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Third case of Tamiflu-resistant swine flu in Japan
OK, I'm lost in the translation. This is saying 28 people had cases of Tamiflu resistant some type of flu? I'm assuming even though they say avian flu they are not talking H5N1.
I added the translations for detail. I believe they indicate that 40 employees were given prophylatic Tamiflu because someone in the worlkplace was H1N1 positive. One worker developed symptoms on the 5th day of treatment. The sample was sent to NIID where they sequenced the isolate and found resistance (I assune H274Y). The infection was mild and the patient has recovered.
Re: Third case of Tamiflu-resistant swine flu in Japan
This case is virtually IDENTICAL to the Osaka case, down to the FIFTH day. The patient is started on a 10 day course of Tamiflu. However, the patient gets infected because the H1N1 with H274Y is at a relatively high level, but just below detection by the sequencers (unless they look closley). The published sequences are just "consensus" sequences and represent the dominant strain. If the strain with H274Y is 20% or less, it won't won't show up in the sequence (if it is 20-50% the sequence will have mixed signals).
The fact that the patient become symptomatic five days after the start of treatment, means the level of H274Y is relatively high (normally it takes 2-4 days to develop symptoms), because the delay in disease onset date is small.
The H1N1 at day 5 is exclusively virus with H274Y, so the sequnecers are stuck with H274Y and announce the "discovery".
H274Y is WIDESPREAD and below the sequencer's radar becasue they are not looking very hard.
Japan has a high level of H1N1 and frequently uses Tamiflu, so 3 of the 5 isolates from treated patients are in Japan.
This case is virtually IDENTICAL to the Osaka case, down to the FIFTH day. The patient is strtaed on a 10 day course of Tamiflu. However, the patient gets infected because the H1N1 with H274Y is at a relatively high level, but just below detection by the sequencers (unless they look closley). The published sequences are just "consensus" sequences and reporesent the dominant strain. If the strain with H274Y is 20% or less, it won't won't show up in the sequence (if it is 20-50% the sequence will have mixed signals).
The fact that teh patient become symptomatic five days after the start of treatment, means the level of H274Y is relatively high (normally it takes 2-4 days to develop symtoms), because the delay in disease onset date is small.
The H1N1 at day 5 is exclusley virus with H274Y, so the sequnecers are stick with H274Y and announce the "discovery".
H274Y is WIDESPREAD and below the sequencer's radar becasue they are not looking very hard.
Japan has a high level of H1N1 and frequently uses Tamiflu, so 3 of the 5 isolates from treated patients are in Japan.
Eagerly awaiting the commentary on this.
Wotan (pronounced Voton with the ton rhyming with on) - The German Odin, ruler of the Aesir.
I am not a doctor, virologist, biologist, etc. I am a layman with a background in the physical sciences.
Re: Third case of Tamiflu-resistant swine flu in Japan
Tokushima Prefecture was confirmed in patients (30 man) for the avian flu was detected, indicating it H275Y Tamiflu resistance was reported from the National Institute of Infectious Diseases and the separation of the avian flu that mutated gene, the information provides an overview.
However, according to the ministry, with the mutant gene are resistant to Tamiflu, the severity of the virus (pathogenic) is a direct influence is not.
Profile of virus detection>
Contents of a genetic analysis by the National Institute of Infectious Diseases
H275Y oseltamivir resistance marker was detected.
The hybridization of seasonal influenza A/H1N1 virus with the genes that have
Was confirmed.
In the future, the National Institute of Infectious Diseases, drug susceptibility tests are being judged.
2 after the patient
Patients, the incidence of Tamiflu for prevention in the administration, immediately after weighting for the antipyretic treatment, a cure.
Then, to spread around, including a family is not approved.
The travel history of patients.
Comment