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Oct 2, 2008 S'pore's million-dollar DEFENCE against flu pandemic Current vaccine stocks to be boosted - enough to treat 1.5 million patients By Salma Khalik SINGAPORE will be spending millions of dollars more taking out additional 'insurance' to protect against a flu pandemic - by buying a vaccine as well as more flu medicine. It has already spent $31 million on 1.05 million courses of Tamiflu and 50,000 courses of Relenza - the only two medicines that are effective in reducing the effects of flu caused by any virus type. It now wants to buy 650,000 more courses of Tamiflu. Patients need to take a course of 10 capsules over five days. This arsenal will give Singapore enough to treat 1.5 million patients - 1.2 million projected to be infected by a pandemic flu bug, and the remainder who would be down with a different strain. The extra medicine is expected to cost $19 million. The Ministry of Health (MOH) will also be stocking up on a vaccine for the H5N1 virus, the bird flu virus which experts think will cause the next serious flu pandemic. It will call a tender to choose a vaccine this month. There is no certainty that the H5N1 would cause a pandemic, when infections would sweep the world and cause untold numbers of illness and death. But at least 16 drug companies think it might, and are at various stages of developing a 'pre-pandemic vaccine' against that strain. Ireland and Switzerland have each bought enough of such a vaccine for every man, woman and child in the country. Singapore will not be going that far, purchasing only 'a limited quantity'. Dr Jeffery Cutter, MOH's deputy director for communicable diseases, said that underpinning the reasons for the decision were: Should Singapore pay for a stock of vaccines that may not be used? What is the bet the next attack would be from H5N1, and not, say, H7N2? The vaccine would be useless against any other strain of flu. It may even lose its effectiveness against H5N1 if that virus mutates enough. But not buying the vaccine means joining the global rush for limited stocks should expert predictions of an H5N1 outbreak pan out and the death toll starts moving into the hundreds of thousands. More than 40 million people died of the Spanish flu in 1918. The flu pandemics of 1957 and 1968 took only six months to spread across the world. The first killed two million people and the second caused one million deaths. Should the next attack be caused by H5N1, as experts widely predict, the results could be lethal, as there is no resistance in humans against this new virus. So far, it has killed more than 60 per cent of the 385 people infected. Furthermore, the current capacity of all vaccine companies combined is about 40 million vaccine doses a year - not even enough for 1 per cent of the global population. Dr Cutter said if Singapore had the vaccine, it would use the supplies as soon as the World Health Organisation declares a Phase Four - when human-to-human transmission increases. Right now, there is very limited transmission of the virus between people. That will hopefully take place weeks before the first avian flu case is seen here. For this vaccine to be effective, people need two doses three weeks apart, unlike a single shot for normal flu. After essential personnel, priority for the vaccine would go to children aged between six months and 12 years, and sick people who are at higher risk of complications. Associate Professor Leo Yee Sin, the head of communicable diseases at Tan Tock Seng Hospital, said: 'Getting the pre-pandemic vaccine gives a level of security. But you hope never to need it.' The vaccine is expected to remain effective for three years. Fresh supplies would be needed beyond that. Singapore has placed a deposit to ensure it is among the first to get any pandemic vaccine - no matter what strain of flu virus causes it. But manufacturers will need three to six months to make the vaccines after a pandemic is declared. At risk would be more than one million people here - about a quarter of Singapore's population - who are expected to be infected in the first wave of about six weeks. But it should protect the population against a second wave that could surface some months later. salma@sph.com.sg Copyright © 2007 Singapore Press Holdings. All rights reserved. Privacy Statement & Condition of Access |