Announcement

**thebes** · July 9, 2009, 06:18 AM

Re: Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

259 A/H1N1 patients recorded, two suspected Tamiflu-resistant cases
17:39' 09/07/2009 (GMT+7)
VietNamNet Bridge ? Vietnam affirmed 11 new A/H1N1 cases on July 8, raising the total number to 259, with no deaths so far.

Of 11 new cases, there were three in a group of 39 students in HCM City who travelled to Australia and shared a flight with 63 other students. They are hospitalised at the HCM City Hospital for Tropical Diseases. The local authorities asked the school of these students to allow them to stay at home.

A total of 186 patients have left hospitals. The remaining cases are in stable condition.

40 days after the first case was recorded in Vietnam, the national flu control system has not discovered any sign that the flu has spread in the community. Vietnam has successfully controlled the disease at its border gates.

However, the Health Ministry worries that A/H1N1 may break out in Vietnam when students go back to school this August, said Dr. Nguyen Huy Nga, chief of the Preventive Health Agency on July 8.

Dr. Nguyen Van Kinh, director of the National Institute for Infectious and Tropical Diseases, said that only four of 19 A/H1N1 cases in the north were still being treated at the hospital. However, two of them, who returned from Australia, showed some signs of Tamiflu resistance. They were treated by Tamiflu for seven days but test results were positive for H1N1 though clinical symptoms disappeared after three days of treatment.

The institute sent samples to the National Institute for Epidemiology for testing again to seek the reason.

The World Health Organisation (WHO) on July 7 announced 94,512 A/H1N1 cases in 135 countries and territories in the world, including 429 deaths.

In Southeast Asia, the Philippines has recorded 1709 cases, with one death; Singapore 1055; Thailand 2428 and 9 deaths.

http://english.vietnamnet.vn/Health/2009/07/857304/

**St Michael** · July 9, 2009, 09:07 AM

Re: Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

Originally posted by thebes View Post

[B]Dr. Nguyen Van Kinh, director of the National Institute for Infectious and Tropical Diseases, said that only four of 19 A/H1N1 cases in the north were still being treated at the hospital. However, two of them, who returned from Australia, showed some signs of Tamiflu resistance. They were treated by Tamiflu for seven days but test results were positive for H1N1 though clinical symptoms disappeared after three days of treatment.

But we are not hearing about any Tamiflu resistance circulating in Australia or San Francisco (Hong Kong case.)

Something doesn't add up.

**wotan** · July 9, 2009, 09:17 AM

Re: Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

Originally posted by St Michael View Post

But we are not hearing about any Tamiflu resistance circulating in Australia or San Francisco (Hong Kong case.)

Something doesn't add up.

Seems likely that the lack of widespread testing (and even less posting of sequences) is why we don't see it. Also, we don't know if they were taking the prophylactic dose or the treatment dose, though the latter seems likely.

Of course, two people in close proximity to each other randomly developing resistant strains would seem to stretch credulity.

**Commonground** · July 9, 2009, 07:43 PM

Re: Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

Vietnam: 2 Tamiflu Resistant

09/07/2009

Patients with influenza A/H1N1 increase dizziness

According to information from Ministry of Health, 8 / 7, Vietnam has recorded 11 more cases positive for influenza A/H1N1 (South: 7 ca, North: 3 CA, Central: 1 CA)

Đến nay, Việt Nam đ? ghi nhận 259 trường hợp dương t?nh, kh?ng c? tử vong.

Presently, Vietnam has recorded 259 positive cases, no deaths.

Trong số những người mắc c?m, đ? c? 186 ra viện, c?c trường hợp c?n lại hiện đang được c?ch ly, điều trị tại c?c bệnh viện trong t?nh trạng sức khỏe ổn định, kh?ng c? biến chứng nặng.

Among those who have flu, there are 186 hospital out, the remaining cases are being isolation, treatment at hospitals in health status is stable, without serious complication.

Việt Nam kh?ng c? bệnh nh?n tử vong do c?m.

Vietnam no patient deaths due to influenza.

Sau gần 40 ng?y kể từ trường hợp đầu ti?n được ph?t hiện, hệ thống gi?m s?t c?m Quốc gia tại 15 điểm tr?n to?n quốc v? tại c?c cơ sở kh?m chữa bệnh chưa ph?t hiện hiện tượng l?y truyền c?m A/H1N1 trong cộng đồng.

After nearly 40 days since the first case was detected, the system monitor influenza Country at 15 points nationally and in the treatment not detect the spread influenza A/H1N1 in the community.

?ng Nguyễn Văn K?nh, Viện trưởng Viện c?c bệnh truyền nhiễm v? nhiệt đới quốc gia cho biết hiện tại ở viện c? 2 bệnh nh?n từ ?c về, mắc c?m, đ? hết sốt, biểu hiện l?m s?ng ổn định nhưng đến ng?y thứ 7 l?m x?t nghiệm vẫn thấy dương t?nh.

Nguyen Van Kinh, Director of the Institute for infectious diseases and tropical countries that currently have 2 in patients from Australia on influenza infected, were fever, manifests clinically stable but 7 days to do still test positive.

B?nh thường sau 3 ng?y hết sốt, x?t nghiệm cũng ?m t?nh, nhưng hai trường hợp hết thời hạn m? vẫn dương t?nh.

Normal after 3 days the fever, the test is negative, but two cases the time limit but still positive.

Viện Vệ sinh Dịch tễ Trung ương đang c? những x?t nghiệm kiểm tra xem hai bệnh nh?n c? kh?ng thuốc thật kh?ng v? nếu c? th? ở mức độ n?o để c? biện ph?p can thiệp.

Institute of Hygiene epidemiological Central are the tests to check two patients with drug resistance is not and with the degree to respond to.

**Commonground** · July 9, 2009, 07:44 PM

Re: Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

Vietnam: Still have drug treatment for patients resistant to tamiflu

09/07/2009

Health of 2 influenza A/H1N1 patients (in Hanoi) risk tamiflu drug resistance remains stable and is being treated isolation, tracking the stars.

Relenza is also capable of treating influenza A/H1N1
Nguyen Van Kinh, Director of the Institute of infectious diseases and Tropical Country, said: Often patients influenza A/H1N1 hết fever after 1-2 days. After 5 days, when tested, the patients have negative reactions with influenza A/H1N1 virus and then the hospital can be, health is stable.

However, this 2 patients (both from Australia) have cachet. After 7 days treatment, 2 were all symptoms of illness (cough, fever, sore throat), but test results showed that patients still positive for influenza A/H1N1 virus.

"This is a sign not normal. There we still keep patients in hospital and implement isolation and continued treatment as other patients, the lens for.

The entire sample's disease 2 patients are transferred to the Institute of Hygiene epidemiological Central to test and determine whether it is the influenza A/H1N1 patients first Vietnam tamiflu drug resistant or not .

Nguyen Huy Nga, Director Department of Department of Health and Environment (Ministry of Health) requirements of the infectious diseases and Tropical Country - where direct treatment of patients on the 2 - need special attention and keep the stars in place and must immediately notify the Ministry of Health if any unusual signs in time to process.

Pm 9 / 7, Nguyen Hong Ha, Vice Director of the Institute for infectious diseases and Tropical Country confirm: "Currently, the health of 2 patients remain on a stable, continuing treatment for isolation and track the stars. "

Exposed control of influenza A/H1N1 by the Ministry of Health issues currently in the hospital seriously and has developed work. If there is any case of drug resistance tamiflu just change to other drugs have similar effects.

He said Russia: "Currently, in addition tamifu, also a drug Relenza is also more capable of treating influenza A/H1N1. This is the way that almost all countries have implemented if there are cases where influenza A/H1N1 patients tamiflu resistance.

Russian information he added: "World research has not confirmed any person infected with influenza A/H1N1 then can become infected or not."

In the meeting on 12 / 6, Nguyen Tran Hien, Director of Institute of Hygiene epidemiological Central said: "Flu A/H1N1 appear first, so patients do not have immunity, the ability of infected people can be high. "

Confirmed by the Ministry of Health, A/H1N1 flu in Vietnam has not spread to the community. All activities supervised by Vietnam still be done very well. Vietnam rated capacity "cầm trees to. After 40 days to appear, in Vietnam, influenza A/H1N1 has not spread to the community. Meanwhile, the water just after 2 weeks to appear, influenza A/H1N1 has B?ng in the community and can not control.
Tan Son Nhat add a measure body temperature
9 / 7, HCM City Department of Health for the Center on Health international border gate in the airport of Tan Son Nhat has been more a measure body temperature.
Day, the Center on International Health detected 26 of body temperature from the high country have. Of which, 15 have been transferred to the track hospital Pham Ngoc Thach, 11 cases remain supervised at Hospital District 7.

According to doctors of Phan Van, manager for Y, Ho Chi Minh City Department of Health said recently, most of the cases positive for influenza A/H1N1 in from abroad which are in body temperature detected. Up to now, in Vietnam, the total number of influenza infection was detected through the machine that is 158 people.

**Commonground** · July 9, 2009, 07:44 PM

Re: Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

Vietnam: Appear risk patients drug-resistant influenza A/H1N1 tamiflu

Excerpt:

Epidemic situation is complicated place, the patients increased and appeared in 2 cases Hanoi risk tamiflu drug resistance.

Therefore, the Ministry of Health guiding hospitals Network prevent influenza A/H1N1 in the country prepare more isolation areas, patient treatment, preparing adequate materials, chemicals, medicine, design and be medical staff to deal with flu.

Nguyen Van Kinh, Director of the Institute for infectious diseases and Tropical national warning: "Patients with influenza A/H1N1 appeared to ch?m patients. There are 4 families who have been, she was the first and then daughter-in-law and 2 grandchildren with them. Or 2 of the children infected by the flu very close contact. "
Mr. Nga, Bureau Chief Department of Health and Environmental concerns: "The control measures, and treatment of influenza A/H1N1 focus requires many resources (material and human), so the system health is not our many resources to the interested audience vulnerable groups (elderly, children, pregnant women), or experiencing the health problems in society. "

Currently, tests to detect influenza A/H1N1 still too lean 2: At the hospital treatment of sanitation and epidemiology, Institute Pastuer Vietnam. Ministry of Health assessed the ability to "cầm trees before pandemic's Male good because after 40 days, and has not spread in the community.

Ministry of Health and Ministry of Education and Training is focused health care for the candidates to contest first University 2. Stage 1 test the safety. 1 / 8, students study students, easy B?ng risk of disease increased the Ministry of Education and Training need of preventive very urgently.

**Commonground** · July 9, 2009, 07:45 PM

Re: Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

Vietnam: 2 positive cases of influenza A/H1N1 after 7 days treatment Tamiflu

Excerpt:

8 pm / 7, Nguyen Van Kinh, Director of the Institute for infectious diseases and tropical countries that are currently in the 2 patients with influenza A/H1N1 treatment were fever, manifests clinically stable but to 7 tested still positive influenza A/H1N1.
Mr. Glass adds, in the actual treatment of influenza A/H1N1 in the Institute, of the disease are very mild, flu as usual. Most patients only after 2 days of treatment were fever. To date 3, when conducting the test to 90% of the patients were negative for influenza A/H1N1. And 5 days after the fever, test negative patients are in hospital.

"However, with two cases, after treatment of stable, but has the fever to 7 days, when tested with the test but results for influenza A/H1N1 positive. Hospital patients have samples sent products of hygiene and from work to test gen surgery, whether the likelihood of drug resistance genes in the two patients is not, "Mr. Glass said.

In meetings to prevent people on your way now (8 / 8), Tran Nhu Duong, Vice Director of Institute of hygiene and epidemiology from that, it should be noted this case 2, as usual, of the disease were negative after 3 days. Moreover, in some countries has been resistant to drug Tamiflu.

"Before this case 2, we must find out why after 7 days treatment still positive? Will there be no drug resistance? If the resistance at any level? We should also note, in the near future to enhance the monitoring service, ch?m of the infected in the community, if any symptoms of flu samples to test, "he said Duong.

Before the this, the lens continues to give a warning, people should not accidentally use the drug-resistant viruses when flu signs to avoid drug resistance, then, the treatment is very difficult.
-snip-

**Commonground** · July 9, 2009, 07:45 PM

Re: Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

Vietnam: Another Article States "Clinical Manifistations have stopped after 3 days of treatment"

Excerpt:

Also at this meeting, Dr. Nguyen Van Kinh, Director of the Institute for infectious diseases and tropical countries, said: Until now, only 4 / 19 patients positive for influenza A (H1N1) in the northern treatment at the Institute. In 4 patients the treatment, significant note of 2 cases of patients from Australia after 7 days treatment with Tamiflu, but the disease still subject to positive results for H1N1, although the clinical manifestation has expired after 3 days of treatment. With 2 cases, the disease has samples of products to hygiene epidemiology central tests as necessary to find the cause, and the ability to review medication Tamiflu resistance in patients to measure processing time time ...

-snip-

**Commonground** · July 12, 2009, 05:31 AM

Re: Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

Vietnam: 2 of Tamiflu resistance and result in negative

12/7/2009

Test results of surgery of both the gene of resistance to Tamiflu medicine have been born about the central epidemiological affirmed without drug resistance gene. Two of the disease was in hospital.
> Two of drug resistance in H1N1 Tamiflu

Previous 8 / 7, The Library of Infectious Diseases and Tropical national Nguyen Van Kinh 2 notification of disease is over 7 days treatment with Tamiflu, but test results remain positive. Both have the fever, clinically stable after 3 days of treatment start.

Many experts are concerned about the likelihood of Tamiflu resistance gene. Therefore, samples of 2 products disease patients were sent to students about epidemiology central test more. Results showed that gene does not appear in two drug-resistant cases.

Some cases of resistance to Tamiflu medicine in the world, according to Dr. Ly Ngoc Kinh, Director Department of Management Department of treatment, this is normal. Because Tamiflu as well as any other medications, such as types of antibiotics are the rate of resistance. This does not mean loss of Tamiflu treatment effects flu H1N1 that it still effective for the majority patients.

Vietnam although no cases of resistance to any drug but the health sector has more reserve drugs Relenza, a drug has effects on H1N1 influenza treatment Tamiflu instead occur if resistance to drug status.

However, Dr. Glass also recommend people should not abuse the drug resistant virus, and risk of drug resistance on a large scale, the treatment more difficult. Tamiflu is the drug treatment of influenza H1N1 and effective dissemination of the world, as well as in Vietnam. Ralenza is also a drug-resistant viruses appear after drug Tamiflu.

"Moreover, if the habit of accidentally drug abuse, use not only to the right even with the new drugs will also be at risk of drug resistance," Dr. Glass said.

Also in the week, Department of Management of treatment (Ministry of Health) will hold a conference drawing on the experience of HPAI H1N1 to experience withdrawal after more than a month apply minded control of HPAI in Taminflu. The Department will simultaneously opinion of experts of the two cases.

Up to the 10 / 7, the country had 285 cases positive for influenza, no deaths, in which 221 people were in hospital.

**Treyfish** · July 15, 2009, 05:05 PM

Re: Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

To propose the Ministry of Health completed the exposed control influenza A (H1N1)
14-07-2009

Handling environmental prevention
after the hospital patients.
NDDT - By now, after 45 days from the cases the first country has nearly 300 cases influenza A (H1N1), all the way under treatment in health facilities. Although no cases of drug resistance but have a number of cases reduced the sensitivity of Tamiflu, a prolonged time of treatment. Concerned states drug resistance, 14 - 7, Ministry of Health organized the workshop to share experiences in treatment of influenza A (H1N1).

Dr. Nguyen Thi Xuyen, Deputy Minister of Health confirmed: from the World Health announced pandemic, the Ministry of Health establish expert urgently building and issuing Guide diagnosis, the of infection and influenza A (H1N1) / improve plans to prevent pandemic, strengthening supervision and control and health ... The fact of treatment for patients in recent years also shows instructions efficiency , all of which are cured from the disease, without complication and death.

However, it appears some people after 10 to 13 days of treatment with Tamiflu drug is still a flu virus (H1N1) in people. They usually only need three to five days as people were viruses. Institute at the infectious disease and tropical countries, there are two cases of influenza A (H1N1) 10 days after treatment, test results are positive.

PTN England, 38 years old, from Australia to go, starting after a sick day, and spread to the house he is PTM. Even if the hospital and during treatment, he said PTN does not have anything special, but it must be after 12 days, the new waste-virus, while PTM he also spent six days after virus treatment.
Case as the second child TMC, 22 months old, traveling with her mother and grandmother in Australia on. Mother, grandmother infection, declaring in Vietnam were infected, the virus after 4 - 6 days of treatment. While you must take up to 11 days.

Hospital in Tropical Ho Chi Minh City also has two cases. LQT which is 21 years old, weighs 81 kg from Vietnam on, fever 40oC, was located on treatment from 29 - 6 to 14 - 7 and the first 14 days with negative results for influenza. Patients remaining NCB is female, 15 years old, 45 kg, as a student Vietnamese American, and only waste the virus after being used twice the dose of Tamiflu in the days 13, 14.

According to Dr. Tran Tinh Hien, Director of Institute of Tropical Diseases in Ho Chi Minh City, can the delayed response to treatment occurred in this case is due to concentration of drug is absorbed in the body not enough, or the local of each person. By analyzing the results showed that the influenza virus vaccine that patients infected with this are not found with gen R294 and H274Y variables related to resistance or reduced levels of sensitive influenza virus A (H1N1) and Tamiflu. Treatment for people infected with influenza A (H1N1) at the Institute of infectious diseases and tropical countries.

Meanwhile, the PGS, Dr. Nguyen Tran Hien, results analysis the nucleotide sequence of the HA genes of the vaccine virus is showing up: We H1N1 virus in Vietnam now have a similar level with all chủng are circulating in the world from 99 - 100%, in New York, Moscow and Shanghai. Results raising trees and the NA genes to sudden changes related to resistance to drugs Tamilflu not detect sudden changes in positions 274 and 294 relating to the resistance or lower levels of sensitive Tamilflu with influenza A/H1N1 virus new

PGS, Dr. Nguyen Tran Hien also adds, the world has four country reports recorded in Tamiflu drug resistance. However, WHO and countries will evaluate the Tamiflu anti-virus performance.

To cope with the situation slowly respond to medications, experts suggest the Ministry of Health staff exposed to the control of HPAI, the official guide to the legal basis for implementation in the treatment for patients. MA Nguyen Hong Ha, Vice Director of the infectious diseases and tropical countries for that: the treatment of virus diseases slow today, Director of the hospital decision the next treatment and must charge responsible for the safety of patients. There are two directions, or to continue long-time treatment with Tamiflu and zanamivir to use, because this medication does not have the resistance.

The old cầm 45 days is a major cause of flu A (H1N1) has not spread to the community. Of cases are most people from those countries are about or have close contact with patients. The focus of disease in the entry, or in healthy virus can bring light. 50% of patients detected through the border gate, the rest through the work shows the role of the flu, to the hospital itself.

http://www.nhandan.com.vn/tinbai/?top=39&sub=62&article=152325

**wotan** · July 15, 2009, 05:24 PM

Re: Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

It is conceivable, is it not, that we could have a new type of Tamiflu resistance instead of the on that is dominant in seasonal H1N1?

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Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

Vietnam - Two Patients Suspected of Having Tamiflu-Resistant Swine Flu

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