Anti-viral resistance in 2009 A/H1N1 flu - historical compilation of news

[Gert van der Hoek]

Re: 1,000 Members!!!

From Weekly Update:

Antiviral Resistance:

Since October 1, 2008, 1,148 seasonal influenza A (H1N1), 261 influenza A (H3N2), 654 influenza B, and 574 2009 influenza A (H1N1) virus isolates have been tested for resistance to the neuraminidase inhibitors (oseltamivir and zanamivir).

In addition, 798 2009 influenza A (H1N1) original clinical samples were tested for a single known mutation in the virus that confers oseltamivir resistance. Also, 1,153 seasonal influenza A (H1N1), 261 influenza A (H3N2), and 526 2009 influenza A (H1N1) viruses have been tested for resistance to the adamantanes (amantadine and rimantadine).

Additional laboratories perform antiviral testing and report their results to CDC. Two additional oseltamivir resistant 2009 influenza A (H1N1) viruses have been identified by these laboratories. The results of antiviral resistance testing performed on these viruses are summarized in the table below.

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Resistant viruses

2009 Influenza A (H1N1) number :1,678 9†‡ (0.6 &#37



†Two screening tools were used to determine oseltamivir resistance: sequence analysis of viral genes or a neuraminidase inhibition assay.
‡Additional laboratories perform antiviral resistance testing and report their results to CDC. Two additional oseltamivir resistant 2009 influenza A (H1N1) viruses have been identified by these laboratories, bringing the total number to 11.

2009 influenza A (H1N1) viruses were tested for oseltamivir resistance by a neuraminidase inhibition assay and/or detection of genetic sequence mutation, depending on the type of specimen tested.

Original clinical samples were examined for a single known mutation in the virus that confers oseltamivir resistance in currently circulating seasonal influenza A (H1N1) viruses, while influenza virus isolates were tested using a neuraminidase inhibition assay that determines the presence or absence of neuraminidase inhibitor resistance, followed by the neuraminidase gene sequence analysis of resistant viruses.

The majority of 2009 influenza A (H1N1) viruses are susceptible to the neuraminidase inhibitor antiviral medication oseltamivir; however, rare sporadic cases of oseltamivir resistant 2009 influenza A (H1N1) viruses have been detected worldwide, including 11 cases in the United States.

All tested viruses retain their sensitivity to the other neuraminidase inhibitor: zanamivir.

Ten patients (including the nine viruses detected at CDC and one identified by an additional laboratory) had documented exposure to oseltamivir through either treatment or chemoprophylaxis, and the remaining patient is currently under investigation to determine exposure to oseltamivir.

Occasional development of oseltamivir resistance during treatment or prophylaxis is not unexpected. Enhanced surveillance is expected to detect additional cases of oseltamivir resistant 2009 influenza A (H1N1) viruses, and such cases will be investigated to assess the spread of resistant strains in the community.

To prevent the spread of antiviral resistant virus strains, CDC reminds clinicians and the public of the need to continue hand and cough hygiene measures for the duration of any symptoms of influenza http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5832a3.htm

Additional information on antiviral recommendations for treatment and chemoprophylaxis of influenza virus infection is available at (http://www.cdc.gov/h1n1flu/recommendations.htm) Antiviral treatment with oseltamivir or zanamivir is recommended for all patients with confirmed or suspected influenza virus infection who are hospitalized or who are at higher risk for influenza complications.

Three seasonal influenza A (H1N1) viruses collected between February 8 and May 11, 2009, were found to be resistant to both oseltamivir and the adamantanes (amantadine and rimantadine). All seasonal influenza A (H1N1) viruses tested retain their sensitivity to zanamivir.

The three dually-resistant viruses represent less than 1% of all seasonal influenza A (H1N1) viruses tested during the 2008-09 influenza season, and as a result, no changes to the influenza antiviral treatment or prophylaxis recommendations will be made at this time. CDC will continue to monitor trends in antiviral resistance over the summer and throughout the upcoming 2009-10 influenza season.

http://www.cdc.gov/flu/weekly/

[Gert van der Hoek]

Re: WHO: Certain H1N1 cases may predict antiviral resistance

WHO: Certain H1N1 cases may predict antiviral resistance

Robert Roos News Editor

Sep 25, 2009 (CIDRAP News) ? While antiviral-resistant H1N1 influenza viruses remain rare, clinicians should watch for two particular kinds of H1N1 cases that seem more likely to give rise to viruses resistant to oseltamivir (Tamiflu), the World Health Organization (WHO) said today.

So far, 28 oseltamivir-resistant viruses have been detected worldwide, the WHO said in today's statement. Twelve of these were linked to use of the drug for postexposure prophylaxis, and 6 were in patients who had severe immunosuppression. Four more cases involved other patients being treated with the drug, and 2 patients were not on the drug.

In view of the findings, the WHO urged clinicians to watch for resistance in:

Patients with severely compromised or suppressed immune systems who have prolonged H1N1 illness and have received oseltamivir (especially if for a long time) but still have evidence of viral replication

People who receive preventive oseltamivir after exposure to another infected person but then get sick anyway

"In both of these clinical situations, health care staff should respond with a high level of suspicion that oseltamivir resistance has developed," the WHO said. "Laboratory investigation should be undertaken to determine whether resistant virus is present, and appropriate infection control measures should be implemented or reinforced to prevent spread of the resistant virus."

The agency also recommended conducting epidemiologic investigations in such situations to find out if a resistant virus has spread to anyone else.

Person-to-person transmission of resistant H1N1 viruses has not yet been clearly shown, the WHO said. Local transmission may have occurred in some situations, but it didn't lead to ongoing or wider transmission.

The agency also said the resistant viruses do not seem to cause different or more severe symptoms. Except for immunocompromised patients, those infected with resistant viruses have had typical flu cases.

The WHO does not generally recommend using oseltamivir to prevent H1N1 illness, today's statement noted. For people who have been exposed and are at risk for a severe case, an alternative is close monitoring and early treatment if symptoms develop.

In August the agency recommended against antiviral treatment for previously healthy people with uncomplicated H1N1 cases. It stressed prompt antiviral treatment for those with severe illness, pregnant women, and people with conditions such as asthma, obesity, or diabetes.

See also:

Sep 25 WHO statement on antivirals and resistance

http://www.who.int/csr/disease/swineflu/notes/h1n1_antiviral_use_20090925/en/index.html

Aug 21 CIDRAP News story "WHO: In treating H1N1, save antivirals for high-risk cases"

http://www.cidrap.umn.edu/cidrap/content/influenza/swineflu/news/sep2509antiviral.html

[Commonground]

Re: Japan. Tamiflu-resistant new influenza detected in patient not given Tamiflu

Japan Tamiflu-resistant H1N1 teen had no Tamiflu record


Thu Oct 8, 2009 8:41am IST
TOKYO (Reuters) - A genetic mutation of H1N1 swine flu that is resistant to the antiviral drug Tamiflu has been detected in a Japanese teenager who had not previously been treated with the drug, a Japanese health official said.

The case could mark Japan's first instance of person-to-person transmission of a Tamiflu-resistant strain of the H1N1 flu but Health Ministry official Takeshi Enami said there was still insufficient evidence to confirm that.

"We cannot deny that this could be person-to-person transmission, but we are not able to reach that conclusion," Enami said. Japan has had eight cases of new H1N1 patients who were resistant to Tamiflu, he added.

The Geneva-based World Health Organisation (WHO) said in late September that drug-resistant pandemic flu viruses had appeared infrequently and there was no evidence that they were spreading, but that further cases were likely.

The mutation was detected by health officials in Sapporo, northern Japan, in a teenage girl who had developed a fever on Aug. 22. She was given GlaxoSmithkline's Relenza and recovered a day later, the ministry said in a statement.

The detected mutation did not worsen the virus, nor were there signs of an unusual rise in new H1N1 cases nearby, it said.

The risk of resistance is higher in patients who suffer from weak immune systems and have already been treated with Tamiflu, manufactured by Roche Holding under license from Gilead Sciences.

It is also high in people who are treated with antivirals as a precaution after exposure to someone with influenza but nevertheless develop the disease.

(Reporting by Linda Sieg and Yoko Nishikawa; Editing by Rodney Joyce and Edwina Gibbs)

http://in.reuters.com/article/worldNews/idINIndia-42994820091008

[sharon sanders]

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Japan. Tamiflu-resistant new influenza detected in patient not given Tamiflu

http://www.flutrackers.com/forum/showthread.php?t=127583

[Giuseppe]

Re: 1,000 Members!!!

Antiviral Res. 2009 Sep 30. [Epub ahead of print]

Detection of Influenza A H1N1 and H3N2 Mutations Conferring Resistance to Oseltamivir using Rolling Circle Amplification.

Steain MC, Dwyer DE, Hurt AC, Kol C, Saksena NK, Cunningham AL, Wang B. - Department of Infectious Diseases and Immunology, University of Sydney, NSW 2006, Australia.

In the event of an influenza pandemic, the use of oseltamivir (OTV) will undoubtedly increase and therefore it is more likely that OTV-resistant influenza strains will also arise. OTV-resistance genotyping using sequence-based testing on viruses isolated in cell culture is time consuming and less likely to detect the low-level presence of drug-resistant virus populations. We have developed a novel Rolling Circle Amplification (RCA) method to achieve the sensitive detection of OTV-resistant viruses from clinical specimens. Using artificially created templates, RCA could detect the presence of OTV-resistant mutations (N2: 119V, 292K, N1: 274Y) even if the population carrying the mutations was <1% of the total. By applying RCA to clinical samples, we identified the emergence of the 274Y mutation in one OTV treated patient, as well as in seven individuals who were treatment-na?ve (confirming community transmission of 274Y-containing resistant influenza A H1N1). These results were further confirmed by neuraminidase region sequencing. In conclusion, RCA technology can provide rapid (<24hours), high-throughput diagnosis of OTV resistance mutations with a high specificity and sensitivity.

PMID: 19800370 [PubMed - as supplied by publisher]

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[Gert van der Hoek]

Re: 1,000 Members!!!

Vietnam detects 3 cases of drug-resistant swine flu

Mon Oct 12, 2009

HONG KONG, Oct 12 (Reuters) - Vietnam has detected three cases of swine flu that were resistant to the antiviral drug Tamiflu, but an expert said there was no evidence the mutant strains had infected other people.

The three were admitted to the Hospital for Tropical Diseases in Ho Chi Minh city in late August and September and have all recovered, said Rogier van Doorn, a clinical microbiologist and doctor at the hospital.

"The viruses that were isolated when they were admitted were still sensitive (to the drug), but during treatment with oseltamivir, resistance built up," said van Doorn, referring to the generic form of Tamiflu.

"So it was not transmission of resistant viruses, but we observed that it developed during treatment of these three patients ... we have no evidence to show that (there was further transmission of resistant viruses)," he told Reuters.

Tamiflu is made by Roche (ROG.VX) and Gilead Sciences Inc (GILD.O) and is one of two drugs shown to work well against H1N1 swine flu.

The three drug-resistant cases were among more than 600 H1N1 patients who were treated at the hospital.

Two of the patients had very mild disease and the third, a 3-year-old child, was admitted to intensive care but made a full recovery within 10 days.

Tamiflu-resistant swine flu cases have been reported in Japan, Hong Kong, Denmark and the United States.

Flu viruses are mutation-prone and experts are not surprised that they would evolve resistance, just as bacteria develop resistance to antibiotics.

However, experts fear such resistance may spread and complicate efforts to treat victims with the approach of what is likely to be a second wave of swine flu infections as the Northern Hemisphere enters the winter season.

http://www.reuters.com/article/rbssHealthcareNews/idUST22356420091012

[Treyfish]

Re: 1,000 Members!!!

Tamiflu-resistant H1N1 in Hamilton
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Young man is first in Ontario with swine flu that doesn't respond to drug
<!-- PUBLISH DATE -->October 16, 2009
<!-- AUTHOR 1 -->Joanna Frketich
<!-- CREDIT 1-->The Hamilton Spectator
<!-- ARTICLE CONTENT-->(Oct 16, 2009)
A young Hamilton man was infected with Ontario's first case of Tamiflu-resistant H1N1.
Only a few dozen people worldwide have been reported to have pandemic influenza resistant to the antiviral treatment. They include a 60-year-old Quebec man and an Alberta woman. Both recovered without being hospitalized.
The Hamilton man is in his 20s. Public health officials don't believe he spread it because no one he had contact with has become sick.
"People should take this seriously, but not panic," said Dr. Chris Mackie, Hamilton's associate medical officer of health.
The emergence of Tamiflu-resistant H1N1 comes at the same time local doctors have reported to the public health department that at least one company tried to pay for its staff to get prescriptions for the antiviral to prevent the flu.
"It sent a letter with all of their employees out to doctors saying we'll pay you $60 to give a 60-day prescription to prophylactics," Mackie said.
"This is exactly the sort of thing that generates resistance."
Tamiflu is only to be used as a treatment for high-risk patients with symptoms and not for prevention.
The H1N1 flu shot is the best way to protect against the pandemic and Mackie says he's hoping to announce today when it will be available and where.
He refused to provide any details about the young man who caught the Tamiflu-resistant strain. He wouldn't even say whether the man is dead or alive.
Normally, public health provides details about whether the person is in hospital or at home and how ill.
"For reasons of confidentiality, I'm afraid we can't say anything more about this individual case and I really apologize about that," said Mackie.
The Ministry of Health is confident it's an isolated case.
"At the moment there is no evidence of widespread resistance to Tamiflu anywhere," said ministry spokesperson David Jensen.
There are other antiviral treatments available when H1N1 is resistant to Tamiflu. However, it can take weeks to determine the strain is resistant. Often, the patient's illness gets worse and that's what prompts doctors to try other antiviral treatments.
So far, it hasn't been a big concern because there have been so few cases.
"This virus has been remarkably stable," said Dr. Michael Gardam, director of infectious disease prevention and control at Ontario's Agency for Health Protection and Promotion. "It hasn't shown any propensity at this point to easily develop resistance and then for those resistant strains to spread."http://www.t
hespec.com/article/654504

[Diane Morin]

Re: 1,000 Members!!!

Cr?dits: Treyfish

Traduction automatique

H1N1 r?sistant au Tamiflu ? Hamilton
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<!-- SUB TITLE 1 -->Un jeune homme est d'abord en Ontario avec la grippe porcine qui ne r?pond pas ? la drogue
<!-- PUBLISH DATE -->
16 octobre 2009
<!-- AUTHOR 1 -->Joanna Frketich
<!-- CREDIT 1-->The Hamilton Spectator
<!-- ARTICLE CONTENT-->(16 oct. 2009)

Un jeune homme de Hamilton a ?t? infect? par le premier cas de l'Ontario de H1N1 r?sistant au Tamiflu.

Seules quelques dizaines de personnes dans le monde ont ?t? rapport?s d'avoir une pand?mie de grippe qui r?sistent au traitement antiviral. Ils comprennent un 60-year-old man Qu?bec et une femme de l'Alberta. Les deux r?cup?r?s sans ?tre hospitalis?.

L'homme de Hamilton est dans son 20s. Responsables de la sant? publique ne crois pas qu'il la propagation parce que personne ne lui avait ?t? en contact avec est devenu malade.

"Les gens doivent prendre cela au s?rieux, mais pas de panique", a d?clar? le Dr Chris Mackie, officier m?dical adjoint de Hamilton de la sant?.
L'?mergence de H1N1 r?sistant au Tamiflu vient dans le m?me temps les m?decins locaux ont rapport? au minist?re de la sant? publique qu'au moins une entreprise a tent? de payer ? son personnel pour obtenir des prescriptions pour l'antiviral pour pr?venir la grippe.

?Il a envoy? une lettre avec l'ensemble de leurs salari?s aux m?decins en disant nous allons vous payer 60 $ pour donner une prescription de 60 jours pour un traitement prophylactique", dit Mackie.

?C'est exactement le genre de chose qui engendre la r?sistance."
Tamiflu ne doit ?tre utilis? comme traitement pour les patients ? haut risque pr?sentant des sympt?mes et non pour la pr?vention.

Le vaccin contre la grippe H1N1 est la meilleure fa?on de prot?ger contre la pand?mie et Mackie dit qu'il esp?re d'annoncer aujourd'hui, quand il sera disponible et o?.

Il a refus? de donner des d?tails sur le jeune homme qui a attrap? la souche r?sistante au Tamiflu. Il ne voulait pas dire, m?me si l'homme est mort ou vivant.

Normalement, la sant? publique donne des pr?cisions quant ? savoir si la personne est ? l'h?pital ou ? la maison et comment malade.

"Pour des raisons de confidentialit?, je crains que nous ne pouvons pas en dire plus sur ce cas particulier et je m'excuse vraiment de cela, dit Mackie.
Le minist?re de la Sant? est convaincu que c'est un cas isol?.

"Pour le moment il n'y a aucune preuve de r?sistance au Tamiflu r?pandue partout?, a d?clar? le porte-parole du minist?re David Jensen.

Il existe d'autres traitements antiviraux disponibles lors de H1N1 r?sistant au Tamiflu. Cependant, il peut prendre des semaines pour d?terminer la souche est r?sistante. Souvent, la maladie du patient s'aggrave et c'est ce qui incite les m?decins ? essayer d'autres traitements antiviraux.
Jusqu'? pr?sent, il n'a pas ?t? une grande pr?occupation car il ya eu si peu de cas.

?Ce virus a ?t? remarquablement stable", a d?clar? le Dr Michael Gardam, directeur de la pr?vention des maladies infectieuses et le contr?le de l'agence de l'Ontario pour la protection de la sant? et de promotion. "Il n'a montr? aucune propension ? ce moment de d?velopper facilement une r?sistance, puis pour ceux des souches r?sistantes de se r?pandre."

jfrketich@thespec.com
905-526-3349

http://www.thespec.com/article/654504

[Commonground]

Re: 1,000 Members!!!

October 17, 2009

Huzita Takashi GENEVA - World Health Organization (WHO) medical officer of the child Shindo奈邦conference in Washington on September 16, a new influenza virus resistance to Tamiflu flu drug revealed that 31 cases were confirmed.

うち半分は感染予防のためにタミフルを服用した人から発見されており、「実際に感染する前はタミフルの服用 を控えるべき」と訴えた。

Half of the people has been found from taking Tamiflu to prevent infection, "before the infection is actually refrain from taking Tamiflu," he said.

31件の耐性ウイルスは世界各地で１万件強の新型インフルエンザウイルスを調査した結果、確認され た。

31-resistant virus in many parts of the world views the survey results of more than a million new influenza virus was confirmed.

進藤医務官は「耐性ウイルスの発生はまだ散発的で連鎖はしていない」と語った。

Shindo medical officer is "the chain in the occurrence of resistant virus has not yet sporadic," he said.

南半球の豪州やニュージーランドでは冬場に「集中治療室（ＩＣＵ）に収容された患者が例年の４〜８倍に上っ た」と述べ、新型インフルエンザは季節性インフルエンザよりも重症患者が多いと分析した。

Australian and New Zealand in the Southern Hemisphere winter, "the intensive care unit (ICU) patients were admitted to the usual 4-8 times climbed," and pandemic influenza are analyzed critically ill patient often than seasonal influenza .

http://translate.googleusercontent.com/translate_c?hl=en&ie=UTF-8&sl=ja&tl=en&u=http://www.cwor.biz/archives/21050/&prev=_t&rurl=translate.google.com&usg=ALkJrhim2nQ5Tnhg4VrgN489UaziY91n6A

[Gert van der Hoek]

Re: Taiwan's first cases of Tamiflu resistant H1N1

Taiwan reports first Tamiflu-resistant flu case


Posted : Tue, 20 Oct 2009

Taipei - Taiwan Tuesday reported its first Tamiflu-resistant H1N1 flu case, but the patient recovered after continuous treatment, a senior official said.

The patient, a 20-year-old man based in southern Taiwan, was found to have contracted the pandemic influenza, also called swine flu, on September 1 and was given Tamiflu for treatment, Deputy Health Minister Chang Shan-chwen said.

The antiviral drug was found helpful to the man on the few days he was given the drug, but on September 4, viral samples showed the man had Tamiflu resistance, Chang said.

He said that because of continuous treatment and the man's own immune system, the patient recovered from the pandemic flu on September 20 and left the hospital where he had been treated and isolated.

Chang said his ministry reported the case to the World Health Organisation Tuesday, making the island the 11th area reporting a Tamiflu-resistant case, making it the first for Taiwan and the 36th for the 11 countries reporting such cases.

http://www.earthtimes.org/articles/show/290990,taiwan-reports-first-tamiflu-resistant-flu-case.html

[Giuseppe]

Re: 1,000 Members!!!

Oseltamivir-Resistant Influenza A Pandemic (H1N1) 2009 Virus, Hong Kong, China (Emerg Infect Dis., abstract, edited)

[Source Full PDF Document: LINK. EDITED.]

DOI: 10.3201/eid1512.091057
Suggested citation for this article: Chen H, Cheung CL, Tai H, Zhao P, Chan JFW, Cheng VCC, et al. Oseltamivir-resistant influenza A pandemic (H1N1) 2009 virus, Hong Kong, China. Emerg Infect Dis. 2009 Dec; [Epub ahead of print]

Oseltamivir-Resistant Influenza A Pandemic (H1N1) 2009 Virus, Hong Kong, China

Honglin Chen, Chung Lam Cheung, **** Tai, Pengxi Zhao, Jasper F.W. Chan, Vincent C.C. Cheng, Kwok-**** Chan, and Kwok-Yung Yuen

Author affiliation: The University of Hong Kong, Hong Kong Special Administrative Region, People?s Republic of China


Resistance to oseltamivir was observed in influenza A pandemic (H1N1) 2009 virus isolated from an untreated person in Hong Kong, China. Investigations showed a resistant virus with the neuraminidase (NA) 274Y genotype in quasi-species from a nasopharyngeal aspirate. Monitoring for the naturally occurring NA 274Y mutation in this virus is necessary.

(...)
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[Gert van der Hoek]

Re: 1,000 Members!!!

October 22, 2009

Surveillance

Tamiflu-resistant swine flu strain detected

The Department of Health has detected a strain of human swine flu virus resistant to Tamiflu. It is the fourth time Tamiflu resistance to the virus has been found in Hong Kong and is the third local case.

However, the strain is sensitive to Relenza.

The virus was taken from a 16-year-old girl who came down with flu-like symptoms September 14 and attended a designated flu clinic September 16. She had no history of taking Tamiflu before the specimen was taken. She has recovered.

The case will be reported to the World Health Organisation. So far more than 5,000 swine flu samples have been tested for anti-viral sensitivity in Hong Kong.

http://www.news.gov.hk/en/category/healthandcommunity/091022/txt/091022en05008.htm?

[Snowy Owl]

Re: CIDRAP Daily News October 2009

<table style="table-layout: auto;" summary="Latest News Items" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td colspan="2" class="blackBold" align="center">Oct 22</td> </tr> <tr><!-- LATEST NEWS ARROW --> <td width="10" valign="top"></td> <!-- LATEST NEWS LINK --> <td align="left" valign="top">CDC notes change in ethnic pattern of H1N1 impact</td> <td>
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</td> </tr> <tr> <td colspan="2" align="left" valign="top">H1N1 Flu Breaking News</td> <td>
</td> </tr> <tr> <td width="20" valign="top">
</td> <td align="left" valign="top"> <table> <tbody><tr> <td align="left" valign="top"> </td> <td>Poll shows growing flu concern, uncertainty about vaccine </td> </tr> </tbody></table> Americans are more concerned about pandemic H1N1 flu than they were a couple of months ago, with about 52% saying they are greatly or somewhat worried, according to the latest Washington Post-ABC poll. The number is up 13 percentage points from August. However, only about a third say they'll get the vaccine, though half said they'll have their kids vaccinated. Those saying they'll pass on the vaccine listed side-effect worries and perceived lack of testing as influencing their decision. [Oct 15-18 Washington Post-ABC News Poll]

</td> <td>
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</td> <td align="left" valign="top"> <table> <tbody><tr> <td align="left" valign="top"> </td> <td>Doctors report rhabdomyolysis in pandemic flu patient </td> </tr> </tbody></table> Australian physicians have documented a rare complication in a patient with pandemic H1N1 flu, myositis, and rhabdomyolysis. They reported their findings in an early online edition of the Pediatric Infectious Disease Journal. According to a news report today about the study, the 16-year-old boy experienced intense muscle pain and nearly black urine 3 days after his flu symptoms began in June when the first wave of the pandemic hit Australia. He recovered after 8 days in the hospital. [Oct 16 PIDJabstract]

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</td> <td align="left" valign="top"> <table> <tbody><tr> <td align="left" valign="top"> </td> <td>Canada's pandemic vaccine campaign will have an unadjuvanted option </td> </tr> </tbody></table> Canada has purchased 1.8 million doses of unadjuvanted pandemic H1N1 vaccine to use in the youngest children as well as pregnant women and others who might want an alternative to the adjuvanted version, the Canadian Press reported yesterday. Canada's adjuvanted vaccine was approved Oct 16. Officials predict the unadjuvanted vaccine will be cleared in early November, but they don't want people to wait for it even though experts say it may produce a more robust response in children under age 3. [Oct 21 Canadian Press story]

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</td> <td align="left" valign="top"> <table> <tbody><tr> <td align="left" valign="top"> </td> <td>Tamiflu treatment spawned resistance in Taiwan H1N1 case </td> </tr> </tbody></table> Taiwan reported this week that the H1N1 virus became resistant to oseltamivir (Tamiflu) after a patient was treated with the drug. Oseltamivir-sensitive H1N1 was isolated from a 20-year-old man before treatment, the Taiwan Centers for Disease Control said. Three days later, after treatment began, an isolate from the man showed the resistance mutation. The man recovered, and there was no evidence that the virus spread. His case marked Taiwan's first report of H1N1 resistance to the agent. [Oct 20 Taiwan CDC report]

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</td> <td align="left" valign="top"> <table> <tbody><tr> <td align="left" valign="top"> </td> <td>Flu control measures seem to reduce other diseases in Bolivia </td> </tr> </tbody></table> Health officials in Bolivia say a massive campaign to promote handwashing to prevent H1N1 flu seems to have reduced the spread of other common diseases, according to a Time magazine report. Dr. Rene Lenis, Bolivia's director of epidemiology, reported a 10% to 15% drop in incidence of acute diarrheal diseases in all age-groups this year compared with last year. Public health agencies began promoting handwashing when the virus emerged in April. [Oct 22 Timereport]

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[Gert van der Hoek]

Re: 1,000 Members!!!

Two cases in the same Japanese city: Nagoya.


Check out two new flu virus resistance from the respondents, their 8-year-old girl - Nagoya

October 23 - The city , living in one city and eight-year-old girls and women nurses (21) has announced that it had found a new influenza virus that are resistant to anti-influenza drug Tamiflu.

Two already recovered.

Not contact each other, having no resistance to Tamiflu in patients with peripheral. Not of the virulent virus. The resistant virus was found in this country was 11 cases.

According to the city, Aug. 16 girl heat out of the Sun, even though the hospital was prescribed Tamiflu, vomiting (vomiting) symptoms and more hospitalizations.

Then recovered, 24 were discharged on the same day.

The nurse said 19 days, women who died at a hospital where he worked (81) was sick with the flu for a new, but taking Tamiflu prevent, the fever in 23 days. Recovering at home taking Relenza. (2009/10/23)

http://www.jiji.com/jc/c?g=soc_30&k=2009102300932

thanks to Makoto, who has a mild flu

[Commonground]

Re: Hong Kong Influenza A H1N1 influenza virus was found on the Tamiflu-resistant cases of

Influenza A virus discovered in Hong Kong on the Tamiflu-resistant cases

http://www.sina.com.cn 2009年10月22日21:20 中国新闻网

http://www.sina.com.cn 2009 Nian 10 Yue 22 Ri 21:20 China News Net
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中新社香港十月二十二日电香港卫生署公共卫生化验服务处二十二日发现一株甲型H1N1流感病毒对奥司他韦( 即特敏福)出现抗药性。

China news agency, Hong Kong, October 22 - Hong Kong Department of Health, Public Health Laboratory Services Branch on the 22nd found an Influenza A H1N1 influenza virus, oseltamivir (ie, Tamiflu) resistance appears.

卫生署发言人说，公共卫生化验服务处就甲型流感病毒对特敏福及扎那米伟的抗药性测试时发现该病 毒株。

Department of Health spokesman said the Public Health Laboratory Services Branch on Tamiflu and the influenza A virus resistance to zanamivir testing found the disease strain.

他说，这是香港第四次发现甲型流感病毒对特敏福出现抗药性，也是第三宗本地个案。

He said that this was the fourth time in Hong Kong found that influenza A virus appears resistant to Tamiflu, is the third local cases.

而测试结果显示，该株病毒对扎那米伟(即乐感清)没有出现抗药性。

The test results showed that the strains of virus zanamivir (Relenza that is) does not appear resistant.

　该株病毒是从一名十六岁女子取得的样本分离出来，她于九月十四日出现类似流感征状，并于九月十六日到指定 流感诊所求诊。

The strain of virus is obtained from a sample of 16-year-old woman, separated, and she appeared on September 14 with flu-like symptoms, and in September 16 to the designated flu clinics.

化验显示其呼吸道样本对人类猪型流感病毒呈阳性反应。

Tests show the human respiratory tract samples of swine influenza virus positive.

今日的进一步测试结果显示，该株病毒对特敏福含抗药性。

Further test results today showed that the strains of virus with resistance to Tamiflu.

该名女子在提供样本前并没有服用特敏福。

The woman in the provision of the sample did not take Tamiflu before.

上述女子已经康复。

The woman has recovered.

调查结果显示，她的五名家人均没有出现类似流感征状，而她所就读的学校近期亦没有出现流感病类 爆发。

Survey results showed that five of her masters per capita does not appear flu-like symptoms, and she attended schools in the near future there is no outbreak of influenza illness.

发言人表示，香港会向世界卫生组织报告这宗个案。

The spokesman said that Hong Kong will report this case to the World Health Organization.

发言人重申，香港对监察流感药物抗药性有一个紧密的监察系统。

The spokesman reiterated that Hong Kong's surveillance of influenza drug resistance, there is a close surveillance system.

港府会与世界卫生组织和海外卫生当局保持紧密联系，密切监察甲型流感病毒出现抗药性的全球发展 。

The Government will work with WHO and overseas health authorities to maintain a close monitoring of influenza A viruses resistant to global development.

(完)

(End)

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