Eeyore's news and view

Obama moves to counter China with Pentagon-NASA link
Demian McLean BLOOMBERG NEWS
Thursday, January 8, 2009
President-elect Barack Obama probably will tear down long-standing barriers between the U.S. civilian and military space programs to speed up a mission to the moon amid the prospect of a space race with China.
Mr. Obama's transition team is considering a collaboration between the Defense Department and the National Aeronautics and Space Administration (NASA) because military rockets may be cheaper and ready sooner than the space agency's planned launch vehicle, which is not slated to fly until 2015, say people who have discussed the idea with the Obama team.
The Pentagon has increasing concerns about China's space ambitions because of what is perceived as an eventual threat to U.S. defense satellites, the lofty battlefield eyes of the military. China, which destroyed one of its aging satellites in a surprise missile test in 2007, is making strides in its spaceflight program. The military-run effort carried out a first spacewalk in September and aims to land a robotic rover on the moon in 2012, with a human mission several years later.
"If China puts a man on the moon, that in itself isn't necessarily a threat to the U.S.," said Dean Cheng, a senior Asia analyst with CNA Corp., an Alexandria-based national-security research firm. "But it would suggest that China had reached a level of proficiency in space comparable to that of the United States."
Mr. Obama has said the Pentagon's space program - which spent about $22 billion in fiscal 2008, almost a third more than NASA's budget - could be tapped to speed the civilian agency toward its goals as the recession pressures federal spending.
NASA faces a five-year gap between the retirement of the space shuttle in 2010 and the first launch of Orion, the six-passenger craft that will carry astronauts to the International Space Station and eventually the moon. Mr. Obama has said he would like to narrow that gap, during which the United States will pay Russia to ferry astronauts to the station.
The Obama team has asked NASA officials about the costs and savings of scrapping the agency's new Ares I rocket, which is being developed by Chicago-based Boeing Co. and Minneapolis-based Alliant Techsystems Inc.
NASA chief Michael Griffin opposes the idea and told Mr. Obama's transition team leader, Lori Garver, that her colleagues lack the engineering background to evaluate rocket options, agency spokesman Chris Shank said.
"The NASA review team is just asking questions; no decisions have been made," said Nick Shapiro, a transition spokesman for Mr. Obama. The team will pass its findings to presidential appointees, he said.
Mr. Obama may find support for his vision at the Pentagon. Although NASA hasn't recently approached the Pentagon about using its Delta IV and Atlas V rockets, building them for manned missions could allow for cost sharing, said Steven Huybrechts, the director of space programs and policy in the office of Defense Secretary Robert M. Gates, who is staying on into the new administration.
The Delta IV and Atlas V are built by United Launch Alliance - a joint venture of Boeing and Bethesda-based Lockheed Martin Corp. - and typically are used to carry satellites.
"No one really has a firm idea what NASA's cost savings might be, but the military's launch vehicles are basically developed," said John Logsdon, a policy specialist at the Smithsonian National Air and Space Museum who has conferred with Mr. Obama's transition advisers. "You don't have to build them from scratch."
Meanwhile, Chinese state-owned companies already are assembling heavy-lift rockets that could reach the moon, with a first launch scheduled for 2013. All that would be left to build for a manned mission is an Apollo-style lunar lander, said Mr. Griffin, who visited the Chinese space program in 2006.
Mr. Griffin said in July that he thinks China will be able to put people on the moon before the United States goes back in 2020. The last Apollo mission left the lunar surface in 1972.
"The moon landing is an extremely challenging and sophisticated task, and it is also a strategically important technological field," Wang Zhaoyao, a spokesman for China's space program, said in September, according to the state-run Xinhua news agency.
China plans to dock two spacecraft in orbit in 2010, a skill required for a lunar mission.
"An automated rendezvous does all sorts of things for your missile accuracy and anti-satellite programs," said John Sheldon, a visiting professor of advanced air and space studies at Maxwell Air Force Base in Alabama. "The manned effort is about prestige, but it's also a good way of testing technologies that have defense applications."
China's State Council Information Office declined to comment on the nation's anti-satellite or manned programs.
http://www.washingtontimes.com/news/2009/jan/08/obama-moves-to-counter-china-with-pentagon-nasa-li/

World stocks drop as U.S. unemployment rate hits 7.2 percent
LONDON – Stock markets dropped Friday as investors fretted over the outlook for the U.S. economy after an unexpectedly large increase in the unemployment rate and confirmation that more jobs were lost in 2008 than in any year since World War Two.
An early relief rally following the news that payrolls in the world's largest economy declined by a smaller than anticipated 524,000 in December soon dissipated as investors focused on the rise in the unemployment rate to a 16-year high of 7.2 percent from 6.8 percent in the previous month. Analysts had expected unemployment to hit 7 percent in December.
Investors were also spooked by the news that for all of 2008, the U.S. economy shed 2.6 million jobs — the most since 1945 when nearly 2.8 million were lost — even though the number of jobs in the U.S. has more than tripled since then.
"In the end, the decline in non-farm payrolls last month wasn't quite as bad as some in the markets had begun to fear," said Paul Ashworth, senior U.S. economist at Capital Economics.
"However, it was bad enough and, arguably more importantly, revisions to the declines in earlier months mean that the three-month average decline in payrolls still reached a 50-year record of more than 500,000," he added.
After briefly moving into positive territory following the release, the FTSE 100 index of leading British shares closed down 56.83 points, or 1.3 percent, at 4,448.54, while Germany's DAX fell 96.02 points, or 2.0 percent, to 4,783.89. France's CAC-40 was 24.83, or 0.8 percent, lower at 3,299.50.
On Wall Street, the Dow Jones industrial average was 109.75 points, or 1.3 percent, lower at 8,632.71, while the broader Standard & Poor's 500 index was down 15.59 points, or 1.7 percent, at 894.14.
Equity markets, which enjoyed a rally at the end of 2008 on hopes that fiscal and monetary stimulus measures would help the global economy recover later this year, have been on the retreat in the last few days amid fears about the scale of the recession in the U.S., where a raft of retailers reported dismal sales figures for December.
The markets' pricing behavior over the coming months will depend on when the green shoots of recovery emerge, analysts say.
"There's still a tug of war in the markets between those who think the economy will recover in the second half of the year and those who think 2009 is a right-off, and that will dominate price action in the months ahead," said ECU Group's chief economist Neil Mackinnon.
Given the apprehension ahead of the data, Asian markets had closed lower.
Tokyo's Nikkei 225 stock average fluctuated through the session, eventually ending 39.62 points lower, or 0.5 percent, at 8,836.80 by the close. Hong Kong's Hang Seng Index lost 38.47 points, or 0.3 percent, to 14,377.44, after rising earlier in the session amid what analysts said was speculation about central government aid for the power sector.
In South Korea, the Kospi shed 2.1 percent even as the country's central bank cut its key interest rate for the fifth time in three months to help shore up the country's sagging economy. Benchmarks in India, Taiwan and Singapore sank, but those in Shanghai and Australia advanced.
Oil prices fell moderately, with light, sweet crude for February delivery down $1.65 to $40.05 a barrel in electronic trading on the New York Mercantile Exchange. The contract overnight fell 93 cents to settle at $41.70.
In currencies, the dollar fell 1.0 percent to 90.18 yen while the euro was down 1.5 percent at $1.3495.
http://news.yahoo.com/s/ap/20090109/ap_ ... ld_markets

FTSE 100 down 28.63 at 4,476.74 January 9, 2009 - 7:28am
LONDON (AP) - Share prices on the London Stock Exchange were lower at midday Friday.
At midday, the FTSE 100-share index was down 28.63 points at 4,476.74.
http://www.wtop.com/?nid=104&sid=1568205

Bank of England cuts interest rates to lowest in more than 300 years The Bank of England has cut interest rates to the lowest level in its 315-year history as it desperately attempts to prevent the UK recession deepening into a slump
The bank rate has been reduced by 0.5 percentage points to 1.5pc after recent economic data suggested that the UK is in store for a deep recession this year as the house price slide, unemployment rises and spending slows.
Economists believe that because the UK is experiencing a significant downturn, with banks unwilling to lend and pass on interest rates cuts in full, the Bank will reduce rates close to zero to try and ease the impact.
"The 50 basis point cut at this juncture was appropriate. However, with survey data continuing to languish at record lows - manufacturing and services surveys in the past few days have confirmed that activity is falling sharply - we see no reason for the Bank to hold back in cutting interest rates to 1pc or below in the coming months," said Hetal Mehta, senior economist from the Ernst & Young ITEM Club.
The Bank's Monetary Policy Committee will have examined all the latest data on the economy before reaching its decision, including most recently a Nationwide survey this week which showed house prices fell 15.9pc in 2008.
In a statement accompanying the decision the MPC said that UK business activity fell sharply during the fourth quarter of 2008 and is likely to continue to do so during the first part of this year.
It reiterated that more action was needed to increase lending to businesses and consumers: "The outlook for business and residential investment has deteriorated. And the availability of credit to both households and businesses has tightened further, pointing to the need for further measures to increase the flow of lending to the non-financial sector," it said.
The Bank is now likely to consider other, less conventional attempts to boost the economy, including printing money, known as quantitative easing.
The MPC's decision to cut interest rates today may also have been influenced by the pound's modest gains against the euro this week after falling to close to parity at the end of 2008 with a low of €1.02 on December 30. It closed yesterday at €1.11.
The MPC has already admitted that it considered bigger rate cuts than it eventually opted for in November and December, partly over fears that it would trigger a run on the pound.
http://www.telegraph.co.uk/finance/financetopics/recession/4175063/Bank-of-England-cuts-interest-rates-to-lowest-in-more-than-300-years.html

Start-ups put farm debris to use as fuel

Start-ups put farm debris to use as fuel
By Paul Davidson, USA TODAY
JENNINGS, La. — Want to see what you'll be pumping into your car in a few years?
Come visit a scruffy patch of land here in sugar-cane country, where 15-foot-high piles of what looks like hay stretch three blocks alongside a gleaming, silver-and-yellow jumble of pipes, tanks and girders.
The hay, actually crushed sugar-cane stalks, is feedstock for the first cellulosic ethanol demonstration plant in the USA. The biorefinery cranked up this week and, according to its backers, kicks off a new era of clean transportation fuels that won't compete with the food supply. Corn-based ethanol, by contrast, has been blamed for driving up food prices and doing little to reduce the global warming gases emitted by petroleum-fueled vehicles.
Cellulosic ethanol is made from plant waste — such as wood chips, corn cobs and stalks, wheat straw and sugar-cane bagasse (stems and leaves) — or municipal solid waste. Simply put, the nation will soon be running its cars, at least partly, on debris.
Cellulosic makers are quietly laying the foundation for a new industry even as some corn ethanol plants, facing supply shortages and low profit margins, shut down, and some oil giants put off production projects amid plummeting crude prices.
The plunge in crude "is a short-term correction and doesn't stop our quest to develop alternative energy," says Carlos Riva, CEO of Verenium, which owns the Jennings plant. "Cellulosic ethanol is right here and ready."
The plant will produce 1.4 million gallons of ethanol a year, a fraction of a typical 60 million-gallon-a-year corn ethanol plant but far more than the output of the handful of tiny cellulosic pilot plants in the U.S. About a dozen cellulosic demonstration plants and six larger commercial facilities are scheduled to start up by 2012, according to the Renewable Fuels Association.
Range Fuels expects to complete the first commercial plant in Soperton, Ga., late this year. The $120 million facility will churn out 10 million gallons of ethanol a year.
Renewed interest
That cellulosic ethanol is this close to commercial production marks a dramatic leap forward. Development in recent decades has been stymied by high costs and difficulty transferring technology that works well in the lab to mass production. Plus, every time oil prices tumbled, research funding evaporated.
"The old joke was that cellulosic ethanol was always just five years down the road," says Andy Aden, a senior chemical engineer at the National Renewable Energy Laboratory. "Now, there's steel going in the ground."
Driving the renewed interest is growing concern about global warming and a belief that Congress eventually will limit carbon dioxide emissions from petroleum-fueled vehicles. It didn't hurt that, in 2005, crude prices shot up to $60 a barrel and hit a high of $147 in 2008 before falling below $50 in recent months.
Venture-capital firms have poured $682 million into cellulosic start-ups since 2006, up from $20 million the previous two years, according to research firm New Energy Finance. And the Department of Energy has provided nearly $850 million for research and development.
"All of a sudden, this went from dog to darling," says Lee Lynd, a pioneer in cellulosic research who co-founded Mascoma, a cellulosic start-up that's still developing its technology.
Producers still face hurdles, including a credit crisis that's delaying several commercial plants. But in 2007, President Bush signed a bill mandating that biofuels make up 36 billion gallons, or 16%, of motor fuel by 2022, with 16 billion gallons coming from cellulosic ethanol. Corn ethanol consumption, which totaled 9 billion gallons, or 7% of the gasoline market, last year, is capped at 15 billion gallons.
A big advantage for cellulosic fuel is that refineries can be tailored to a region's leading crop, reducing delivery costs: wheat straw and corn residue in the Midwest; sugar cane in the South; and wood in the Pacific Northwest and Southeast. Corn ethanol refineries are largely confined to the Midwest.
Another selling point is that cellulosic ethanol can cut greenhouse gas emissions by 86% compared with gasoline, while grain ethanol trims emissions just 20%, DOE says. That's because diverting corn to fuel means razing forests or plowing grasslands to plant substitute corn crops, according to the Natural Resources Defense Council. That releases CO2 into the air.
Special enzymes
But it's a lot harder to make ethanol from farm waste than corn. Corn has starches that enzymes can easily break down into sugars; yeast ferments the sugars to produce ethanol. By contrast, stalks and leaves contain carbohydrates that are tougher to unravel because they're tightly bound with other compounds that make plants firm so they can stand and resist wind.
Manufacturers must create special enzymes to unlock the carbohydrates. At about 10 cents a gallon of ethanol, they're twice as costly as those used for corn ethanol. They also must genetically engineer bacteria to ferment the sugars into ethanol.
Recent advances have resulted in more efficient enzymes that substantially cut costs, Aden says. Still, he says, cellulosic wholesale costs are $2 to $3 a gallon, vs. $1.56 for corn ethanol. But since feedstock costs about half as much, Aden says prices should drop to $1.33 by 2012.
There are other challenges. Producers must scavenge enough agricultural residue to supply a factory that will churn out as much as 100 million gallons of ethanol a year. They typically must round up the scraps within a 75-mile radius to avoid high transportation costs that can erase profits.
At its Jennings plant, Verenium gets its bagasse from a sugar mill that's supplied by area sugar-cane farms. To ensure a steady supply, it's also growing "energy cane," a crop that has too little sugar for mills but much thicker stalks.
Other companies plan to raise similar energy crops, such as switch grass, that theoretically can be grown on land degraded by farming. But environmental groups such as NRDC worry that if the crops are grown on regular soil, they'll pose the same food supply and CO{-2} concerns as corn.
Verenium is also experiencing some growing pains as it shifts a chemical process involving delicate microbes from a pristine lab to a bustling, three-story factory. In tests several months ago, a strainer did not remove all the rocks and clay from the sugar bagasse, jamming machines. Manager Mark Eichenseer purchased a $90,000 grinder to more finely chop the bagasse before feeding it to the conveyor.
Another machine that uses heat, pressure and acid to separate glucose and non-glucose sugars was not finishing the job. Eichenseer raised the temperature and acid dosage. Eichenseer is hiring a pump expert to improve the flow of the cellulose, which becomes a sticky mush and sometimes clogs equipment. He's also careful to keep tanks and pumps from getting infected with foreign bacteria, which can reduce ethanol yields. "That's the most difficult challenge," he says.
Fungi that produce enzymes are grown in three stages over eight days. Fermentation takes an additional two to three days. Ensuring continuous output can be tricky. In tests last month, most of the plant was abruptly shut down to prevent backups on the conveyor. Corn ethanol is processed in two to four days.
To make cellulose cost-competitive with corn, Eichenseer is working to scale back the nutrients he feeds the bacteria and the energy to run the refinery without sacrificing ethanol yields. The company also may chop and store energy cane at the farm to trim handling costs.
Different approaches
Some competitors are working on technology they say could slash costs further. Mascoma is developing a bug that does double-duty: It makes enzymes to produce sugars and ferments the sugars into ethanol. Costs should be under $1 a gallon, Lynd says.
Others are taking different approaches by tapping:
•Corn cobs. Poet, the world's largest ethanol producer, has tested two types of combines that allow both corn and cobs to be gathered at the same time to slash labor expenses. The company expects to produce 27% more ethanol per acre of corn.
Poet plans to expand a 50 million-gallon-a-year corn ethanol plant in Emmetsburg, Iowa, to produce 100 million gallons of corn ethanol and 25 million gallons of cellulosic fuel by 2011. "It's going to take both (grain and cellulosic ethanol) to replace oil from dangerous parts of the world," Poet CEO Jeff Broin said.
•Wood chips. Range Fuels plans to buy wood waste from paper mills and loggers for the plant it's building in Soperton, a heavily forested area. Instead of using enzymes, Range says it has a less-expensive process that employs heat and pressure to convert wood into a synthetic gas. It then runs the gas over a catalyst to make ethanol.
Range CEO David Aldous says the plant eventually will make 100 million gallons of ethanol a year, requiring a delivery of 12.5 dry tons of wood scraps every seven minutes. But a second phase of the facility that was to be done by early 2012 is delayed six months because financing isn't available.
•Municipal solid waste. BlueFire Ethanol will use trash to feed a 3 million-gallon-a-year demonstration plant it's planning in Lancaster, Calif. Its secret sauce: a low-cost acid that breaks a variety of materials into sugars, rather than an enzyme that's optimized for a certain type of plant. By taking tree remains, lawn clippings and construction debris from the city, BlueFire will gets its feedstock for free while Lancaster avoids paying landfill fees, says company Chief Financial Officer Christopher Scott. Because it doesn't have to use farm residue, BlueFire can build plants near big cities on the East or West coasts, avoiding high costs to truck ethanol long distances.
But construction of the $30 million Lancaster plant, scheduled to start last month, has been pushed back because the credit crisis has dried up funding.
The delays have raised uncertainty over whether the industry will meet the production mandates. The Bush administration is providing tax incentives of $1.01 a gallon for cellulosic ethanol as well as loan guarantees. Analyst Laurence Alexander of Jefferies & Co. says much more federal aid is required. At least some additional funding is likely, he says, citing President-elect Barack Obama's support for biofuels. And start-up Coskata raised $40 million in private equity in October despite the brutal climate.
Yet how much cellulosic ethanol will motorists actually use?
Most U.S. gas pumps now contain 10% ethanol blends, and the government is testing blends up to 20%. In two decades, more flex-fuel cars that can accept blends of up to 85% ethanol are expected to be on the road.
By then, cellulosic ethanol realistically could replace a quarter of the nation's gasoline — which would dramatically reduce both oil prices and global warming emissions, says David Friedman of the Union of Concerned Scientists. DOE says there's enough feedstock to supplant 30% of gasoline consumption. Of course, electric cars and hybrids are also expected to play a big role.
There are skeptics. David Pimentel, an agricultural science professor at Cornell University, calls the DOE estimate "imaginary." Removing too much plant waste from fields will erode soil, he says, while growing energy crops will jeopardize the food supply.
Vinod Khosla of Khosla Ventures, the top backer of cellulosic start-ups, remains upbeat. By 2050, he says, "You should be able to replace most (gasoline)" with cellulosic ethanol.
http://www.usatoday.com/money/industries/energy/2009-01-08-cellulosic-waste-ethanol_N.htm

Literacy study: 1 in 7 U.S. adults are unable to read this story
A long-awaited federal study finds that an estimated 32 million adults in the USA — about one in seven — are saddled with such low literacy skills that it would be tough for them to read anything more challenging than a children's picture book or to understand a medication's side effects listed on a pill bottle.
Though many communities are making strides to tackle the problem, it's worsening elsewhere — in some cases significantly.
Overall, the study finds, the nation hasn't made a dent in its adult-literacy problem: From 1992 to 2003, it shows, the USA added about 23 million adults to its population; in that period, an estimated 3.6 million more joined the ranks of adults with low literacy skills.
LOCATION: Seattle, Minneapolis most literate big cities
How low? It would be a challenge to read this newspaper article or deconstruct a fuel bill.
"They really cannot read … paragraphs (or) sentences that are connected," says Sheida White, a researcher at the U.S. Education Department.
The findings come from the department's National Assessment of Adult Literacy, a survey of more than 19,000 Americans ages 16 and older. The 2003 survey is a follow-up to a similar one in 1992 and for the first time lets the public see literacy rates as far down as county levels.
In many cases, states made sizable gains. In Mississippi, the percentage of adults with low skills dropped 9 percentage points, from 25% to 16%. In every one of its 82 counties, low-skill rates dropped — in a few cases by 20 percentage points or more.
By contrast, in several large states — California, New York, Florida and Nevada, for instance — the number of adults with low skills rose.
David Harvey, president and CEO of ProLiteracy, an adult-literacy organization, says Mississippi "invested more in education … and they have done innovative programming. We need much more of that."
U.S. Education Secretary Margaret Spellings says efforts in adult literacy are inefficient and "scattered" across government agencies.
"We're not using research-based practices, broadly applied," she says.
Harvey cites undiagnosed learning disabilities, immigration and high school dropouts as reasons for the poor literacy numbers.
The findings are published online at nces.ed.gov/naal/estimates/index.aspx.
http://www.usatoday.com/news/education/ ... racy_N.htm

New rules on toys could spell doom
By Lea Ann Overstreet Allen and Clay Carey, USA TODAY
Looming federal regulations that could force used-item retailers and thrift stores to trash many children's toys and clothing are getting a second look from the Consumer Product Safety Commission.
The regulations, passed under the Consumer Product Safety Improvement Act in August and set to go into effect Feb. 10, are aimed at eliminating lead-tainted products designed for children 12 and younger. They require all such products — clothes, toys and shoes — be tested for lead and phthalates, the chemicals used to make plastics pliable.
The main issue for retailers is the costly testing, which can run from about $400 for a small item to thousands of dollars for larger toys with multiple pieces, according to Kathleen McHugh, president of the American Specialty Toy Retailing Association.
Products not tested would be deemed hazardous whether they contain lead or not, under the wording of the law.
Abby Whetstone, owner of Twice as Nice Kids in Denver, said consignment stores such as hers would not be able to afford expensive lead tests.
"It would affect every piece of inventory we have," Whetstone said. "We're a little terrified at this point."
The Consumer Product Safety Commission voted this week to work on exemptions to the regulations and evaluate the way they could impact sales from consignment shops, online retailers and even yard sales.
"We are working on a 30-day comment period where we will hear from consumers, manufacturers, retailers, anybody affected by the act," commission spokesman Scott Wolfson said. The review won't be finished by Feb. 10, but the law will still go into effect that day, he said.
Wolfson said there are some obvious holes in the act, which the commission will seek to fill.
Lara Lang, who has helped run consignment sales which raise between $25,000 and $30,000 a year for the Hermitage United Methodist Church preschool in Nashville, says the concept of protecting children is good, but she was critical of the act.
"How on earth are they going to enforce that? They can't. There are people who have yard sales. Are they going to police those?" she asked.
The changes would also affect toy wholesalers and distributors such as Challenge & Fun, a Massachusetts-based company that imports most of its products from Europe. Company co-owner Rob Wilson said he'd have to cut his 500-product line to 20 or 30 to meet the requirements. "Even there, if I have to spend $20,000 or $30,000 on testing, that's a big hit," he said.
Goodwill Industries International, among the charities that could be affected, is waiting for clarification before it starts changing the way it does business, spokeswoman Charlene Sarmiento said.
Carrie Weir, who owns Web-based Los Pollitos Dicen, a children's clothing line specializing in T-shirts, would be hit both as a clothing designer and a parent.
"We all want regulations to make sure our children our safe, but this law goes too far," Weir said.
http://www.usatoday.com/news/washington/2009-01-08-toys_N.htm

Flu in U.S. found resistant to main antiviral drug
Virtually all the flu in the United States this season is resistant to the leading antiviral drug Tamiflu, and scientists and health officials are trying to figure out why.
The problem is not yet a public health crisis because this has been a below-average flu season so far and the chief strain circulating is still susceptible to other drugs — but infectious disease specialists are worried nonetheless.
Last winter, about 11 percent of the throat swabs from patients with the most common type of flu that were sent to the Centers for Disease Control and Prevention for genetic typing showed a Tamiflu-resistant strain. This season, 99 percent do.
"It's quite shocking," said Dr. Kent Sepkowitz, director of infection control at Memorial Sloan-Kettering Cancer Center in New York. "We've never lost an antimicrobial this fast. It blew me away."
The single mutation that creates Tamiflu resistance appears to be spontaneous, and not a reaction to overuse of the drug. It may have occurred in Asia, and it was widespread in Europe last year.
Panel recommends Illinois governor be impeached
In response, the CDC issued new guidelines two weeks ago. They urged doctors to test suspected flu cases as quickly as possible to see if they are influenza A or influenza B, and if they are A, whether they are H1 or H3 viruses.
The only Tamiflu-resistant strain is an H1N1. Its resistance mutation could fade out, a CDC scientist said, or a different flu strain could overtake H1N1 in importance, but right now it causes almost all flu cases in the country, except in a few mountain states, where H3N2 is prevalent.
Complicating the problem, antiviral drugs work only if they are taken within the first 48 hours. A patient with severe flu could be given the wrong drug and die of pneumonia before test results come in. So the new guidelines suggest that doctors check with their state health departments to see which strains are most common locally and treat for them.
"We're a fancy hospital, and we can't even do the A versus B test in a timely fashion," Sepkowitz said. "I have no idea what a doctor in an unfancy office without that lab backup can do."
If a Tamiflu-resistant strain is suspected, the disease control agency suggests using a similar drug, Relenza. But Relenza is harder to take — it is a powder that must be inhaled and can cause lung spasms, and it is not recommended for children under 7.
Relenza, made by GlaxoSmithKline, is known generically as zanamivir. Tamiflu, made by Roche, is known generically as oseltamivir.
Alternatively, patients who have trouble inhaling Relenza can take a mixture of Tamiflu and rimantadine, an older generic drug that the agency stopped recommending two years ago because so many flu strains were resistant to it. By chance, the new Tamiflu-resistant H1N1 strain is not.
"The bottom line is that we should have more antiviral drugs," said Dr. Arnold Monto, a flu expert at the University of Michigan's School of Public Health. "And we should be looking into multidrug combinations."
New York City had tested only two flu samples as of Jan. 6, and both were Tamiflu-resistant, said Dr. Annie Fine, an epidemiologist at the city's health department. Flu cases in the city are only "here and there," she said, and there have been no outbreaks in nursing homes. Elderly patients, and those with the AIDS virus or on cancer therapy are most at risk.
But, she added, because of the resistance problem, the city is speeding up its laboratory procedures so it can do both crucial tests in one day.
"And we strongly suggest that people get a flu shot," she said. "There's plenty of time and plenty of vaccine." Exactly how the Tamiflu-resistant strain emerged is a mystery, several experts said.
Resistance appeared several years ago in Japan, which uses more Tamiflu than any other country, and experts feared it would spread.
But the Japanese strains were found only in patients already treated with Tamiflu, and they were "weak" — that is, they did not transmit to other people.
"This looks like a spontaneous development of resistance in the most unlikely places — possibly in Norway, which doesn't use antivirals at all," Monto said.
Dr. Henry Niman, a biochemist in Pittsburgh who runs recombinomics.com, a Web site that tracks the genetics of flu cases around the world, has been warning for months that Tamiflu resistance in H1N1 was spreading.
He argues that it started in China, where Tamiflu use is rare, was seen last year in Norway, France and Russia, then moved to South Africa (where winter is June to September), and back to the northern hemisphere in November.
The mutation conferring resistance to Tamiflu, known in the shorthand of genetics as H274Y on the N gene, was actually, he said "just a passenger, totally unrelated to Tamiflu usage, but hitchhiking on another change."
The other mutation, he said, known as A193T on the H gene, made the virus better at infecting people.
Furthermore, he blamed mismatched flu vaccines for helping the A193T mutation spread. Flu vaccines typically protect against three flu strains, but none have contained protections against the A193T mutation.
Dr. Joseph Bresee, the CDC's chief of flu prevention, said he thought Niman was "probably right" about the resistance having innocently piggy-backed on a mutation on the H gene — which creates the spike on the outside of the virus that lets it break into human cells. But he doubted that last year's flu vaccine was to blame, since the H1 strain in it protected "not perfectly, but relatively well" against H1N1 infection, he said.
Niman said he was worried about two aspects of the new resistance to Tamiflu. Preliminary data out of Norway, he said, suggested that the new strain was more likely to cause pneumonia.
The flu typically kills about 36,000 Americans a year, the CDC estimates, most of them the elderly or the very young, or people with problems like asthma or heart disease; pneumonia is usually the fatal complication.
And while seasonal flu is relatively mild, the Tamiflu resistance could transfer onto the H5N1 bird flu circulating in Asia and Egypt, which has killed millions of birds and about 250 people since 2003. Although H5N1 has not turned into a pandemic strain, as many experts recently feared it would, it still could — and Tamiflu resistance in that case would be a disaster.
http://www.iht.com/articles/2009/01/08/america/09flu.php