Cost, resistance aired in HHS webcast on antivirals

first_imgDec 17, 2008 (CIDRAP News) – Cost issues and the risk of viral resistance drew considerable attention today in an online presentation by federal health officials on their revised guidance regarding use of antiviral drugs in an influenza pandemic.The Department of Health and Human Services (HHS) released two guidance documents this week, one on antiviral use in general and one on employer stockpiling of antivirals.The general guidance says national and state antiviral stockpiles will be reserved mainly for treating the sick in a pandemic. It says that healthcare and emergency workers likely to be exposed to the sick should receive preventive antiviral treatment, with the doses provided by their employers.The guidance on employer stockpiling supports the general guidance, recommending that businesses and organizations that employ workers likely to be exposed to infection provide prophylactic antiviral treatment for them. It also says that critical infrastructure employers should strongly consider providing antiviral prophylaxis for essential workers.In today’s HHS “PlanFirst” webcast, Dr. Benjamin Schwartz, MD, said the retail costs of the two recommended antivirals, oseltamivir (Tamiflu) and zanamivir (Relenza), range from about $50 to $80 per treatment course.It may be possible for some groups, particularly healthcare organizations, to buy the drugs at a much lower cost through their state health department, but this would be limited to groups working with health departments as part of state pandemic planning, said Schwartz, who is senior science advisor with HHS’s National Vaccine Program Office.The other option for organizations seeking to buy antivirals, Schwartz said, is to participate in manufacturer programs that permit groups to reserve a supply by paying a small annual fee per treatment course. The manufacturer keeps the doses up to date, and in the event of a pandemic, the buyer pays the wholesale price for delivery of the product. Both Roche, maker of Tamiflu, and GlaxoSmithKline, maker of Relenza, offer such programs.”It could almost be looked at as pandemic insurance,” Schwartz said.However, the cost of an antiviral program is more than just the per-regimen amount, HHS officials said. Workers who will receive the drugs will need medical screening, and there will be storage and dispensing costs as well.The HHS acknowledges the risk that a pandemic virus develops resistance to the antiviral drugs. Schwartz noted that one of the three subtypes of seasonal influenza, A/H1N1, recently has shown increased resistance to oseltamivir.”What is the implication of this?” Schwartz said. “I have to emphasize that this one virus is largely resistant, whereas other flu viruses that are circulating and the avian H5N1 virus remain susceptible to Tamiflu and Relenza. The types of changes, the mutations that have made the H1N1 virus resistant are unlikely to occur in a pandemic virus, so therefore we have not changed our recommendations for planning and stockpiling.”He also commented later, “It’s possible that resistance might occur to one drug but not the other, and because of that, some level of diversification between the two products is wise.”The national stockpile of antivirals is about 80% oseltamivir and 20% zanamivir, according to HHS. The reason it’s divided this way, said Schwartz, is that oseltamivir as an oral drug spreads throughout the body, whereas zanamivir is inhaled and therefore may work best in the respiratory tract.”So there may be a theoretical benefit to Tamiflu,” he said. “Tamiflu may also be a little bit easier to stockpile and there’s a little more flexibility with use because you can go down to a lower age.” (Oseltamivir is approved for treatment and prophylaxis in persons 1 year and older; zanamivir is approved for treatment of those aged 7 years and older and for prophylactic use in those aged 5 years and up.)In response to a question, Schwartz said the national stockpile includes some pediatric doses of antivirals. Relenza does not come in a pediatric dose, he said, adding, “It’s possible to open up the Tamiflu capsule and put the material from it in a syrup or liquid and dispense it in that way.””I would reassure people that there is drug available for treatment of their children if their children become ill,” he said.Another question from a listener was whether school teachers and staff are included in the HHS recommendations for prophylactic antiviral treatment.Lisa Koonin, MN, MPH, replied that schools would probably be closed early in a pandemic, a step that would help protect teachers and staff. Koonin is senior adviser in the Influenza Coordinating Unit at the Centers for Disease Control and Prevention.In other comments, Schwartz said there is no evidence that the two antiviral drugs are harmful in pregnant women, “so for read more

WHO likely to counsel restraint on antivirals for H1N1

first_img Shindo said the WHO has little information so far about the results of antiviral treatment in novel H1N1 cases and wants countries to communicate their findings. In particular, the agency has very little information about the effectiveness of late treatment with oseltamivir or about results with zanamivir. For both drugs, the manufacturers say treatment should be started within 48 hours after illness onset. May 12, 2009 (CIDRAP News) – The World Health Organization (WHO) plans to release clinical guidance that will say most patients sick with the novel H1N1 influenza (swine flu) will not need antiviral treatment, but the drugs should be considered for high-risk groups, a WHO official said today. “European countries, which are mainly importing their cases, have been using antivirals very aggressively,” she said. “Countries like Mexico and the United States are trying to save their treatment for patients with underlying conditions and also the other groups at increased risk, such as pregnant women.” Besides discussing antivirals, the WHO clinical guidance will recommend simple supportive treatment such as antipyretics and hydration, Shindo said. CDC guidance on antiviralshttp://www.cdc.gov/h1n1flu/recommendations.htm Children and youth on long-time aspirin therapy At a CDC news briefing today, Dr. Anne Schuchat said, in response to a question about extensive antivral use in Europe, that the focus in the United States is on using antivirals for treatment of sick people, whereas some other countries are using antivirals to try to prevent the virus from spreading from infected travelers to others. Since geographic containment of the virus is no longer possible in the United States, the emphasis is on reducing its impact, she noted. “It largely depends on the availability of antivirals,” she said. Later she commented, “We don’t have a really strong position on the use of antivirals, because it’s part of their national pandemic preparedness plan.” The CDC and WHO say the new virus is sensitive to oseltamivir and zanamivir (the neuraminidase inhibitors) but resistant to amantadine and rimantadine (the adamantanes). Later she added, “We will recommend to consider the use of antivirals for high-risk groups or the group of people at increased risk, depending on availability.” Nursing home residents Yesterday the WHO said the new virus usually causes only a mild illness in otherwise healthy people. Shindo emphasized that the use of antiviral treatment in any given country will be strongly influenced by the availability of the drugs and the country’s pandemic preparedness plan.center_img See also: Also, in some human H5N1 cases in Vietnam, the rise of oseltamivir resistance was ascribed to “suboptimal treatment doses,” she said, adding, “So public health officials may decide to use antivirals aggressively because that’s what they’ve been preparing for and that’s part of their pandemic preparedness plan.” Shindo also commented that antivirals are being used much more extensively for H1N1 in Europe than in North America. Children under 5 Shindo was asked if the aggressive use of antivirals in Europe might contribute to resistance to the drugs. She replied that the rise of osletamivir resistance in seasonal H1N1 viruses over the past 2 years seemed unrelated to use of the drug, as it arose in areas where oseltamivir was not often prescribed for seasonal flu. As described by Shindo, the WHO guidance on antivirals will probably align with what the US Centers for Disease Control and Prevention (CDC) is recommending. The CDC’s interim clinical guidance says that patients who have an uncomplicated febrile illness typically do not need antiviral treatment unless they are at risk for complications. High-risk groups are the same as those for seasonal flu: “Soon we will be publishing initial guidance for clinical management for this disease,” said Dr. Nikki Shindo, leader of the WHO clinical team for response to the H1N1 epidemic, speaking at a news briefing. “We are highlighting the fact that most of the patients will not require hospitalization or antiviral therapy.” Pregnant women People with chronic medical conditions or immunosuppression WHO’s novel H1N1 flu page Adults 65 and olderlast_img

Thierry Henry reacts after Arsenal draw to Bournemouth in Mikel Arteta’s first match as head coach

first_imgAdvertisement ‘There were positive but a point at struggling Bournemouth isn’t great. He has a lot of work to do.‘These players haven’t suddenly turned a corner. It will take months and months, if not new players to do it.’Arteta’s Arsenal, currently 11th in the Premier League, face London rivals Chelsea this weekend.MORE: Mesut Ozil shows support for Mikel Arteta after Arsenal’s draw with BournemouthMORE: Mikel Arteta praises Mesut Ozil after Arsenal’s draw against Bournemouth Thierry Henry has reacted after Arsenal drew to Bournemouth in Mikel Arteta’s first match (Picture: Amazon)Thierry Henry admits he saw little sign of progress after Arsenal drew to Bournemouth in Mikel Arteta’s first match as head coach.Arteta was confirmed as the new Arsenal boss last week and saw his side draw 1-1 with struggling Bournemouth on Boxing Day.Arsenal striker Pierre-Emerick Aubameyang’s 12th Premier League goal of the season cancelled out Dan Gosling’s first-half strike at Dean Court. Arteta’s side could only clinch a point at Bournemouth (Picture: Getty)Asked for his thoughts on the match, Arsenal legend Henry told Amazon: ‘In all fairness it’s very difficult to judge someone after one game and only a few days of training.ADVERTISEMENT‘What I’ve seen today is what I’ve seen for a long time with Arsenal. I don’t think they played well but Aubameyang scored. I’ve seen that so many times.AdvertisementAdvertisement‘We go back to the [Bournemouth] goal. I don’t want to name names but we’re talking about the same guys again and again.More: FootballRio Ferdinand urges Ole Gunnar Solskjaer to drop Manchester United starChelsea defender Fikayo Tomori reveals why he made U-turn over transfer deadline day moveMikel Arteta rates Thomas Partey’s chances of making his Arsenal debut vs Man City‘[Alexandre] Lacazette should have won it with a good chance but it’s difficult to judge that team right now. They are trying to learn under a new manager so we will see.‘But what I’ve seen today is what I’ve seen for a long time… not that great and Aubameyang scored.’Former Arsenal star Lee Dixon added: ‘The problem is we’ve got used to mediocrity. Arteta has come in to a new club so he’s going to praise his players.”The urgency is now”@Arsenal fans – happy with how Arteta set up your side today?#PLonPrime #BOUARS pic.twitter.com/Ko2b52X30g— Amazon Prime Video Sport (@primevideosport) December 26, 2019 Commentcenter_img Metro Sport ReporterThursday 26 Dec 2019 11:26 pmShare this article via facebookShare this article via twitterShare this article via messengerShare this with Share this article via emailShare this article via flipboardCopy link5kShares Advertisement Thierry Henry reacts after Arsenal draw to Bournemouth in Mikel Arteta’s first match as head coachlast_img

ADS Crude Carriers to Start Fitting Scrubbers on Its VLCCs

first_imgThe newly established tanker owner and operator ADS Crude Carriers is about to fit scrubbers on board its very large crude carriers.   The company was set up in April this year in Cyprus, with a fleet of three VLCCs, built in Japan as sister vessels. The VLCC owner and operator plans to expand its fleet with more acquisitions.“After a period of start-up activities and building up the initial fleet of VLCC’s, the company will focus on streamlining the operations to maximize shareholder returns. In addition, the project of installing scrubbers on board the vessels for the purpose of reducing emissions and operating costs will be started.”All three ships have been delivered to the company and have secured employment, the company said in its first business results.The vessel Front Page, to be renamed ADS Eagle, was delivered to the company on July 20 and went directly to a charter as FSO west of Nigeria. The duration of the charter is between 150 and 210 days.ADS Stratus was delivered on August 9, 2018 and is on its way to an approximately 40-day spot charter for transport of crude oil. Finally, ADS Serenade was delivered on September 13, 2018 and will be trading in the spot market.The vessels have been put under commercial management of Frontline Management and technical management of OSM Ship Management AS.On August 28, 2018 ADS Crude Carriers Plc was accepted for trading at the Oslo Stock Exchange’s Merkur Market.last_img

Would You Accept a First Date Invite Via Text?.

first_imgIs a phone call too much to ask for these days, or is being asked out via text the new (unromantic) norm? -Faye Brennan, BettyConfidential.comRomance really is dead. I came to this unfortunate realization a few days ago when I received a two-message text that went something like this: “Hi Faye, it’s Jake [not his real name], we met last weekend. Hope you had a great week! Mine was good but work was really busy… I’m going out of town this weekend, but I’d love to get together for a drink next week – would Tues or Weds work for you?”How can a girl resist that offer?Pretty easily, actually. Jake seemed like a nice guy when I met him, and I would’ve went out with him… if he hadn’t blown it with this first date invite text. For starters, why didn’t he just use his phone for what it was originally intended for, CALL ME and use his words to ask me out for the first time? He obviously had a lot to say – a two-message text just seems ridiculous, and it requires zero effort.Do you know what that means to me when your very first move has no effort involved? It means you’re probably going to also pick a place that’s more convenient for you for our date, you’ll expect to get some at the end despite the fact that you didn’t really do anything exceptional, and that pattern will continue for the rest of our relationship. Why would I want to go out with someone like that?I’m usually not so against texting, I think it’s a great and useful way to communicate, but it’s situations like this where I find it unacceptable. You text your friends to ask what they’re doing tonight. You text your mom to wish her a great day at work. You text your guy to make plans once you’ve been dating for awhile. But, you don’t text someone you’re trying to “woo.”Yes, like that girl from Glee, I want to be wooed. Call me old-fashioned, but I expect a phone call when you want to ask me out for the first time. I don’t think that is asking for too much, do you?My personal bottom line: call me, and you will get the date. Text me, and I feel like I’m nothing special and not worth taking up five minutes of your time. You may be a nice guy, but you will not get a response. LifestyleRelationships Would You Accept a First Date Invite Via Text?. by: – June 9, 2011 Tweet Share 104 Views   no discussionscenter_img Share Sharing is caring! Sharelast_img

West Harrison man arrested on drug-related charges

first_imgDEARBORN COUNTY, Ind. — A Dearborn County man has been arrested after police say he passed out from a drug overdose while his young nephew was in his care.According to police, Jesse Conn, 28, was arrested on charges of Possession of a Narcotic Drug, Neglect of a Dependent, and Possession of Paraphernalia.A relative called police after believing he passed out during a phone call she had with him.When police arrived they found Conn unresponsive on a bed.Medics used two doses of Narcan to revive Conn.During a search of the house, officers found a substance that tested positive for heroin and a straw that contained residue.last_img

All eyes on Ferran Torres for Valencia trip to Real Madrid

first_imgThe front page of Thursday’s edition of Diario AS highlights how this is a ‘high pressure showcase’ game for Torres, as his side travel to Real Madrid – to whom he has been strongly linked.Madrid are five points off Barcelona at the top of La Liga and the pressure is on the hosts to win, while Los Che are chasing a European spot.Earlier this week, Le10Sport reported Manchester United, Liverpool and Real Madrid were among the clubs interested in a summer move for the player.Torres has enjoyed an excellent campaign at Los Che but his contract expires in the summer of 2021 and his future is now said to be in doubt.The 20-year-old penned a new contract with Los Che in April 2018 in a deal which runs through until next summer with a reported €100m release clause, although due to the expiration date on the deal the Spanish club may lower this value.Valencia are said to be hopeful of tieing the highly-rated winger Torres down to a new deal to ward off interest from clubs, including Barcelona and Real Madrid – whose interest was outlined in a report in Diario AS this December.“I hope Ferran can stay at our club for a very long time,” Valencia boss Albert Celades is cited as saying in February by Superdeporte.“He is a player from our club and he feels it, that is always a big deal. I hope an agreement can soon be reached with Ferran.”Torres made his first team debut in November 2017 and has made 80 senior appearances for the club since, becoming a regular under Marcelino Garcia Toral and then Albert Celades.Read Also: La Liga: Felix double sends Atletico to top fourThe winger starred in the UEFA European Under-19 Championship in Armenia last year, netting both goals in a 2-0 final victory over Portugal and is now a member of the Under-21 side.It is claimed that Madrid have been interested in Torres since his pre-teen days at the Mestalla and could make their move again this year.FacebookTwitterWhatsAppEmail分享 Valencia winger Ferran Torres is one of the most in-demand players ahead of the summer transfer window and Thursday night could be significant for him.Advertisement Loading…last_img

Rohr: Ejaria better than ‘New Jay Jay’

first_imgRelatedPosts Solskjaer criticises England over handling of youngster Greenwood Townsend: Eze’s an incredible talent Eberechi Eze to add spark to Crystal Palace Nigeria’s national team head coach Gernot Rohr has urged the Nigerian Football Federation to focus on getting Ovie Ejaria rather than QPR’s Eberechi Eze to play for the national side.Both Ejaria and Eze have impressed so far this season and have both featured for England at U21 level.Now it appears that the Nigerian head coach would rather Ejaria declare for the Nigerian national side than his QPR counterpart.Rohr told Brila FM: “He’s (Ovie Ejaria) a good player no doubt and I will prefer him in the team now than the player (Eberechi Eze) the Federation are in talks with.“We will contact him and know what must be done to make him play for us.“He is a better player than Eze.“My fears are if we start chasing him in the media, England may join the race and it could be difficult.” Tags: Eberechi EzeEnglandOvie EjariaQPRlast_img

Yuvraj Singh Takes Fun Dig at India’s Nagging No 4 Woes

first_imgMumbai: India’s World Cup hero Yuvraj Singh on Friday took a fun dig at India’s nagging No. 4 woes after Harbhajan Singh threw his weight behind Sanju Samson to bat in that position in One Day International matches.Samson smashed a 48-ball 91 in India A’s 36-run victory over South Africa A, batting at No. 3. “Why not Sanju Samson at number 4 in ODI.. with good technique and a good head on his shoulders.. well played today anyways against SA A,” Harbhajan said in a tweet.Replying to his long-time former teammate, Yuvraj Singh said: “Top order is very strong bro they don’t need no. 4 batsmen.” He followed it up with a laughing emoticon.Iyer batted at number five during the recently-concluded ODI series in the West Indies and scored 71 and 65 in the two innings he played and impressed both head coach Ravi Shastri and skipper Virat Kohli.At the World Cup earlier this year, India struggled to find their right No. 4 batsman as both K.L. Rahul and Vijay Shankar failed.While in Tests, India doesn’t have the problem of who will bat at No.4 with Kohli making the position his own, the opening slots have been a worry for quite some time.With Prithvi Shaw suspended, India went with just two openers — K.L. Rahul and Mayank Agarwal — for the two-Test series in against the Windies. While Agarwal did seem to be in control, Rahul didn’t play any substantial knock. IANS Also Read: Hockey India Relaunches Website, App with user-Friendly FeaturesAlso Watch:Biswanath Police cracks murder case within 24 hours, Accused Arrested | The Sentinel Newslast_img

Men’s Basketball: Wisconsin dominates I-94 rivalry with Marquette, slows down Markus Howard

first_imgIn front of an electric Kohl Center, the University of Wisconsin men’s basketball team beat in-state rivals Marquette 77–61 Sunday.The hype was there all week for the I-94 in-state rivalry between the Badgers and the Golden Eagles, and it didn’t disappoint.Wisconsin’s white-out themed crowd clearly made an impact on the game. They helped the Badgers jump up 16–8 early, on five points each from Aleem Ford and Nate Reuvers.That I-94 intensity was especially prevalent on drives to the rim and the glass. Every time someone went down low, there was just a little extra contact waiting, which forced both teams out beyond the arc.Big shots from Marquette’s star point guard Markus Howard kept it close. After a seven-point run by Marquette, including a 3-pointer from Howard, the Golden Eagles led 18–16.Men’s Basketball: Badgers roll over McNeese State sans Kobe KingThe University of Wisconsin men’s basketball team (2-1) took on the McNeese State Cowboys (1-3) Wednesday night at the Kohl Read…The biggest impact player on the floor all night was without a doubt Badger guard Brevin Pritzl. He was all over the glass with eight rebounds in the first half alone, four of which came on the offensive end, and hit a few big momentum shots as well.With 1:08 remaining in the first half, the Badgers took control the game. Between a big D’Mitrik Trice three, a backdown by Kobe King, a Brad Davison euro-step and a layup by Ford, the Kohl Center was bumping. The explosive run put Wisconsin up 34–29 heading into halftime.At the break, Trice, Ford and Pritzl led the way with seven points each. Men’s Basketball: Familiar faces absent in upcoming 2019-20 installment of Wisconsin-Marquette matchupThe University of Wisconsin men’s basketball team (2-1) is set for an in-state rivalry matchup against the Marquette Golden Eagles Read…King again showed everyone the type of player he can be on the first play of the second half. A lightning-quick stepback dropped Eagles’ Sacar Anim to the floor and then King hit a three over his dead body. He finished with ten points, four assists and three rebounds.All night long, guys made plays for Wisconsin. After fighting for his tenth rebound of the night, Pritzl ran down the floor and found himself open for a corner three. With that, the senior guard had officially recorded a double-double on his way to a 15 point, 13 rebound outing.Just moments later, Ford hit an NBA-range 3-pointer and followed it up by sending a Markus Howard layup into the backcourt. Ford ended with 12 points, seven rebounds and two blocks.The rich got richer when Trice and Pritzl hit back-to-back threes. It sent the Kohl Center into a frenzy, and Badger fans were undoubtedly in the Golden Eagles’ heads.Men’s Basketball: Badgers find new identity as season beginsThe absence of Ethan Happ is conjuring up many questions about the future of the University of Wisconsin men’s basketball Read…Howard was heckled all day, and it really started to show. An airball followed by a few missed layups clearly stagnated the Marquette offense, who seemed to be throwing up worse and worse shots as the game went on. Howard went 0-9 from the field in the second half, finishing with 18 points and four turnovers.Marquette’s Koby McEwen saw plenty of shots start to fall in the second half, and he finished with 19 points of his own, but it simply wasn’t enough.Despite a relatively quiet night from Reuvers, who finished with ten points, the Badgers dominated every facet of the I-94 matchup. They busted straight through Marquette’s full man press all game and forced a total of 15 turnovers.Men’s Basketball: Badgers secure bounceback win against Eastern IllinoisThe University of Wisconsin men’s basketball team (1-1) got their first win of the season Friday night after getting big Read…To add to the Badgers’ balanced attack, Davison also had a big performance. He finished with a team-high 15 points and was an emotional leader on the defensive end guarding McEwen and Howard.It was probably Pritzl’s best game as a Badger, but everyone showed up big. Wisconsin wound up winning 77–61 with six players scoring in double figures, a much-needed offensive win against their in-state rival. Davison gave credit to the adjustments made by the Badgers throughout.“It makes it a lot harder not knowing where you’re going to get attacked from,” said Davison in the postgame press conference. “We all focus on the little things outside of scoring, because we know the offense will come with those things.”Wisconsin stays home for another in-state matchup with Green Bay this Thursday before heading to Brooklyn for the Legends Classic the following week.last_img