Announcement

**HenryN** · January 22, 2009, 07:05 PM

Re: Flu shots urged for elderly, young as Tamiflu-resistant cases rise (Hong Kong)

H274Y at 90% in Hong Kong

http://www.chp.gov.hk/files/pdf/Antiviral%20report-12.08.pdf

**HenryN** · January 22, 2009, 07:33 PM

Re: Flu shots urged for elderly, young as Tamiflu-resistant cases rise (Hong Kong)

Originally posted by niman View Post

<TABLE cellSpacing=5 cellPadding=0 width="100%" border=0><TBODY><TR><TD vAlign=bottom align=left>Flu shots urged for elderly, young as Tamiflu-resistant cases rise

</TD></TR><TR><TD vAlign=bottom align=left>

</TD></TR><TR><TD bgColor=#999999 height=1></TD></TR><TR vAlign=top><TD>Mary Ann Benitez
Jan 23, 2009
</TD></TR><TR><TD>Hongkongers whose health is more vulnerable, such as the elderly, are urged to get their flu shots in the next week or so, after latest figures show Tamiflu-resistant flu is dominating the reported cases....</TD></TR></TBODY></TABLE>

http://www.scmp.com/portal/site/SCMP...ng+kong&s=news

Report notes that 90% of H1N1 is resistant and 70% of flu in Hong Kong is H1N1.

Includes a quote on resistance and mutations (hand waving - no data cited because such data doesn't exist).

**HenryN** · January 23, 2009, 02:39 AM

Re: Flu shots urged for elderly, young as Tamiflu-resistant cases rise (Hong Kong)

Hong Kong "Flu Express" weekly reports

Centre for Health Protection 衞生防護中心

http://www.chp.gov.hk/guideline1_year.asp?lang=en&id=304&pid=134&ppid=29

**HenryN** · January 23, 2009, 02:41 AM

Re: Flu shots urged for elderly, young as Tamiflu-resistant cases rise (Hong Kong)

Week 2 report (H1N1 dominates)

Centre for Health Protection 衞生防護中心

http://www.chp.gov.hk/files/pdf/FLU%20EXPRESS%20(Wk%202%20%202009).pdf

**HenryN** · January 23, 2009, 03:13 AM

Re: Flu shots urged for elderly, young as Tamiflu-resistant cases rise (Hong Kong)

Commentary at

H1N1 Tamiflu Resistance in Hong Kong Approaches 100%

http://www.recombinomics.com/News/01230901/H274Y_Hong_Kong.html

Recombinomics Commentary

**AlaskaDenise** · January 23, 2009, 03:17 AM

Re: Flu shots urged for elderly, young as Tamiflu-resistant cases rise (Hong Kong)

Originally posted by niman View Post

Commentary at

http://www.recombinomics.com/News/01...Hong_Kong.html

Commentary

High Levels of H1N1 Tamiflu Resistance in Korea Continue
Recombinomics Commentary 21:57
January 21, 2009

1,854 influenza viruses were isolated until the 2nd week in 2008-2009 season.

1,772 viruses were identified as A/H1N1 type and 82 viruses were identified as A/H3N2 type.

The above comments from the week 2 report from Korean CDC reflect high levels of H1N1 oseltamivir resistance and an associated high ILI rate, 11.96%. Although this level was lower than the 17.63% in the prior week, it was still above the high for last season, which was below 10%, and extends the double digit rate to three straight weeks. Moreover, the number of new H1N1 isolates, 497, was similar to the 508 isolates a week earlier and signaled a continuing explosion of oseltamivir resistance in South Korea.

The Japan NIH recently released a phylogenetc tree that included 33 recent isolates from Japan, which were similar to the isolates in the United States this season, all of which had A193T in the receptor binding domain, suggesting this acquisition was the key driver in the emergence of H1N1 with H274Y. Japan has reported a number of school closings which have been linked to H1N1.

More information on impact of this explosion of cases in South Korea would be useful.

.

**HenryN** · January 23, 2009, 03:51 AM

Re: Flu shots urged for elderly, young as Tamiflu-resistant cases rise (Hong Kong)

Originally posted by AlaskaDenise View Post

Commentary

High Levels of H1N1 Tamiflu Resistance in Korea Continue
Recombinomics Commentary 21:57
January 21, 2009

1,854 influenza viruses were isolated until the 2nd week in 2008-2009 season.

1,772 viruses were identified as A/H1N1 type and 82 viruses were identified as A/H3N2 type.

The above comments from the week 2 report from Korean CDC reflect high levels of H1N1 oseltamivir resistance and an associated high ILI rate, 11.96%. Although this level was lower than the 17.63% in the prior week, it was still above the high for last season, which was below 10%, and extends the double digit rate to three straight weeks. Moreover, the number of new H1N1 isolates, 497, was similar to the 508 isolates a week earlier and signaled a continuing explosion of oseltamivir resistance in South Korea.

The Japan NIH recently released a phylogenetc tree that included 33 recent isolates from Japan, which were similar to the isolates in the United States this season, all of which had A193T in the receptor binding domain, suggesting this acquisition was the key driver in the emergence of H1N1 with H274Y. Japan has reported a number of school closings which have been linked to H1N1.

More information on impact of this explosion of cases in South Korea would be useful.

.

The above commentary is on Korea (not Hong Kong).

**HenryN** · January 23, 2009, 07:25 AM

Re: Flu shots urged for elderly, young as Tamiflu-resistant cases rise (Hong Kong)

Originally posted by niman View Post

<TABLE cellSpacing=5 cellPadding=0 width="100%" border=0><TBODY><TR><TD vAlign=bottom align=left>Flu shots urged for elderly, young as Tamiflu-resistant cases rise

</TD></TR><TR><TD vAlign=bottom align=left>

</TD></TR><TR><TD bgColor=#999999 height=1></TD></TR><TR vAlign=top><TD>Mary Ann Benitez
Jan 23, 2009
</TD></TR><TR><TD>Hongkongers whose health is more vulnerable, such as the elderly, are urged to get their flu shots in the next week or so, after latest figures show Tamiflu-resistant flu is dominating the reported cases....</TD></TR></TBODY></TABLE>

http://www.scmp.com/portal/site/SCMP...ng+kong&s=news

<TABLE class=MsoNormalTable style="WIDTH: 100%" cellSpacing=5 cellPadding=0 width="100%" border=0><TBODY><TR><TD style="PADDING-RIGHT: 0in; PADDING-LEFT: 0in; PADDING-BOTTOM: 0in; PADDING-TOP: 0in" vAlign=bottom>Flu shots urged for elderly, young as Tamiflu-resistant cases rise
</TD></TR><TR><TD style="PADDING-RIGHT: 0in; PADDING-LEFT: 0in; PADDING-BOTTOM: 0in; PADDING-TOP: 0in" vAlign=bottom>
</TD></TR><TR><TD style="PADDING-RIGHT: 0in; PADDING-LEFT: 0in; PADDING-BOTTOM: 0in; PADDING-TOP: 0in">Mary Ann Benitez
Updated on Jan 23, 2009
</TD></TR><TR><TD style="PADDING-RIGHT: 0in; PADDING-LEFT: 0in; PADDING-BOTTOM: 0in; PADDING-TOP: 0in">Hongkongers whose health is more vulnerable, such as the elderly, are urged to get their flu shots in the next week or so, after latest figures show Tamiflu-resistant flu is dominating the reported cases.
Of 66 samples of influenza A tested, nearly 70 per cent were H1N1 Brisbane flu, a sub-strain of the virus that caused the 1918 Spanish flu pandemic, the most deadly in the past century.
Thomas Tsang Ho-fai, the controller for the Centre for Health Protection, said last weekend that laboratory tests showed that 90 per cent of flu-like illnesses were caused by the H1N1 virus, which had been shown to be resistant to the antiviral Tamiflu in the US.
Thomas Chung Wai-****, who heads the centre's emergency response and information branch, said it also found that more than 90 per cent of the H1N1 Brisbane flu samples tested were Tamiflu-resistant.
"We are more or less comparable to the other places, that is, we have a relatively high proportion of Tamiflu-resistant H1N1 flu," said Dr Chung.
"We are concerned too, having noted that this virus can mutate from time to time. That is why we monitor very closely the situation in Hong Kong as well as globally.
"We are aware that the resistant strain is circulating elsewhere."
Its prevalence meant doctors could not use Tamiflu to treat a person infected with the H1N1 flu strain, Dr Chung said.
But he also noted that most flu cases needed only rest and symptomatic medication for treatment.
Just 10 per cent of the 66 samples tested were of the H3N2 Brisbane strain, the same strain that caused the last flu pandemic, called Hong Kong flu, in 1968. Last year, H3N2 caused outbreaks in schools in Hong Kong and, this winter, it is slowly moving towards continental Europe after affecting Britain.
The resistant strain has been found to respond to the inhalant drug Relenza, though Hong Kong is stockpiling more Tamiflu.
Antivirals are effective when given within a few days of the symptoms.
Dr Chung said no study had conclusively established why the H1N1 strain was resistant to Tamiflu.
"One of the characteristics of this virus [H1N1 Brisbane] is it mutates a little bit from time to time," he said.
The good news was that a vaccine could still protect the vulnerable from Tamiflu-resistant H1N1, he said.
The flu season was expected to peak in three weeks, he said.
The immune response does not kick in until two weeks after vaccination, and for young children receiving the flu shot for the first time, it will take four weeks for them to have full immunity because they need two shots two weeks apart.
</TD></TR></TBODY></TABLE>

**HenryN** · January 23, 2009, 07:52 AM

Re: Flu shots urged for elderly, young as Tamiflu-resistant cases rise (Hong Kong)

Influenza detection was 69 in week 3 (Jan 11 to 17). Laboratory surveillance detected 45 influenza A (H1N1) viruses, 17 influenza A (H3N2) viruses and 3 influenza B viruses (Figure 6).

Centre for Health Protection 衞生防護中心

http://www.chp.gov.hk/files/pdf/INFLUENZA_DAILY_SITUATION_UPDATE.pdf

**tropical** · January 23, 2009, 08:59 AM

Re: Flu shots urged for elderly, young as Tamiflu-resistant cases rise (Hong Kong)

#9:
"... H1N1 Brisbane flu, a sub-strain of the virus that caused the 1918 Spanish flu pandemic ..."

Looking to the above text words formulation I had the usual impression of an news reporting way of writing scientific briefing statements, but ...
maybe I was wrong, maybe somebody realy "did it",
what is the exact meaning of the above words:

H1N1 Brisbane is an actual "inoque" (but Tamiflu resistant) sub-strain of its distant ancestor, the Spanish flu H1N1 virus
or
that is an actual H1N1 sub-strain now changed and became more deadly as it's ancestor the Spanish flu virus?

Thank you.

**HenryN** · January 23, 2009, 09:02 AM

Re: Flu shots urged for elderly, young as Tamiflu-resistant cases rise (Hong Kong)

Originally posted by tropical View Post

#9:
"... H1N1 Brisbane flu, a sub-strain of the virus that caused the 1918 Spanish flu pandemic ..."

Looking to the above text words formulation I had the usual impression of an news reporting way of writing scientific briefing statements, but ...
maybe I was wrong, maybe somebody realy "did it",
what is the exact meaning of the above words:

H1N1 Brisbane is an actual "inoque" (but Tamiflu resistant) sub-strain of its distant ancestor, the Spanish flu H1N1 virus
or
that is an actual H1N1 sub-strain now changed and became more deadly as it's ancestor the Spanish flu virus?

Thank you.

The 1918 serotype was H1N1. H1N1 has been circulating in human populations ever since (and probably before).

**tropical** · January 23, 2009, 09:19 AM

Re: Flu shots urged for elderly, young as Tamiflu-resistant cases rise (Hong Kong)

So we are fortunately still on the first option answer yet.

Thank you Dr. Niman.