BMJ  2003;327:105-106 (12 July), doi:10.1136/bmj.327.7406.105-c

Letter

Neuraminidase inhibitors for influenza A and B

Antivirals need to be protected from adverse conditions to retain effectiveness

EDITOR—Cooper et al outlined the role of neurominadase inhibitors in prophylaxis against and treatment of influenza.¹ These agents would be important during the early phase of any outbreak of influenza. Nevertheless, their efficacy would be reduced if they were not primed to resist the adverse conditions encountered in the field.

Like vaccines, the potency of antiviral drugs is only maintained during storage at controlled temperatures not exceeding 25-30°C.² Inadvertent exposure to temperatures above this could easily happen. Also, in 1992 temperatures inside refrigerators in paediatric clinics in Los Angeles exceeded 8°C in 22% of cases.³ Power cuts are also a threat.

Designers of prospective influenza vaccines and chemotherapeutics should therefore ensure that such products can withstand environmental rigours while being transported at short notice to different continents during a pandemic. Adding pirodavir and deuterium oxide to the most labile of the childhood vaccines, live poliovirus vaccine, has resulted in vaccine immunogenicity being maintained after 10 hours of exposure to 42°C.⁴ Practitioners of clinical medicine and public health need also to appreciate the value of storing influenza therapeutics or prophylactics according to manufacturers' recommendations during epidemics.

subhashji{at}hotmail.com

Sant Parmanand Hospital, 18 Alipore Road, Delhi 110054, India

---

Competing interests: None declared.

References

1. Cooper NJ, Sutton AJ, Abrams KR, Wailoo A, Turner D, Nicholson KG. Effectiveness of neuraminidase inhibitors in treatment and prevention of influenza A and B: systematic review and meta-analyses of randomised controlled trials. BMJ 2003;326: 1235-40. (7 June.)[Abstract/Free Full Text]
2. Physicians' desk reference 56th ed. Montvale: Medical Economics, 2002.
3. Bidshai DM, Bhatt S, Miller LT, Hayden GF. Vaccine storage practices in pediatric offices. Pediatrics 1992;89: 193-6.[Abstract/Free Full Text]
4. Verheyden B, Andrus K, Rombart B. Capsid and viral RNA stabilization of the poliovirus. Vaccine 2001;19: 1899-905.[CrossRef][ISI][Medline]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Effectiveness of neuraminidase inhibitors in treatment and prevention of influenza A and B: systematic review and meta-analyses of randomised controlled trials

Nicola J Cooper, Alexander J Sutton, Keith R Abrams, Allan Wailoo, David Turner, and Karl G Nicholson
BMJ 2003 326: 1235. [Abstract] [Full Text] [PDF]