Oseltamivir Phosphate

THURSDAY, Feb. 6, 2025 -- When it comes to the potential of H5N1 avian flu, otherwise known as bird flu, picking up mutations that might lead to human-to-human spread, that "train has already left the station," warns one infectious disease expert. If and when bird flu -- already widespread in cattle, cats and other mammals -- gains the ability to transmit between people, the best Americans can hope for is to "control the speed of the train" with vaccines, masks and treatment, said Dr. Peter Chin-Hong . He's a professor of medicine at the University of San Francisco. Speaking with HealthDay , Chin-Hong stressed that both rapid surveillance and reporting on any new cases of H5N1 that arise are crucial. So the recent silencing of communications from the U.S. Centers for Disease Control and Prevention (CDC) by the Trump administration is worrisome. "It's not that people won't get the information eventually if it's serious, it's the rapidity of information that I'm worried about," Chin-Hong said. He compared the recent CDC gag order to a dysfunctional smoke alarm. "You hope the fire isn't going to come, but if it comes, there will be a delay before you feel it," Chin-Hong said. "Time means lives when we're talking about infectious diseases that really don't know any borders." As the UCSF expert explained, the current strain of bird flu has been circulating through avian species for about 30 years. It has only occasionally infected people -- usually those who've had extended close contact with birds, such as poultry farm workers. However, viruses are built to mutate and find new hosts. That's what's been happening with alarming rapidity in recent years, with more cases of mammals -- such as seals, cattle, cats, dogs and pigs -- coming down with bird flu. Just one mutation Over the past year, especially, there's been an uptick of cases among American people, including the recent death of an already frail patient in Louisiana. In most human cases, H5N1 was thought to have been contracted from close contact with an infected animal. Unfortunately, human-to-human transmission may only require a few new genetic tweaks by the virus, Chin-Hong warned. "I think the length of the road before [we see] a mutation that allows easier entry into our lungs is much shorter than people think," he said. One recent study "looked at the amount of mutations needed before that can occur, and it was very, very short, just one mutation," Chin-Hong noted. "[That] doesn't mean that this mutation will be picked up, but what it means to me is that it's not that far away." He explained that H5N1 can also interact with "regular" seasonal flu viruses. "We have a lot of influenza going around and influenza is engineered to really swap genes with each other and they can pick up tricks," Chin-Hong told HealthDay . "And some of those tricks include getting the combination to enter our bodies, which it is not so great at doing right now." In the relatively few U.S. cases of human bird flu so far recorded, symptoms have typically been mild -- congestion, pink eye and other transitory effects. But if H5N1 mutated so that it could pass easily between people, "all of this may change," Chin-Hong said. "You might get 'inside' disease, and that includes shortness of breath and you may have other organ involvement," he said. Vaccines, masks, treatments Chin-Hong stressed that societies are in a better position to fight mutated H1N1 than they were with COVID-19. "We're in a very different place from the early days of COVID because we have a test, we have vaccines," he said. The United States currently has a stockpile of 4.5 million H5N1 vaccines, based on older mutations. "I think that the stockpiled vaccines would mitigate the effects probably by preventing serious disease, hospitalization and death," Chin-Hong said. But 4.5 million vaccines would run out very quickly, especially when two doses might be needed to protect each recipient. "It's a good start and it will be a good way to protect probably frontline workers in the event that we need to," Chin-Hong said, but production of any vaccine would need to be scaled up enormously in a potentially short period of time. Other forms of prevention would be key, too, such as handwashing and widespread use of N95 masks, he said. A handful of influenza treatments appear to be somewhat effective against H5N1, including oseltamivir ( Tamiflu ). "We may also need to stockpile more Tamiflu," Chin-Hong said. A hobbled CDC and FDA Key to all of this will be a coordinated effort by key government players, however. Central to that effort is the CDC, which at the present moment seems hamstrung, Chin-Hong said. "The CDC is generally the conductor of the orchestra" when it comes to safeguarding public health, he said. "And right now, different parts of the orchestra are playing their own music. And, you know, I think that's that's what we suffered from in the early days of COVID, too." The potential appointment of anti-vaccine activist Robert F. Kennedy Jr. to head the Department of Health and Human Services (which oversees both the CDC and the Food and Drug Administration) also has Chin-Hong "worried." "I'm concerned about, you know, any barriers at the FDA level" when it comes to areas such as vaccine research and distribution, he said. "I know that humans are resourceful and will come up with the science, but the devil is always in the details, and implementing the science is often even more important than the science itself," Chin-Hong concluded. 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