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Open Access Articles- Top Results for Stockpiling antiviral medications for pandemic influenza

Stockpiling antiviral medications for pandemic influenza

An antiviral stockpile is a reserve supply of essential antiviral medications in case of shortage. Many countries have chosen to stockpile antiviral medications against pandemic influenza.[1] Because of the time required to prepare and distribute an influenza vaccine, these stockpiles are the only medical defense against widespread infection for the first six months.[2] The stockpiles may be in the form of capsules or simply as the active pharmaceutical ingredient, which is stored in sealed drums and, when needed, dissolved in water to make a bitter-tasting, clear liquid.[3]

There are no evidence-based guidelines to guide the use of these stockpiled drugs,[1] and plans are based on assumed similarities to seasonal influenza. The most common antivirals are neuraminidase inhibitors, which, if begun during the first 48 hours after symptoms appear, will reduce the duration of seasonal influenza by about one day. Taken before symptoms appear, it may prevent disease in about three-quarters of people treated prophylactically.[4] Currently, this is recommended in institutionalized elderly people and other high-risk groups as a form of post-exposure prophylaxis during seasonal influenza outbreaks. [2] However, since pandemic influenza differs somewhat from normal seasonal influenza, it is not clear that these drugs will prove either safe or effective for their intended purpose. [4]

For a person that has very recently been exposed to seasonal influenza, effective post-exposure prophylaxis generally requires taking a drug like oseltamivir for seven to ten days, at half the daily dose needed for treatment. A person that is repeatedly exposed, such as hospital staff members, may require continuous treatment throughout the duration of the outbreak in a community. Based on experience with seasonal influenza in nursing homes, control of influenza requires full treatment of any ill persons and prophylactic treatment of all their contacts. In a pandemic situation, before a vaccine becomes available, this level of treatment and medical prevention may require providing drugs to 80% of the people in an affected community.[3] Consequently, very large supplies of the drugs must be made available — much larger supplies than could be produced on demand. Stockpiles are generally arranged in advance by government health authorities, due to fear of shortages and an awareness of manufacturing limitations during an outbreak. [3]

Supplies in each country

List of available treatments of antiviral per country.

Rank Country / Territory Population Treatments Date Last Updated Source
1 23x15px China 1,337,722,000
2 Template:Country data India 1,267,500,000
3 23x15px United States 322,882,000 50,000,000 April 27, 2009 Bloomberg.com
Report of antiviral stockpile sales
4 Template:Country data Indonesia 230,014,115
5 23x15px Brazil 208,155,308
6 23x15px Pakistan 166,146,000
7 23x15px Bangladesh 162,221,000
8 23x15px Nigeria 154,729,000
9 23x15px Russia 141,833,393
10 Template:Country data Japan 127,630,000
11 23x15px Mexico 109,610,000
12 23x15px Philippines 92,226,600
13 23x15px Vietnam 88,069,000
14 23x15px Germany 82,062,200
15 23x15px Ethiopia 79,221,000
16 23x15px Egypt 76,030,000
17 23x15px Turkey 71,517,100
18 Template:Country data Iran 70,495,782
19 23x15px Dem. Rep. of Congo 66,020,000
20 23x15px France 65,073,482
21 23x15px Thailand 63,389,730
22 23x15px United Kingdom 61,612,300 30,000,000 April 28, 2009 BBC News
Swine flu: How serious a threat?
23 23x15px Italy 60,090,400
24 23x15px Myanmar (Burma) 50,020,000
25 23x15px South Africa 48,697,000
26 Template:Country data South Korea 48,333,000 21,100,000 August 21, 2009 The Korea Times
More Flu Virus Vaccines to Be Stockpiled
27 23x15px Ukraine 46,143,700
28 23x15px Spain 45,853,000
29 23x15px Colombia 44,830,423
30 23x15px Tanzania 43,739,000
31 23x15px Sudan 42,272,000
32 Template:Country data Kenya 39,802,000
33 23x15px Argentina 39,745,613
34 23x15px Poland 38,130,300
35 23x15px Algeria 34,895,000
36 23x15px Canada 33,476,688 1,400,000 April 27, 2009 Bloomberg.com
Report of Antiviral Stockpile Sales
37 23x15px Uganda 32,710,000
38 23x15px Morocco 31,394,044
39 Template:Country data Iraq 30,747,000
40 File:Flag of Nepal.svg   Nepal 29,331,000
41 23x15px Peru 29,165,000
42 23x15px Venezuela 28,685,400
43 23x15px Malaysia 28,200,000
44 23x15px Afghanistan 28,150,000
45 23x15px Uzbekistan 27,488,000
46 23x15px Saudi Arabia 25,721,000
47 Template:Country data North Korea 23,906,000
48 23x15px Ghana 23,837,000
49 23x15px Yemen 23,580,000
50 23x15px Taiwan 23,027,672
51 23x15px Mozambique 22,894,000
52 23x15px Syria 21,906,000
53 23x15px Australia 21,745,000
54 23x15px Romania 21,496,700
55 23x15px Côte d'Ivoire 21,075,000
56 23x15px Sri Lanka 20,238,000
57 23x15px Madagascar 19,625,000
58 23x15px Cameroon 19,522,000
59 23x15px Angola 18,498,000
60 23x15px Chile 18,028,000 950,000 June 6, 2009 Ministerio de Salud de Chile
Nueva Influenza Humana A (H1N1)
61 23x15px Netherlands 16,508,734
62 23x15px Burkina Faso 15,757,000
63 Template:Country data Kazakhstan 15,571,506
64 23x15px Niger 15,290,000
65 23x15px Malawi 15,263,000
66 23x15px Guatemala 14,027,000
67 23x15px Ecuador 13,938,115
68 23x15px Cambodia 13,388,910
69 23x15px Mali 13,010,000
70 23x15px Zambia 12,935,000
71 23x15px Senegal 12,534,000
72 23x15px Zimbabwe 12,523,000
73 23x15px Greece 11,262,500
74 23x15px Chad 11,206,000
75 23x15px Cuba 11,204,000
76 23x15px Belgium 10,741,000 3,000,000 1 Jan. 2007 Influenza[1]
77 23x15px Portugal 10,631,800
78 23x15px Czech Republic 10,474,600
79 23x15px Tunisia 10,327,800
80 23x15px Dominican Republic 10,090,000
81 23x15px Guinea 10,069,000
82 Template:Country data Haiti 10,033,000
83 23x15px Hungary 10,029,900
84 23x15px Rwanda 9,998,000
85 23x15px Bolivia 9,863,000
86 23x15px Serbia 9,850,000
87 23x15px Belarus 9,690,000
88 23x15px Sweden 9,264,000
89 23x15px Somalia 9,133,000
90 23x15px Benin 8,935,000
91 23x15px Azerbaijan 8,629,900
92 23x15px Austria 8,356,700
93 23x15px Burundi 8,303,000
94 23x16px  Switzerland 7,705,800
95 23x15px Bulgaria 7,602,100
96 Template:Country data Honduras 7,466,000
97 Template:Country data Israel 7,411,000
98 23x15px Tajikistan 6,952,000
99 23x15px Papua New Guinea 6,732,000
100 23x15px Togo 6,619,000
101 23x15px Libya 6,420,000
102 23x15px Paraguay 6,349,000
103 23x15px Laos 6,320,000
104 Template:Country data Jordan 6,316,000
105 23x15px El Salvador 6,163,000
106 23x15px Nicaragua 5,743,000
107 23x15px Sierra Leone 5,696,000
108 23x15px Denmark 5,511,451
109 Template:Country data Kyrgyzstan 5,482,000
110 23x15px Slovakia 5,411,100
111 23x15px Finland 5,333,089
112 23x15px Turkmenistan 5,110,000
113 23x15px Eritrea 5,073,000
114 23x15px Singapore 4,839,400 500,000 April 28, 2009 Referenced. Confirmation expected.
115 23x15px Norway 4,814,075 1,400,000 April 28, 2009 [2]
116 23x15px United Arab Emirates 4,599,000
117 23x15px Costa Rica 4,579,000 3,000 April 28, 2009 Nacion.com (Spanish)
118 23x15px Ireland 4,517,800
119 23x15px Croatia 4,432,000
120 23x15px Central African Republic 4,422,000
121 23x15px Georgia 4,382,100
122 23x15px New Zealand 4,306,500
123 23x15px Lebanon 4,224,000
124 23x15px Puerto Rico 3,982,000
125 23x15px Liberia 3,955,000
126 23x15px Bosnia and Herzegovina 3,767,000
127 23x15px Palestine 3,761,646
128 23x15px Republic of the Congo 3,683,000
129 23x15px Moldova 3,572,700
130 23x15px Panama 3,454,000
131 23x15px Uruguay 3,361,000
132 23x15px Lithuania 3,350,400
133 23x15px Mauritania 3,291,000
134 23x15px Armenia 3,230,100
135 23x15px Albania 3,170,000
136 Template:Country data Kuwait 2,985,000
137 23x15px Oman 2,845,000
138 Template:Country data Jamaica 2,719,000
139 23x15px Mongolia 2,671,000
140 23x15px Latvia 2,259,400
141 23x15px Namibia 2,171,000
142 23x15px Lesotho 2,067,000
143 23x15px Slovenia 2,053,355
144 23x15px Republic of Macedonia 2,048,900
145 23x15px Botswana 1,950,000
146 23x15px Gambia 1,705,000
147 23x15px Guinea-Bissau 1,611,000
148 23x15px Gabon 1,475,000
149 23x15px Qatar 1,409,000
150 23x15px Estonia 1,340,341
151 23x15px Trinidad and Tobago 1,339,000
152 23x15px Mauritius 1,288,000
153 23x15px Swaziland 1,185,000
154 23x15px East Timor 1,134,000
155 23x15px Djibouti 864,000
156 23x15px Fiji 849,000
157 23x15px Cyprus 801,600
158 23x15px Bahrain 791,000
159 23x15px Guyana 762,000
160 23x15px Bhutan 697,000
161 23x15px Comoros 676,000
162 23x15px Equatorial Guinea 676,000
163 23x15px Montenegro 624,000
164 23x15px Solomon Islands 523,000
165 23x15px Suriname 520,000
166 23x15px Western Sahara 513,000
167 23x15px Cape Verde 506,000
168 23x15px Luxembourg 491,700
169 23x15px Malta 412,600
170 23x15px Brunei 400,000
171 23x15px Bahamas 342,000
172 Template:Country data Iceland 319,326
173 23x15px Maldives 309,000
174 23x15px Belize 307,000
175 23x15px Barbados 256,000
176 23x15px Vanuatu 240,000
177 23x15px Netherlands Antilles 198,000
178 23x15px Samoa 179,000
179 23x15px Guam 178,000
180 23x15px Saint Lucia 172,000
181 23x15px São Tomé and Príncipe 163,000
182 23x15px Federated States of Micronesia 111,000
183 23x15px U.S. Virgin Islands 110,000
184 23x15px Saint Vincent and the Grenadines 109,000
185 23x15px Aruba 107,000
186 23x15px Grenada 104,000
187 23x15px Tonga 104,000
188 Template:Country data Kiribati 98,000
189 23x15px Jersey 89,300
190 23x15px Antigua and Barbuda 88,000
191 23x15px Northern Mariana Islands 87,000
192 23x15px Andorra 86,000
193 23x15px Seychelles 84,000
194 23x15px Isle of Man 80,000
195 23x15px Dominica 67,000
196 23x15px American Samoa 67,000
197 23x15px Bermuda 65,000
198 23x15px Marshall Islands 62,000
199 23x15px Guernsey 61,811
200 23x15px Greenland 57,000
201 23x15px Cayman Islands 56,000
202 23x15px Saint Kitts and Nevis 52,000
203 23x15px Faroe Islands 48,797
204 23x15px Liechtenstein 35,700
205 23x15px Monaco 33,000
206 23x15px Turks and Caicos Islands 33,000
207 23x15px San Marino 30,800
208 23x15px Gibraltar 31,000
209 23x15px British Virgin Islands 23,000
210 23x15px Cook Islands 20,000
211 23x15px Palau 20,000
212 23x15px Anguilla 15,000
213 23x15px Tuvalu 10,000
214 23x15px Nauru 10,000
215 23x15px Saint Helena 6,600
216 23x15px Montserrat 5,900
217 23x15px Falkland Islands 3,000
218 23x15px Niue 1,500
219 23x15px Tokelau 1,400
220 23x16px  Vatican City 800
221 23x15px Pitcairn Islands 50

References

  1. ^ a b Schünemann HJ, Hill SR, Kakad M et al. (January 2007). "WHO Rapid Advice Guidelines for pharmacological management of sporadic human infection with avian influenza A (H5N1) virus". Lancet Infect Dis 7 (1): 21–31. PMID 17182341. doi:10.1016/S1473-3099(06)70684-3. 
  2. ^ a b de Jong JC, Beyer WE, Rimmelzwaan GF, Fouchier RA, Osterhaus AD (January 2004). "[Neuraminidase inhibitors oseltamivir and zanamivir: new means of defence against influenza]". Ned Tijdschr Geneeskd (in Dutch and Flemish) 148 (2): 73–9. PMID 14753128. 
  3. ^ a b c Ward P, Small I, Smith J, Suter P, Dutkowski R (February 2005). "Oseltamivir (Tamiflu) and its potential for use in the event of an influenza pandemic". J. Antimicrob. Chemother. 55 (Suppl 1): i5–i21. PMID 15709056. doi:10.1093/jac/dki018. 
  4. ^ a b Harrod ME, Emery S, Dwyer DE (November 2006). "Antivirals in the management of an influenza pandemic". Med. J. Aust. 185 (10 Suppl): S58–61. PMID 17115954.