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Netherlands: Tamiflu resistant flu strain kills two

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  • #16
    Re: Netherlands: Tamiflu resistant flu strain kills two

    you speculate that Tamiflu treatment _caused_ the deaths ?
    I'm interested in expert panflu damage estimates
    my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

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    • #17
      Re: Netherlands: Tamiflu resistant flu strain kills two

      Here's a brief background which may keep this thread on track. In the past H274Y was thought to impose a fitness penalty. Thus, H274Y could develop in Tamiflu treated patients because wild type (normal) H1N1 would be inhibited by the anti-viral drug, while the H274Y strain would not. However, the fitness penalty would prevent H274Y from spreading into untreated hosts (because wild type would dominate or the host immune system would quickly clear the crippled H1N1 with H274Y).

      However, the spread of H274Y in Europe and worldwide clearly shows that the circulating virus with H274Y doesn't have much of a fitness penalty, and can successfully compete with wild type (which is also true of H274Y in H5N1 in wild birds), so these patients are being infected with H1N1 that already has H274Y. Thus, there is no DEVELOPMENT in these patients (and no requirement for Tamiflu treatment for development).

      As a result, treating immuno-compromised patients with Tamiflu will not be effective, since the Tamiflu doesn't inhibit H1N1 with H274Y. These patients could be treated with Relenza or possibly one of the amantadines, but not Tamiflu.

      The data for the two fatal cases would appear to involve unsuccessful treatment of these two patients with Tamiflu. The failure was not due to an excessive virulence in the H1N1 or the DEVELOPMENT of resistance, but the resistance did influence the outcome because H274Y was in the H1N1 BEFORE these patients were infected.

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      • #18
        Re: Netherlands: Tamiflu resistant flu strain kills two

        Originally posted by gsgs View Post
        you speculate that Tamiflu treatment _caused_ the deaths ?
        Please.

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        • #19
          Re: Netherlands: Tamiflu resistant flu strain kills two

          even Osterhaus can not exclude that the young patients were
          hit by a flu virus that is immune to Tamiflu.

          And I give it ~70% at this moment.
          But can we exclude the opposite ?
          I'm interested in expert panflu damage estimates
          my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgT

          Comment


          • #20
            Re: Netherlands: Tamiflu resistant flu strain kills two

            Resistant influenza virus evaluates two patients
            From our correspondent Marjolein den Dekker
            published on May 23, 2008 15:50, updated at 15:50

            She had the flu virus known as H1N1 among members.

            This virus appeared spontaneously insensitive to withstand the prevailing virusremmer oseltamivir, better known under the brand name Tamiflu.

            The Rotterdam virologists Charles Boucher spent this last week (Friday, May 16) at the scientific symposium 100 years of Pharmacology outwards.

            Boucher also warned that the flu virus HIV alongside one of the main dangers for the world population. In so doing he was referring to the H5N1 avian flu virus, which feared that it makes the transition from the bird to humans.

            According collegaviroloog Ab Osterhaus is the H1N1-flu virus, last winter the dominant virus, a relatively harmless variety.

            "Studies of early this year shows that on average 25 percent of Europeans infected with the virus that is insensitive to antivirals such as Tamiflu," says Osterhaus, 'in the Netherlands is only 6 percent. "He stressed that this resistance only dangerous for certain risk groups such as transplant patients and the elderly in nursing homes.

            The two deceased patients were relatively young according Osterhaus because transplants under a immuunbehandeling. 'In this way rejection of the transplant, but it means also an inhibition of the immune system. It is not uncommon for such patients receive a respiratory infection but which would still have little to do. "

            Osterhaus know that it is the first time that a resitentie against a antiviraalmiddel has occurred spontaneously.

            "Therefore we must be extra vigilant on that risk. If an antiviral treatment appears to have paid off is a multiple or triplebehandeling advised by other virusremmers as zanamivir (Relenza) and amantadine or rimantadine administration.

            The Dutch government has a large stock tamiflu as the first remedy for a pandemic. Ostenhaus sees no reason for concern that the virusremmer would not work.
            -
            http://www.volkskrant.nl/binnenland/...twee_patienten
            ------

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            • #21
              Re: Netherlands: Tamiflu resistant flu strain kills two

              Two deaths from tamiflu resistant griepvariant
              Friday, May 23, 2008 11:15

              (Novum) - Two patients from Rotterdam and Utrecht are deceased this year as a result of an griepvariant proved resistant against conventional medicine tamiflu.

              That indicates the journal Medical Contact Friday.

              The victims were relatively young: they fell outside the risk of the elderly. But they had a significantly weakened immune system.

              In the Netherlands, according to death virology professor Charles Boucher of the UMC Utrecht some thousand people annually to flu. "But these are elderly. It was hard to lose these young patients to flu. " The age of the victims and where exactly they are deceased is not known in the trade press.

              In January docks in Norway griepvariant one that is resistant to tamiflu.

              These variant came under Roel Coutinho Director of the Centre Infectieziektebestrijding of the National Institute of Health and Environment (RIVM), Netherlands barely. It is unclear whether the two Dutch deaths is connected with the flu virus that appeared in Norway. 'In the RIVM is not known what the virus is two deceased "explains a spokesman.

              In the Netherlands, the antigriepmiddel tamiflu mainly used in old people's homes. When an occupant gets flu, the preventive medicine for other residents administered.
              -
              http://www.elsevier.nl/nieuws/laatst.../artnr/206827/
              -------

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              • #22
                Re: Netherlands: Tamiflu resistant flu strain kills two

                Originally posted by gsgs View Post
                even Osterhaus can not exclude that the young patients were
                hit by a flu virus that is immune to Tamiflu.

                And I give it ~70% at this moment.
                But can we exclude the opposite ?
                The H1N1 likely has H274Y but it did NOT develop in the patients.

                Comment


                • #23
                  Re: Netherlands: Tamiflu resistant flu strain kills two

                  Commentary

                  Fatal Tamiflu Resistant H1N1 Cases in The Netherlands
                  Recombinomics Commentary 12:58
                  May 23, 2008

                  Both in Utrecht and Rotterdam is a deceased patient with flu, by resistance to oseltamivir (Tamiflu). The victims were young patients with a weakened immune system strong.

                  The above translation describes two patients in the Netherlands who died from infection with Tamiflu resistant H1N1. Their immune system was compromised, and the H1N1 was not susceptible to Tamiflu (oseltamivir) treatment.

                  The report highlights the limitations of using Tamiflu to treat seasonal flu when the H274Y status is unknown. H274Y is common in many European countries. In Norway, more H1N1 infections are Tamiflu resistant than wild type. High levels have also been reported in France and Russia, while many countries have frequencies between 10-20% of H1N1 cases.

                  Although these isolates are susceptible to Relenza, and some are still sensitive to amantadines, the reliance on Tamiflu can have deadly consequences.

                  Moreover, the widespread distribution of H274Y in H1N1 can impact H5N1 treatment if the polymorphism is acquired by recombination.

                  Recent mild H5N1 cases raise concerns that the level of H5N1 in human populations is significantly higher than the confirmed cases reported by the WHO.


                  .
                  "The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation

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