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Denmark - Dane with novel H1N1 found resistant to Tamiflu
"The infected Dane had been in close contact with another infected person, and was therefore prevented treatment with Tamiflu."
What is the meaning of this, why it is important to wrote "with another infected person" - does it mean that this "infected person" have a new flu form already known to be tamiflu resistant and because of this they start an Relenza-only treatment?
If not, why they start an Relenza-only treatment on an patient previously supposedly non treated with Tamiflu, did they miss the first 2 days (which somewhere stated to be best also for Relenza(?)),
or what?
Any more details?
He was in close contact with another person who had been sick and was put on tamiflu before he had any symptoms as a preventive messure, when he got sick and tested positive for h1n1 despite the tamiflu treatment he was given relenza. (Here in Scandinavia they still put everyone in contact with a positive case on tamiflu)
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu
Roche says 1st case of H1N1 resistance to Tamiflu
29 Jun 2009 14:54:14 GMT
Source: Reuters
ZURICH, June 29 (Reuters) - A patient with H1N1 influenza in Denmark showed resistance to Roche Holding AG's <ROG.VX> antiviral Tamiflu, a company executive said on Monday.
"This is the first case we have of it in H1N1," David Reddy, Roche's pandemic taskforce leader, told reporters on a conference call.
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu
UPDATE 1-Roche finds 1st case of H1N1 resistance to Tamiflu
Mon Jun 29, 2009
.
(Adds details)
ZURICH, June 29 (Reuters) - A patient with H1N1 influenza in Denmark showed resistance to Roche Holding AG's (ROG.VX) Tamiflu, the main antiviral flu drug, a company executive said on Monday.
"While receiving the drug, the patient appeared to develop resistance to it," David Reddy, Roche's pandemic taskforce leader, told reporters on a conference call on the Danish case. "This is the first report we have of it in H1N1."
The World Health Organisation has raised its pandemic flu alert on the H1N1 flu virus to phase 6 on a six-point scale, indicating the first influenza pandemic since 1968 is under way.
Common seasonal flu can resist Tamiflu and Reddy said a case of resistance in H1N1 was not unexpected, adding Roche has been working on strategies to counter such a development.
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu
Roche Executive: Tamiflu Is Still Working In Swine Flu
ZURICH -(Dow Jones)- Roche Holding AG (ROG.VX) Monday said that its drug Tamiflu still works in the currently spreading swine flu virus, and that a patient in Denmark who had developed resistance to the drug had done so during treatment.
"Such a development had to be expected, and is no surprise from a scientific point of view," David Reddy, Roche's Pandemic Taskforce leader told journalists on a conference call.
This is a case of so-called drug-induced resistance, which is rare, but it was known from clinical studies that this can happen, Reddy said. Drug-induced resistance occurs when a patient who is taking the drug develops resistance. It differs from naturally incurring resistance, where a virus strain in itself isn't responding to the drug.
This isn't the case here, meaning that Tamiflu is still working against swine flu, and Roche thus expects the World Health Organisation to continue to back the use of the drug, Reddy said.
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu
UNE 29, 2009, 11:31 A.M. ET
Roche's Tamiflu Still Works In Swine Flu Despite Denmark Case
By Anita Greil
Of DOW JONES NEWSWIRES
ZURICH (Dow Jones)--Roche Holding AG (ROG.VX) said Monday that a patient in Denmark developed resistance to Tamiflu, but that the drug is still effective in the circulating H1N1 swine flu virus.
"Such a development had to be expected, and is no surprise from a scientific point of view," David Reddy, Roche's Pandemic Taskforce leader told journalists on a conference call.
The Danish patient, who has since recovered, was taking the drug as a prevention to avoid the contraction of swine flu, Reddy said. He was probably already infected with the virus, and resistance to the drug emerged because he was given the lower prevention dose.
This is a case of so-called drug-induced resistance, which is rare, but it was known from clinical studies that this can happen, Reddy said. Around 0.4% of adults, and around 4% of children, were shown to develop resistance to Tamiflu in clinical studies, he said.
Drug-induced resistance occurs when a patient who is taking the drug develops resistance. It differs from naturally incurring resistance, where a virus strain in itself isn't responding to the drug. This had been the case with the winter flu virus that was spreading in Europe in 2008, he added.
This isn't the case here, meaning that Tamiflu is still working against swine flu, and Roche thus expects the World Health Organization to continue to back the use of the drug, Reddy said.
At some point, there will certainly be resistance to Tamiflu, said Birgit Kulhoff, pharmaceutical analyst in Zurich with private bank Rahn & Bodmer.
"Sooner or later there will be resistance, and I would expect that to happen when the swine flu virus starts mixing with seasonal flu viruses," she said.
As such, an isolated case in Denmark doesn't yet change the sales prospects of Tamiflu. "It would have been much more worrisome if we saw repeated cases of resistance in the Southern hemisphere, where it's winter now, and the viruses could mix," she said.
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu
My translation of the black highlighted part of the newsreport:
The person was originally not ill at all. The person was in precaution treatment with Tamiflu, because the person had been in close contact with a person who was infected with Swine Flu abroad (OR the person had been abroad and been in close contact with a H1N1 infected person, can´t be sure which it is). After 5 days treatment with Tamiflu, the person suddenly got sick with H1N1, but it didn´t seem like the treatment had any effect. It turned out via tests her in Denmark and in UK, that the person had developed resistance twards Tamiflu, explains Nils Strandberg ( President & CEO of -Statens Serum Institut )
Insted the person was treated with Relenza. - We can be glad that the person today is well and have not infected others said Nils Strandberg.
The Journalist ask Nils Strandberg:
But isen´t it a worrying perspectives that Tamiflu now no longer can be concidered a safe tratment against Swine Flu?
-Yes it is worrying if Tamiflu does not work on the most vulnerable groups. But there are still things that work if a vulnerable patient get infected with H1n1. There is another treatment Relenza.
Statens Serum Institut har fundet den første person i verden, der er resistent overfor medicinen oseltamivir, der sælges under navnet Tamiflu og blandt andet har vist sig virksom mod svineinfluenzaen H1N1.
Det er det første tilfælde af resistens overfor medicinen på verdensplan. Det er forventeligt, at influenzavirus kan mutere spontant. Resistensen har ikke ændret H1N1-virus’ evne til at smitte eller fremkalde sygdom, meddeler instuttet.
- Både bakterier og vira kan mutere og blive resistente. Og det er altså det, der er sket her, bekræfter administrerende direktør på Statens Serums Institut Nils Strandberg.
- Vedkommende var til at begynde med slet ikke syg. Den pågældende var i forebyggende behandling med Tamiflu, fordi vedkommende havde været i tæt kontakt med en svineinfluenza-ramt i udlandet. Da der var gået fem dage med Tamiflu, blev personen så pludselig syg med H1N1, men det så ikke ud til, at medicinen virkede. Det viste sig så via prøver her og i England, at personen var blevet resistens, fortæller Nils Strandberg.
Uheldigt for alvorligt syge
I stedet blev patienten behandlet med medicinen Relenza.
- Vi kan glæde os over, at personen i dag er helt rask og ikke har smittet andre, siger Nils Standberg.
- Men der er vel dystre perspektiver i, at Tamiflu nu ikke længere kan betragtes som et sikkert middel mod svineinfluenza?
- Ja, det er bekymrende, hvis Tamiflu ikke virker på de mest udsatte grupper. Men der er stadig noget at gøre, hvis en svagelig patient bliver smittet med H1N1. Der er jo et andet stof, som man kan bruge.
Skruer ned for forebyggende brug
Ifølge Nils Strandberg vil fundet af den resistente dansker betyde, at lægerne fremover vil blive mere tilbageholdende med at bruge Tamiflu forebyggende - med mindre der altså ligefrem er tale om meget syge og skrøbelige patienter.
- Hvorfor er det netop en dansker, der bliver den første resistente influenza-patient?
- Det beror nok mest på et tilfælde. Vi har et godt system, hvor vi er gode til at overvåge situationen.
Episoden slår fast, at influenza-virus kan mutere, og at Tamiflu på ingen måde kan betragtes som mirakelmedicin. Tamiflu kan i forvejen ikke kurere influenza, men medicinen kan nedsætte symptomerne og forkorte forløbet.
Epidemi til efteråret
Selv om sommeren, udendørslivet og de lukkede skoler er ensbetydende med mindre influenzasmitte i Danmark, vil danskernes rejseaktivitet sommeren over betyde, at der bliver slæbt mere smitte til landet.
- Vi skal formodentlig frem til det sene efterår eller vinter, før vi kan risikere en H1N1-epidemi herhjemme. Men det behøver ikke at give problemer, da det stadig er en ret mild influenzatype, siger Nils Standberg.
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu
Mon, 16:16 29 Jun 2009 GMT
Denmark finds 1st case of H1N1 resistance to Tamiflu
29 Jun 2009 16:10:11 GMT
Source: Reuters
* Patient showed resistance to main antiviral flu drug
* Drug maker says resistance not unexpected
(Rewrites with Danish comment, adds details and background)
By Sam Cage and Teis Jensen
ZURICH/COPENHAGEN, June 29 (Reuters) - Scientists have established the first case of the new H1N1 influenza strain showing resistance to Tamiflu, the main antiviral flu drug, Danish officials and the manufacturer said on Monday.
"While receiving the drug, the patient appeared to develop resistance to it," David Reddy, Roche Holding AG's <ROG.VX> pandemic taskforce leader, told reporters on a conference call on a case observed in Denmark. "This is the first report we have of it in H1N1."
Common seasonal flu can resist Tamiflu and Reddy said a case of resistance in H1N1 -- also know as swine flu -- was not unexpected. Roche had been working on strategies to counter such a development.
The World Health Organization declared an influenza pandemic earlier this month and advised governments to prepare for a long-term battle against an unstoppable new flu virus. The WHO had no immediate comment on the case of Tamiflu resistance.
The United Nations agency raised its pandemic flu alert to phase 6 on a six-point scale, indicating the first influenza pandemic since 1968 is under way. [ID:nLC321991]
"The person is well now and no further contagion with the resistent virus has been detected," Denmark's State Serum Institute said in a statement.
Roche shares closed up 1.4 percent at 149 Swiss francs, outperforming a 0.7 percent firmer DJ Stoxx European drugs index <.SXDP>.
This case does not change the recommendation to use Tamiflu, the institute said.
The U.S. Centers for Disease Control and Prevention has expressed concern the new strain may mix with seasonal flu strains, which are still circulating.
The WHO has said Tamiflu was working against strains of the new H1N1 flu but some analysts have expressed concern it might be less effective than Relenza, GlaxoSmithKline's <GSK.L> inhaled drug, since there have been widespread reports of resistance by seasonal H1N1 flu.
The seasonal strain of H1N1 is a distant cousin of the swine flu and was widely resistant to Tamiflu this year. (Additional reporting by Paul Arnold; Editing by David Holmes)
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu
The two key qualifiers in the comments from Roche are "appeared" and "probably", indicating they have ZERO evidence that the patient was NOT infected with pandemic H1N1 with the "mutation" PRIOR to prophylactic treatment.
After 5 days treatment with Tamiflu, the person suddenly got sick with H1N1, but it didn?t seem like the treatment had any effect. It turned out via tests her in Denmark and in UK, that the person had developed resistance twards Tamiflu, explains Nils Strandberg ( President & CEO of -Statens Serum Institut )
Insted the person was treated with Relenza. - We can be glad that the person today is well and have not infected others said Nils Strandberg.
And how do we know they have not infected others? Were they quarantined?
And what are the odds of this resistance spontaneously arising elsewhere, even if this particular resistant virus was not communicated to others?
"While receiving the drug, the patient appeared to develop resistance to it," David Reddy, Roche's pandemic taskforce leader, told reporters on a conference call on the Danish case. "This is the first report we have of it in H1N1."
The Danish patient, who has since recovered, was taking the drug as a prevention to avoid the contraction of swine flu, Reddy said. He was probably already infected with the virus, and resistance to the drug emerged because he was given the lower prevention dose.
The two key qualifiers in the comments from Roche are "appeared" and "probably", indicating they have ZERO evidence that the patient was NOT infected with pandemic H1N1 with the "mutation" PRIOR to prophylactic treatment.
Yes, Roche is not an independent source.
?Addressing chronic disease is an issue of human rights ? that must be our call to arms"
Richard Horton, Editor-in-Chief The Lancet
And how do we know they have not infected others? Were they quarantined?
And what are the odds of this resistance spontaneously arising elsewhere, even if this particular resistant virus was not communicated to others?
Roche has ZERO evidence that the resistance (probably H274Y) was not present PRIOR to prophylactic treatment. This is ALL hopes and dreams on their part.
For their dreams to come true, they have to show the patient had wild type prior to treatment or the patient who infected the patient had wild type.
Since they have NEITHER, they say what PROBABLY or APPEARED to have happen.
Actually, they are VERY dependent on tamiflu, so if they had EVIDENCE of wild type in the patient or the patient who infected the patient they would have said so.
Instead they said what PROBABLY or APPEARED to happen.
Their press release is VERY weak and the between the lines read is OBVIOUS (no evidence for their hopes and dreams).
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