There is some evidence of human-to-human transmission for the highly pathogenic H5N1 strain of avian influenza. A possible catastrophic pandemic could, therefore, emerge writes Kenneth Tsang (University of Hong Kong) and colleagues. Many governments, including those of Hong Kong, Thailand, Singapore, Malaysia, and Korea, have already stockpiled, vast quantities of a neuraminidase inhibitor called oseltamivir to prepare for an outbreak. However, another neuraminidase inhibitor, zanamivir, has a similar effectiveness, fewer side-effects, and has a favourable resistance profile when compared with oseltamivir. Governments should therefore also consider stockpiling zanamivir in their emergency plans, state the authors.
Professor Tsang adds: "Actual logistics for giving out antivirals to patients and close contacts need to be efficient and completed within 48 h. It seems more appropriate for community-based healthcare personnel or even pharmacists, rather than hospital based health-care workers, to handle such procedures."
Contact: Professor KWT Tsang, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong. T) 852 2855 4542 kwttsang@hku.hk
Journal
The Lancet