affiliate actively solicited adverse event reports from 70,000 institutions and physicians in Japan. These adverse event reports included the 2003-04 flu season and were subsequently reported to the FDA and are included in the BPCA safety review.
It is particularly difficult to assess the relationship of Tamiflu to the reported pediatric deaths. It is known that young children (less than 2 years of age) are hospitalized more often for influenza-associated illness than older children and young adults. Infants and the elderly are known to have higher influenza-associated death rates than other age groups. However, in the U.S., influenza deaths in children were not among the events requiring reporting to public health departments and the CDC until the 2004-05 flu season.
Review of the available information on the safety of Tamiflu in pediatric patients suggests that the increased reports of neuropsychiatric events in Japanese children are most likely related to an increased awareness of influenza-associated encephalopathy, increased access to Tamiflu in that population, and a coincident period of intensive monitoring adverse events. Based on the information available to us, we can not conclude that there is a causal relationship between Tamiflu and the reported pediatric deaths.
So the FDA interprets the data as uncertain but worthy of watching.
A WHO affliated organization takes the position that since we are uncertain, and we face the prospects of widespread use of oseltamivir for prophylaxis, then intense scrutiny is warranted (Jan 2006).
Oseltamivir Roche has pledged to provide WHO with three million
treatment courses of the medicine oseltamivir to a WHO
international antiviral stockpile. It is necessary therefore that the
efficacy and safety of this medicine is adequately documented both
prior to and during the possible pandemic. Roche should be asked
to share the methodology of active surveillance and assist countries
which will be using oseltamivir as mass treatment during influenza
pandemics. Particular attention should be given to pregnant women
who take this drug. The risk of counterfeited products appearing on
the market was noted.
I will present in the Suicide Prevention Resources Thread a source that states the suicide rate in Japan is more than 2x in USA (25 per 100,000 compared with 12 per 100,000).
Joe Thornton, M.D.
Last edited by Thornton; March 2, 2007, 06:18 AM.
Reason: Deleted a non-contributory sentence. -JT
Thought has a dual purpose in ethics: to affirm life, and to lead from ethical impulses to a rational course of action - Teaching Reverence for Life -Albert Schweitzer. JT
Tamiflu and neuropsychiatric disturbance in adolescents
Related Article
Effectiveness of neuraminidase inhibitors in treatment and prevention of influenza A and B: systematic review and meta-analyses of randomised controlled trials
Nicola J Cooper, Alexander J Sutton, Keith R Abrams, Allan Wailoo, David Turner, and Karl G Nicholson
BMJ 2003 326: 1235.
Thought has a dual purpose in ethics: to affirm life, and to lead from ethical impulses to a rational course of action - Teaching Reverence for Life -Albert Schweitzer. JT
Was reading Dawkins' "The Extended Phenotype" the other night which includes a lengthy discussion on parasites and how they can manipulate the behavior of their hosts.
After giving several examples, he speculates about rabies:
Originally posted by Dawkins ("EP", page 220)
Do the behavioural symptoms of rabies infection increase the chance of the virus being passed on (Bacon & Macdonald 1980)? 'When a dog gets rabies, its temper changes quickly. It is often more affectionate for a day or two, and given to licking its human contacts, a dangerous practice, for the virus is already in its saliva. Soon it grows restless and wanders off, ready to bit anyone that gets in its way' (Encyclopedia Britannica 1977). Even non-carnivorous animals are driven by the rabies virus to vicious biting, and there are recorded cases of humans contracting the disease from the bites of normally harmless fruit-eating bats. Apart from the obvious power of biting to spread a saliva-borne virus, 'restless wandering' might very well serve to spread the virus more effectively (Hamilton & May 1977). That the widespread availability of cheap air travel has had a dramatic impact on the spread of human disease is obvious: dare we wonder whether the phrase 'travel bug' might have a more than metaphorical significance?
Apart from the obvious things that influenza viruses perhaps "manipulate" us in to doing which helps them spread (sneeze, cough, etc.), it would be really interesting to know if an influenza infection manipulates the behavior of its host in any other ways. I'm thinking of particularly during the incubation period before one is obviously ill -- do we, like rabies infected dogs, become more social? Perhaps have more energy to go out and do more activities?
Fascinating stuff!
...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes
Was reading Dawkins' "The Extended Phenotype" the other night which includes a lengthy discussion on parasites and how they can manipulate the behavior of their hosts.
After giving several examples, he speculates about rabies:Apart from the obvious things that influenza viruses perhaps "manipulate" us in to doing which helps them spread (sneeze, cough, etc.), it would be really interesting to know if an influenza infection manipulates the behavior of its host in any other ways. I'm thinking of particularly during the incubation period before one is obviously ill -- do we, like rabies infected dogs, become more social? Perhaps have more energy to go out and do more activities?
Fascinating stuff!
Interesting mind experiment, Theresa42. But, all we have to do is look at human social behavior among people who are infected with the common flu. Pretend for a moment that H5N1 is the common flu. After all, the only current difference is a low attack rate, a high CFR, and a more debilitating period of sickness for those who recover. When people come down with a true case of influenza, it is my experience they are not out clubbing.
Because H5N1 can't "know" about human behavior when it makes the final pandemic jump from mammals to humans, how could it direct behaviors?
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When people come down with a true case of influenza, it is my experience they are not out clubbing.
Absolutely not! I agree.
I was really thinking about the incubation period -- those couple of days before one actually comes down with symptoms (and feels like cr*p). One is shedding viruses then, right? I was just thinking it would be so fascinating if it were shown that during the incubation period people were, on average, more social than usual -- kind-of like how the rabies infected dogs are more affectionate for the first couple of days before they become rabid.
I've been reading too much about parasites lately -- with particular interest in the ones that manipulate their hosts behavior -- I've got parasites "on the brain at the moment" (actually, I hope not!).
The definitive host is an ungulate such as a sheep, and the intermediate hosts are first a snail and then an ant. The normal life cycle calls for the ant to be accidentally eaten by the sheep.... By burrowing into the suboesophageal ganglion, the aptly named 'brainworm' changes the ant's behavior. Whereas an unifected ant would normally retreat into its nest when it became cold, infected ants climb to the top of grass stems, clamp their jaws in the plant and remain immobile as if asleep. Here they are vulnerable to being eaten by the worm's definitive host.
It has been found that the parasite has the ability to change the behavior of its host: infected rats and mice are less fearful of cats - in fact, some of the infected rats seek out cat-urine-marked areas. This effect is advantageous to the parasite, which will be able to sexually reproduce if its host is eaten by a cat [10]. The mechanism for this change is not completely understood, but there is evidence that toxoplasmosis infection raises dopamine levels in infected mice.
The findings of behavioral alteration in rats and mice have led some scientists to speculate that toxoplasma may have similar effects in humans, even in the latent phase that had previously been considered asymptomatic. Toxoplasma is one of a number of parasites that may alter their host's behaviour as a part of their life cycle. [11] The behaviors observed, if caused by the parasite, are likely due to infection and low-grade encephalitis, which is marked by the presence of cysts in the brain, which may produce or induce production of a neurotransmitter, possibly dopamine, [12] therefore acting similarly to dopamine reuptake inhibitor type antidepressants and stimulants.
"In populations where this parasite is very common, mass personality modification could result in cultural change. [Variations in the prevalence of Toxoplasma gondii] may explain a substantial proportion of human population differences we see in cultural aspects that relate to ego, money, material possessions, work and rules." — Kevin Lafferty [13]
Correlations have been found between latent Toxoplasma infections and various characteristics: [14]
Increased risk taking behavior
Slower reactions
Feelings of insecurity and self-doubt
Neuroticism (one of the Big Five personality traits)
...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes
There's also syphilis, cause by a bacterium -- neurosyphilis can lead to 'Cupid's Disease' which clearly has implications for the spreading of the disease (bacteria):
Neurosyphilis often led to the terrifying condition known as general paralysis of the insane, or paresis. In the warning stage, before dementia set in, there were some rewards (leading to syphilis being called a Faustian bargain of sorts): extreme euphoria, electric excitement, bursts of creative energy, grandiose self-definition and (often criminal) relaxation of inhibitions. Many physicians today, perhaps most, have never seen a case of tertiary syphilis. An exception is the medical writer Oliver Sacks, who described a 90-year-old patient who correctly self-diagnosed a late case of "Cupid's disease" - and didn't want it treated. I feel livelier, friskier, she said: "I've had impulses, I won't tell you." She hoped to live to a hundred in this rejuvenated state.
See Oliver Sacks' "The Man Who Mistook His Wife For His Hat".
(I think during the 1800s tuberculosis was also thought to lead to promiscuous behavior, but that's pretty much been discounted nowadays. But maybe there was something to it after all...?)
Ok. I'll shut up about manipulative parasites now.
Last edited by Theresa42; June 19, 2007, 12:45 AM.
Reason: Added TB comment
...when you have eliminated the impossible, whatever remains, however improbable, must be the truth. - Sherlock Holmes
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