Announcement

**HenryN** · August 22, 2009, 05:30 AM

Re: 2 further cases of Tamiflu resistance

Raleigh, NC-- State public health officials are asking health care providers across the state to adhere to guidance pertaining to the use of antivirals for the 2009 H1N1 influenza virus. Caregivers are being reminded that the use of oseltamivir (Tamiflu) and zanamivir (Relenza) as a preventative measure should be limited to people at higher risk for influenza complications and the health care workers who care for them.

The call for strict adherence to CDC (Centers for Disease Control and Prevention) and state medical treatment guidelines comes on the heels of CDC testing two North Carolina viral samples found to have resistance to oseltamivir. Both samples, taken in July, were from people who were receiving oseltamivir as a preventative measure after they had been exposed to others who had the virus. Both had mild illness and have since recovered. The two cases were discovered by the CDC through testing of samples submitted by the N.C. State Laboratory of Public Health.

"When it comes to the use of antivirals, our primary concern is that they be used for those who really need them," State Epidemiologist Megan Davies said. "Healthy people who are exposed to the flu don't need to take antivirals for prevention."

Dr. Davies said that care givers across the state are being reminded that use of antivirals as prevention may be considered for persons at higher risk for complications due to flu or for health care workers with an unprotected exposure to influenza. However, watching carefully for symptoms after an exposure and treating early if symptoms develop could be an appropriate alternative in these settings, and could reduce the potential for developing antiviral resistance.

Antiviral treatment is recommended for all patients with confirmed, probable or suspected cases of 2009 influenza H1N1 virus infection who are hospitalized or who are at higher risk for influenza complications.

"Most infections with the novel H1N1 are uncomplicated and resolve without treatment," Dr. Davies said. "And the best way to prevent the spread of flu is to continue following the precautions you've heard before; wash your hands frequently with soap and water or alcohol-based hand rub, cover your mouth and nose when coughing or sneezing, avoid close contact with those who are sick, and stay at home if you are sick."

More information about use of antivirals is found at: www.epi.state.nc.us/epi/gcdc/H1N1flu.html. For general information about influenza, please visit: www.flu.nc.gov.

404 Not Found | wfmynews2.com

http://www.digtriad.com/news/health/article.aspx?storyid=129182&catid=8

**HenryN** · August 22, 2009, 05:32 AM

Re: 2 further cases of Tamiflu resistance

2 NC campers resistant to Tamiflu

Overuse of antiviral drug increases odds of vaccine rejection

<SCRIPT type=text/javascript>var collab_title = '2 NC campers resistant to Tamiflu';</SCRIPT>
NYT Regional Media Group

Published: Saturday, August 22, 2009 at 3:15 a.m.
Last Modified: Friday, August 21, 2009 at 10:00 p.m.
HENDERSONVILLE, N.C. -- The nation's first cases of H1N1 resistant to Tamiflu came from a Henderson County camp, health officials said Friday.

Two campers from Camp Blue Star in Henderson County are resistant to Tamiflu, an antiviral drug used to treat the swine flu.
One camper resides in Buncombe County, and the other lives in Florida.
The campers became ill with H1N1 in July while receiving Tamiflu for exposure to other ill campers. Both had mild illness and have since recovered.
"Both are fine," said Tom Bridges, health director for the Henderson County Health Department.
The two cases were discovered by the federal Centers for Disease Control through testing of samples submitted by the Henderson County Health Department through the N.C. State Laboratory of Public Health. Camp Blue Star has completed all summer camp sessions and now is closed for the season.
Other camps in Henderson County reported cases of swine flu as well as campers and staff with flu-like symptoms over the summer. In June, three cases of swine flu were confirmed in counselors at Camp Judaea, and five children at Camp Ton-A-Wandah had flu-like symptoms.
Now that there is a resistance to Tamiflu, health officials are alerting caregivers across the state.
State Epidemiologist Megan Davies is reminding them that the use of antivirals as prevention might be considered for people at higher risk of complications or for health care workers with an unprotected exposure to influenza.
However, watching carefully for symptoms after an exposure and treating early if symptoms develop could be an appropriate alternative in these settings. Overuse of an antiviral drug increases the likelihood for developing resistance to that treatment, she said.
"When it comes to the use of antivirals, our primary concern is that they be used for those who really need them," Davies said. "Healthy people who are exposed to the flu don't need to take antivirals for prevention."
Antiviral treatment is recommended for all patients with confirmed, probable or suspected cases of H1N1 virus infection who are hospitalized or who are at higher risk for influenza complications.
"Most infections with swine flu are uncomplicated and resolve without treatment," Davies said. "And the best way to prevent the spread of flu is to continue following the precautions you've heard before: Wash your hands frequently with soap and water or alcohol-based hand rub, cover your mouth and nose when coughing or sneezing, avoid close contact with those who are sick and stay at home if you are sick."
More information about H1N1 prevention can be found at www.buncombecounty.org. Information about antivirals can be found at www.epi.state.nc.us/epi/gcdc/H1N1flu.html.

Page Not Found (404) | Spartanburg Herald Journal

http://www.goupstate.com/article/20090822/ARTICLES/908221019/1083/ARTICLES?Title=2-NC-campers-resistant-to-Tamiflu

**Snicklefritz** · August 22, 2009, 05:43 AM

Re: 2 further cases of Tamiflu resistance

Overuse of antiviral drug increases odds of vaccine rejection

**HenryN** · August 22, 2009, 07:20 AM

Re: 2 further cases of Tamiflu resistance

<a rel="nofollow" href="http://www.recombinomics.com/News/08220901/H274Y_NC.html">Commentary</a>

**Solarpanel** · August 22, 2009, 09:08 AM

Re: 2 further cases of Tamiflu resistance

Dr. Niman

This quote is from another forum, but it is tied to this discussioin:

"The official report confirms the UK government plans to set up mass graves for the victims of the swine flu pandemic.

It is predicted that if no concrete measures are taken for preventing the spread of swine flu, the number of swine flu victims will reach to two billion worldwide in 2011 that will undoubtedly result in deaths of 10 to 20 percent of the patients."

And in my reading in your and others post I remember that there were studies using the H5N1 on different test animal cycling the virus from one infected animal to the next subject aminal. The result use that the virus became more virilant as it use passed on.

Now my 2 questions:
1. As the H1N1 virus continues to spread and as it picks up more resistance will it reach a 10 to 20 percent kill ability?
2. Why is the UK posting this and not the US and other countries?

**HenryN** · August 22, 2009, 09:54 AM

Re: 2 further cases of Tamiflu resistance

Originally posted by Solarpanel View Post

Dr. Niman

This quote is from another forum, but it is tied to this discussioin:

"The official report confirms the UK government plans to set up mass graves for the victims of the swine flu pandemic.

It is predicted that if no concrete measures are taken for preventing the spread of swine flu, the number of swine flu victims will reach to two billion worldwide in 2011 that will undoubtedly result in deaths of 10 to 20 percent of the patients."

And in my reading in your and others post I remember that there were studies using the H5N1 on different test animal cycling the virus from one infected animal to the next subject aminal. The result use that the virus became more virilant as it use passed on.

Now my 2 questions:
1. As the H1N1 virus continues to spread and as it picks up more resistance will it reach a 10 to 20 percent kill ability?
2. Why is the UK posting this and not the US and other countries?

I don't think there is much evidence for numbers that high. The number infected will likelyreach the billions, but 10-20% CFR for that many infections is much less likely.

**HenryN** · August 22, 2009, 09:54 AM

Re: 2 further cases of Tamiflu resistance

<a rel="nofollow" href="http://www.recombinomics.com/News/08220902/H274Y_WA_NC.html">Commentary</a>

**estacion** · August 22, 2009, 09:52 PM

Re: 2 further cases of Tamiflu resistance

Originally posted by Solarpanel View Post

Dr. Niman

This quote is from another forum, but it is tied to this discussioin:

"The official report confirms the UK government plans to set up mass graves for the victims of the swine flu pandemic.

It is predicted that if no concrete measures are taken for preventing the spread of swine flu, the number of swine flu victims will reach to two billion worldwide in 2011 that will undoubtedly result in deaths of 10 to 20 percent of the patients."

And in my reading in your and others post I remember that there were studies using the H5N1 on different test animal cycling the virus from one infected animal to the next subject aminal. The result use that the virus became more virilant as it use passed on.

Now my 2 questions:
1. As the H1N1 virus continues to spread and as it picks up more resistance will it reach a 10 to 20 percent kill ability?
2. Why is the UK posting this and not the US and other countries?

The document speaks about ranges of 0.4 to 2.5 CFR and 25% to 50% CAR, wich aren't few deaths, but of course, not many as if it were 10 to 20 CFR (it would mean extintion or total collapse for a country for a aceptted CAR of 35% in this current pandemic).

The document is here (see pag. 13):
http://www.cabinetoffice.gov.uk/medi..._framework.pdf