Cold, Flu, & Cough Health Center

Avian Flu: 10 Questions, 10 Answers

4. What can the government do about bird flu? continued...

Tier 1, Group A:

• The approximately 40,000 people essential to vaccine manufacture.
• Medical workers with direct patient contact

Tier 1, Group B:

• People with two medical conditions that put them at high risk of flu complications
• People with a past history of flu hospitalization

Tier 1, Group C:

• Pregnant women
• Household contacts of people with immune-system problems (such as transplants or AIDS) that prevent them from being vaccinated
• Household contacts of children under 6 months of age

Tier 1, Group D:

• Emergency response workers critical to pandemic response
• Key government leaders

Tier 2, Group A:

• Healthy people aged 65 and older
• People aged 6 months to 64 years with one medical condition that puts them at high risk of flu complications
• Healthy children aged 6 to 23 months

Tier 2, Group B:

• Emergency responders not critical to pandemic response
• Public safety workers (firefighters, police, 911 dispatchers, correctional facility staff)
• Utility workers essential for maintaining power, water, and sewage systems
• Transportation workers transporting fuel, water, food, and medical supplies
• Transportation workers providing public ground transportation
• Telecommunications and internet technology workers essential for network operation and maintenance

Tier 3:

• Other key government health decision-makers
• Funeral directors and embalmers

Tier 4:

• Healthy people aged 2 to 64 years not included in the above categories.

5. What good are antiviral drugs?

Antiviral drugs taken within 48 hours of the first symptoms -- such as a sudden fever -- make the illness less severe. The sooner after infection these drugs are taken, the better.

The H5N1 bird flu is resistant to an older and less potent class of flu drugs, which includes Symmetrel and Flumadine. These drugs won't work and would not be used in bird flu pandemic.

Newer and more effective flu drugs, Tamiflu and Relenza, can still work against H5N1 viruses. However, several bird flu viruses isolated from infected humans have already become resistant to Tamiflu.

Relenza is sprayed in the nose. It is extremely effective at neutralizing flu viruses. But people who get bird flu from poultry tend to get infections deep in their respiratory tracts. It's not at all clear that Relenza could reach such deep-seated infections.

Could flu drugs protect people from getting the flu? Yes and no.

People who are stockpiling Tamiflu likely will take the drugs at the wrong time, in the wrong way. That's likely to offer little protection -- and to spur the virus to become even more resistant to Tamiflu.

But in a community experiencing a flu pandemic, Tamiflu and Relenza could be quite effective, says flu expert Anne Moscona, MD, professor of pediatrics and microbiology and immunology, and vice chairwoman of pediatrics research at Weill Medical College of Cornell University in New York.