Tamiflu and Public Health

I am gravely concerned about the generous use (or abuse) of Tamiflu. Lately, I have been pressured by patients to prescribe Tamiflu " just in case to have it at home." I often deny the request to avoid the prophylactic use of Tamiflu and argue as follows:
• The " regular flu" kills approximately 36,000 Americans annually and I still have a hard time convincing people to get their flu shot. In comparison,17 countries have reported 653 cases of H1N1 and 17 Mexicans have died.In the US 160 cases have been confirmed and only one patient has died in the US so far!
• Outside Mexico the virus does not appear to be severe, and this virus might not be any more virulent than normal seasonal flu infections.
• Scientists are encouraged by initial analyses of the DNA sequence of the virus, which has found it lacks the traits that led to the death of nearly 50m people in the 1918 Spanish flu outbreak.
• A WHO medical health officer, said the biggest concern was that the virus could mutate and become resistant to Tamiflu, the anti-viral drug. This could be accelerated by the indiscriminate use of Tamiflu fueled by doctors who mean well but may cause greater harm to the public health by prescribing the drug to any one requesting it.
• The Centers for Disease Control in Atlanta, Georgia, says 98% of existing H1 flu strains were resistant to Tamiflu in the last flu season. Scientists are struggling to understand why this is.Dr Nikki Shindo, a WHO medical health officer, said that he worst-case scenario is the virus will mutate and become Tamiflu-resistant. The best-case scenario is that it causes only mild illness and continues to respond to Tamiflu.

What Can We Do?

Please DO NOT prescribe Tamifu unless their is a reasonable concern that the patient suffers from the flu and diagnostic testing was initiated (nasal swab). For more information about proper testing procedures see http://www.cdc.gov/h1n1flu/.
Tamiflu overuse can lead to resistance and the drug itself can cause significant side affects and even serious reactions (see http://www.drugs.com/sfx/tamiflu-side-effects.html)

I hope someone will listen and please forward this e-mail to anyone interested.

Yours
Bernd