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Denmark - Dane with novel H1N1 found resistant to Tamiflu

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  • #46
    Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

    Originally posted by theforeigner View Post
    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.




    http://ekstrabladet.dk/kup/sundhed/article1188161.ece

    Dansker er resistent overfor Tamiflu



    En dansker er som den første i verden blevet resistent overfor medicin mod svineinfluenza H1N1. Dystre perspektiver for risiko-patienter

    16:40 - 29. jun. 2009 | Frederik Bjerre Andersen, Gitte Hejberg


    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.

    Thank you very much theforeigner!
    "May the long time sun
    Shine upon you,
    All love surround you,
    And the pure light within you
    Guide your way on."

    "Where your talents and the needs of the world cross, lies your calling."
    Aristotle

    “In a gentle way, you can shake the world.”
    Mohandas Gandhi

    Be the light that is within.

    Comment


    • #47
      Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

      Roche Sees First Case of Tamiflu-Resistant Swine Flu (Update1)


      Share | Email | Print | A A A



      By Christian Wienberg and Marthe Fourcade
      June 29 (Bloomberg) -- Roche Holding AG said a swine flu patient treated with its Tamiflu drug in Denmark showed resistance to the antiviral medicine for the first time.
      The patient was given a low dose of Tamiflu preventively after coming in contact with someone infected with the H1N1 pandemic virus, said David Reddy, who heads Roche’s influenza task force. The person developed flu symptoms and was found to have a virus mutation that evaded the drug, Reddy said on a conference call today.
      The patient has recovered and doctors have found no other people carrying the resistant strain, Denmark’s National Board of Health said today in a statement on its Web site. Tamiflu studies show that 0.4 percent of adults and 4 percent of children with seasonal influenza develop resistance, according to Reddy.
      “We know from seasonal flu that a proportion of patients can develop resistance,” Reddy said. “We fully expect that this also can occur during treatment with a new flu strain.”
      The new virus, which has killed more than 300 people worldwide, “remains sensitive to the drug,” Reddy said. “What this does underscore is the continued need for resistance monitoring.”
      Gauging Resistance
      The virus hasn’t acquired new characteristics that make it resistant to Tamiflu, according to Reddy. Instead, in this one patient, when faced with a low dose of the medicine it found a way to evade it, he said. That’s known as drug-induced resistance, he said.
      Roche, based in Basel, Switzerland, is studying flu sufferers in several countries to gauge drug resistance.
      Swine flu hasn’t previously shown resistance to Roche’s Tamiflu or GlaxoSmithKline Plc’s Relenza, antiviral medicines that reduce the severity of the disease when administered in the first few days. The World Health Organization reported today that there have been 70,893 cases of the virus globally, including 44 people in Denmark.
      “This one case of a resistant virus doesn’t change our recommendations to use Tamiflu and the treatment remains part of Denmark’s preparedness measures,” the National Board of Health said in the statement.
      To contact the reporter on this story: Christian Wienberg in Copenhagen at cwienberg@bloomberg.net; Marthe Fourcade in Paris at mfourcade@bloomberg.net
      Last Updated: June 29, 2009 11:52 EDT

      http://www.bloomberg.com/apps/news?p...d=an3udfKwF4Do

      Comment


      • #48
        Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

        > The patient has recovered

        so, when was it ? What delay can we expect in similar potential
        future official statements ?
        I'm interested in expert panflu damage estimates
        my current links: [url]http://bit.ly/hFI7H[/url] ILI-charts: [url]http://bit.ly/CcRgT[/url]

        Comment


        • #49
          Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

          Originally posted by gsgs View Post
          > The patient has recovered

          so, when was it ? What delay can we expect in similar potential
          future official statements ?
          I did not see a press release at the Roche website. They held a conference call, and the media reports (with PROBABLY and APPEARS) presumably came from the conference call.

          I suspect Roche would like to talk about this as little as possible, because as soon as they are asked about sequences of thed virus prior to treatment or the virus from the person who infected the patient with resistant H1N1, they will be force to admit there comments are based on NO data (just hopes and dreams about reporters failing to ask to correct question).

          Comment


          • #50
            Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

            And....what are the chances that this is the only person in the world that has not responded to Tamiflu for the treatment of Swine flu? It is the first recorded case - that is all.

            I think people who follow FT knew that oseltamivir treatment might become ineffective. So this is no surprise.

            We urge quick sequence release so that the world's scientists can study this event.
            "May the long time sun
            Shine upon you,
            All love surround you,
            And the pure light within you
            Guide your way on."

            "Where your talents and the needs of the world cross, lies your calling."
            Aristotle

            “In a gentle way, you can shake the world.”
            Mohandas Gandhi

            Be the light that is within.

            Comment


            • #51
              Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

              Originally posted by niman View Post
              doctors have found no other people carrying the resistant strain, Denmark’s National Board of Health said today
              ...

              The virus hasn’t acquired new characteristics that make it resistant to Tamiflu, according to Reddy. Instead, in this one patient, when faced with a low dose of the medicine it found a way to evade it, he said. That’s known as drug-induced resistance, he said.

              ...

              “This one case of a resistant virus doesn’t change our recommendations to use Tamiflu and the treatment remains part of Denmark’s preparedness measures,” the National Board of Health said in the statement.
              Yes...and the victim was probably a twelve year old obese pregnant male, too.

              Comment


              • #52
                Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

                Originally posted by Florida1 View Post
                And....what are the chances that this is the only person in the world that has not responded to Tamiflu for the treatment of Swine flu? It is the first recorded case - that is all.

                I think people who follow FT knew that oseltamivir treatment might become ineffective. So this is no surprise.

                We urge quick sequence release so that the world's scientists can study this event.
                The sequence after teatment won't say much. It is the sequence PRIOR to treatment (from the tested patient or the patient who infected the tested patient) and I suspect NEITHER exists (because they would have been mentioned in the comments).

                Comment


                • #53
                  Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

                  "the lower prevention dose"

                  prevention dose: 1 x daily 75mg (or new ...mg)
                  treatment dose: 2 x daily 75mg (or new ...mg)


                  So if the dosage could be a factor instead of an resistant mutation of the virus - "hopes and dreams" - at least until it became throughout unusable -

                  "Instead, in this one patient, when faced with a low dose of the medicine it found a way to evade it, he said. That’s known as drug-induced resistance, he said."

                  - so (by continuing to dream) to cope with this chimera virus if the above realy are linked to dosage only, Roche need a change in a preventive dosage policy:
                  prevention dose=treatment dose

                  If the dreams proved to be only dreams, the scientifical health shielding will be another "blow".

                  Comment


                  • #54
                    Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

                    Originally posted by tropical View Post
                    "the lower prevention dose"

                    prevention dose: 1 x daily 75mg (or new ...mg)
                    treatment dose: 2 x daily 75mg (or new ...mg)


                    So if the dosage could be a factor instead of an resistant mutation of the virus - "hopes and dreams" - at least until it became throughout unusable -

                    "Instead, in this one patient, when faced with a low dose of the medicine it found a way to evade it, he said. That’s known as drug-induced resistance, he said."

                    - so (by continuing to dream) to cope with this chimera virus if the above realy are linked to dosage only, Roche need a change in a preventive dosage policy:
                    prevention dose=treatment dose

                    If the dreams proved to be only dreams, the scientifical health shielding will be another "blow".
                    Resistance can develop by using a sub-optimal dose, as happened with H5N1 in Vietnam. However, it that case the sister's brother (who infected her) did NOT have the resistance (H274Y or S294N) so there was evidence that the resistance developed in response to treatment (the H5N1 isoaltes from the sister had BOTH).

                    For pandemic H1N1 in Denmark, NO ONE has provided ANY such evidence (because it doesn't exist).

                    Roche (and WHO) are relying on NEGATIVE evidence (no one has reported the resistance previously and most have concentrated on airport screening involving a VERY small number of patients. They need to rapidly screen COMMUNITY SPREAD of the H274Y spreading silently (remember - almost no one with mild H1N1 is being treated in the community).

                    Comment


                    • #55
                      Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

                      (Adds background)
                      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, which is causing the first flu pandemic of the 21st century.
                      "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 ...

                      http://online.wsj.com/article/BT-CO-...29-710385.html

                      Comment


                      • #56
                        Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

                        Originally posted by niman View Post
                        (Adds background)
                        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, which is causing the first flu pandemic of the 21st century.
                        "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 ...

                        http://online.wsj.com/article/BT-CO-...29-710385.html
                        Note that the above teaser from the WSJ includes the REQUIRED "probably".

                        Comment


                        • #57
                          Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

                          #56:
                          "They need to rapidly screen COMMUNITY SPREAD of the H274Y spreading silently (remember - almost no one with mild H1N1 is being treated in the community)."


                          I agree Dr. Niman,
                          but seems that such measures will not be seen, worldwide.

                          The false negative fast tests problem, and the actual policies, seems to suggest an overall failure to: initialy insurgence containment; further screen/test inner containment; and failured treatments when moderate/serious.

                          Did remain something the humans could made successfuly in time,
                          or we will seen only after-battle (pandemic) scientific explanations of the illness, without any modern treatment?

                          The New Era of Middle Age ...

                          Comment


                          • #58
                            Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

                            From ECDC Europe, today's update:

                            Denmark health authorities have reported today one case of oseltamivir-resistant A(H1N1)v influenza virus (29. juni 2009 - Resistens hos pandemisk influenza A H1N1v påvist i Danmark).

                            This is an isolated case, part of a cluster of cases investigated.

                            No additional cases have been identified through extensive contact tracing.

                            http://ecdc.europa.eu/en/files/pdf/H...29_1700hrs.pdf
                            “Addressing chronic disease is an issue of human rights – that must be our call to arms"
                            Richard Horton, Editor-in-Chief The Lancet

                            ~~~~ Twitter:@GertvanderHoek ~~~ GertvanderHoek@gmail.com ~~~

                            Comment


                            • #59
                              Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

                              I just viewed Denmarks two main TV-channels DR and TV2´s primetime newsreports (1/2 houer each) and not one word about the new danish tamiflu resistance case !

                              A cupple of houers ago, I called the The National Board of Health press chief Mette Ebdrup and asked her if she could arrange that in depth information about the danish Tamiflu resitance case could be posted on their webpage in english, and/or if she could arrange that a H1N1 representative from The National Board of Health or Statens Serum Institut could attend Flutrackers so that more precice information could be provided.
                              Her answer was that she was very buissy so she didn´t have time to talk and that all info was provided to WHO and they would provide relevant information.
                              I asked if she knew when WHO would release this info but she said she didn´t know.

                              Weeks ago I provided both The National Board of Health and Statens Serum Institut (+ different newsmedia) links to Flutrackers and encuraged them to read/become members, wheter any of them read or have become members I dont know.

                              Media reports, meaning LACK OF media reports, on H1N1 in Denmark and elsewere, IMO is a HUGE problem her in Denmark.

                              One of many consequense is that lots of people her in Denmark who get flu symptoms will possibly not contact a doctor unless they get seriously ill, therefore we possibly don´t know if feks. the Tamiflu resistance patient infected others.

                              Comment


                              • #60
                                Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

                                Originally posted by Dutchy View Post
                                From ECDC Europe, today's update:

                                Denmark health authorities have reported today one case of oseltamivir-resistant A(H1N1)v influenza virus (29. juni 2009 - Resistens hos pandemisk influenza A H1N1v påvist i Danmark).

                                This is an isolated case, part of a cluster of cases investigated.

                                No additional cases have been identified through extensive contact tracing.

                                http://ecdc.europa.eu/en/files/pdf/H...29_1700hrs.pdf
                                How many in the "cluster" were H1N1 positive?????? (hint: if you guessed "1", you are too high).

                                Comment

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