Japanese flu medication and ‘No Excuses’ shingles vaccine

The 2018 flu season is still hitting North Americans hard. At least 22 children died from the virus between Feb. 4 and Feb. 10, bringing the total as of Feb. 26 to 85, according to the Centers for Disease Control and Prevention. They report “during week 7 (Feb. 11-17) influenza activity remained elevated in the United States.”

As I reported in late January, although flu has not impacted Cuenca and the tropical areas of South America this year, there are a significant number of cases in Quito and surrounding province of Pichincha.

According to HarvardHealth.edu, there is at least one antiviral medication, oseltamivir (Tamiflu). When taken within two days of getting the flu, it may reduce symptoms and help you recover from the flu a day or two earlier. However, the World Health Organization (WHO) removed Tamiflu from its list of essential medications in June 2018 based “on the relatively low effectiveness in clinical trials and clinical practice.”

Breaking news! A Japanese pharmaceutical company has obtained approval for manufacture and distribution the flu medication Xofluza (baloxavir marboxil) that significantly reduces severity and duration of the flu.

Isao Teshirogi, president and chief executive officer of Shionogi & Co., speaks during an interview in Tokyo. (Kiyoshi Ota/Bloomberg)

In Phase 3 clinical trials, Xofluza needed a single dose (one pill) to significantly reduce symptoms within 24 hours. In contrast, Tamiflu took about 72 hours (two pills daily) to reduce symptoms, and a placebo took 96 hours. As reported in Fortune.com, “… Xofluza’s unique action mechanism is the secret behind its success.

Unlike other flu antivirals, Xofluza actually stops virus replication in its tracks by inhibiting an enzyme that the flu virus needs to multiply.” Forbes.com reports, “The key with any of these flu medications is early treatment, especially within the first 24 to 48 hours of infection, which may be before you notice any symptoms. Once the virus has replicated and is all over your body, your options are limited. The vaccine still remains the best way to prevent an infection.”

As reported in ABCNews.go.com, Xofluza’s manufacturer, Shionogi, will offer it for sale in Japan, probably in May. Roche, the drug manufacturer of Tamiflu, is working with Shionogi and another drug maker on trials in the U.S. with hope for approval for next year’s 2018-2019 flu season.

The “No Excuses” Vaccine — Shingrix

“I wouldn’t wish shingles on my worst enemy!” According to Medlineplus.gov, this painful skin rash is caused by the same virus that causes chickenpox, and at least 25% of all healthy adults will get shingles — it’s 10 times more likely to occur in adults over 60 than in children under 10. The older one is when afflicted, the more severe the pain and an increased risk of additional permanent injury.

It’s understandable that the New York Times’ headline reads, “No Excuses, People: Get the New Shingles Vaccine.” They report, “… this vaccine has spectacular initial protection rates in every age group. The immune system of a 70- or 80-year-old responds as if the person were only 25 or 30.”

In large, international clinical trials the vaccine called Shingrix (GlaxoSmithKline) prevents more than 90% of shingles cases, even at older ages. Compare that to Zostavax, currently the only approved vaccine for shingles, deemed effective in only 50% of those over age 60, and only 18 percent in people 80 and older. As the Times reports, seniors are “… the people that are at most risk for the intense pain, threat to vision and the associated nerve pain that sometimes lasts months, even years, after the initial rash fades.”

Shingrix is not yet available in Ecuador, according to my Cuenca physician. The Times reports that in early 2018, “… it should be broadly available to consumers in the U.S.” and that Canada has also approved Shingrix; it awaits approval in Australia, Japan and Europe.” Read more about Shingrix from the New York Times. https://www.nytimes.com/2017/11/10/health/shingrix-shingles-vaccine.html

Update April 4, 2018.  I contacted GSK to find out when the Shingrix vaccine will be available in Ecuador or in Europe (where we’re visiting this summer) and they said there’s no immediate information about that. They also said that they advise two doses, 2-6 months apart, but the CDC has approved a shorter vaccination schedule, as little as 4 weeks apart.  Also, one dose (instead of the two recommended shots) appears to have excellent efficacy, and just slightly less effective than one dose.  Speak with your physician in the USA or Canada (if you have the opportunity).