Anti-viral resistance in 2009 A/H1N1 flu - historical compilation of news

[Pathfinder]

Tamiflu resistance in pandemic influenza - historical compilation of news

If the new gene recombinant influenza experts worry brewing in Taiwan and the United States disaster


(Central News Agency, Taipei Chen Qingfang 28, Xinhua)

Taiwan, the United States, Chinese experts were today warned that if the new H1N1 avian influenza and the H5N1 flu virus genetic recombination, would be disastrous to create highly infectious and drug-resistant virus; if the new influenza and drug-resistant Seasonal influenza virus mixed, then make Tamiflu failure.

Respiratory disease experts, the Chinese Academy of Engineering, Zhong Nanshan, told Xinhua here today, H1N1 influenza virus currently does not appear a new variation, it has a very infectious, but the lethality is not high, but once mixed with a high lethal H5N1 avian influenza virus, would be very dangerous.

U.S. Department of Health Office of Health Services, director of Southeast Asia, Mali W (Dr.Michael D. Malison) today at the Department of Health Center for Disease Control press conference pointed out that, H5N1 bird flu fatality rate more than 5 into, if the new H5N1 avian influenza and H1N1 influenza in the same person body infection, once the genetic recombination, creating highly lethal flu virus, it will be a disaster.

Mali Sheng pointed out that the World Health Organization (WHO) and Viet Nam, Indonesia, Egypt to cooperate in monitoring, the three countries at the same time both influenza pandemic virus, fearing there mixed virus.

Deputy Director of Health-Chwen Chang to make another worry that 9 percent of seasonal influenza H1N1 viruses are resistant to Tamiflu, if and H1N1 influenza virus genes new hybrid, resulting in a new drug-resistant influenza virus, then the Tamiflu will lapse, Tamiflu is also stored more useless.

The former Health and Director of the Academia Sinica Chen Chien-jen, today suggested that the Department of Health should be widely at the grassroots level to build hospitals and clinics cloth Tamiflu to prevent the patient pushed large hospitals, causing severe infection in hospital patients.

In response, CDC chief Hsu-Sung Kuo believes that the Department of Health will consider part of the publicly-funded Tamiflu shop at the grassroots level, but not a comprehensive distribution in order to avoid misuse promote drug resistance.

http://www.cna.com.tw/SearchNews/doDetail.aspx?id=200908280293

[Pathfinder]

Tamiflu resistance in pandemic influenza - historical compilation of news

Sunday, Aug. 30, 2009


Pregnant women warned to protect against H1N1
Death rates in Brazil prompt calls for precautions

Kyodo News

Since more than 10 percent of the H1N1 swine flu fatalities in Brazil were pregnant women, doctors in Japan are asking expectant mothers ? who have a higher risk of developing complications if infected ? to wash their hands and take other precautions.

The Japan Society of Obstetrics and Gynecology, an organization of OB-GYN doctors, is calling for pregnant women with suspected swine flu symptoms to get treatment at fever clinics and general hospitals rather than OB-GYN clinics to prevent the H1N1 virus from spreading to other expectant mothers during the epidemic.

JSOG is recommending Tamiflu and Relenza for pregnant women who catch the new flu. A guideline in the United States says the two antiviral drugs have no negative side effects on babies. The organization is also urging the government to give expectant women priority for swine flu vaccines.

The figures announced Wednesday by the Brazilian government sent shock waves around the world. Of the 557 people who died, 58 were pregnant. No such deaths have been reported so far in Japan.

The government is expected to formally place expectant mothers on the vaccine priority list in September.

"Pregnant women comprise only about 1 percent of the population but the number of deaths (among those women) is high," Hisanori Minakami, a professor at Hokkaido University who belongs to JSOG, said during a meeting Thursday to discuss the priority list for new influenza vaccines. "I have a sense of crisis."

Women are also concerned.

"I'm worried about the higher risk of pregnant women but I'm also worried what will happen to my newborn baby," said a 42-year-old woman in Bunkyo Ward, Tokyo, who is close to giving birth.

She wears a mask when she needs to go out and avoids crowds. "But I don't know which department to be treated at when I am infected," she said.

When women are pregnant, their immunity to viruses weakens, putting them at higher risk of complications. Seasonal and new flu viruses can lead to pneumonia and other diseases.

JSOG is urging pregnant women with potential flu symptoms ? fever, runny nose, sore throat and cough ? to call a general hospital and get treated early.

Nationwide, total swine flu deaths grew to seven Saturday when a woman in her 30s in Tatsuno, Hyogo Prefecture, died after contracting the virus, the municipal government of Himeji said the same day.

She was preceded by a female cancer patient, also from Hyogo, in her 60s, the Kagoshima Prefectural Government said.

The woman, from Makurazaki, Hyogo Prefecture, had cancer of the digestive system and a tumor that spread to her lungs after surgery, local government officials said.

She was treated with Tamiflu on Friday after being entering a hospital complaining of a sore throat, coughing and a 38-degree fever she had developed the previous day, officials said. But her condition worsened, and she died early Saturday, becoming the nation's sixth swine flu fatality.

In Shiga Prefecture, a 5-year-old boy infected with swine flu showed signs of resistance toward Tamiflu, the prefecture said Saturday, becoming the fifth Tamiflu-resistant patient in the country.

Prefecture officials said the virus is likely to have mutated in his body.

Although the boy was given Tamiflu, he showed no signs of recovery and was admitted to a hospital, the officials said, adding he has now fully recovered from the virus.

http://search.japantimes.co.jp/cgi-bin/nn20090830a2.html

[Pathfinder]

12 countries report Tamiflu-resistant H1N1

12 countries report Tamiflu-resistant H1N1

Kounteya Sinha, TNN 31 August 2009, 12:27am IST
|

NEW DELHI:

An increasing number of countries, including some in Asia, are now reporting Tamiflu resistant H1N1 virus. The worrying development,
according to WHO, has seen 12 countries including China and Singapore. India has not reported the mutation in the virus so far.

The changes in the virus reported in samples are making these strains of swine flu resistant to oseltamivir or Tamiflu - the antiviral of choice globally. Such cases have also been found in Japan, US, Hong Kong, Denmark and Canada.

While India is monitoring these reports closely, it will begin exit screening of pilgrims bound for Saudi Arabia for Haj as the desert nation is refusing entry to anyone with even a common cold. Saudi authorities are insisting on certificates stating that Haj pilgrims are completely free of any influenza infection.

Changes in the virus are also being tracked closely as scientists are concerned that new strains may make the vaccines being developed at a feverish pace infructuous. As of now, WHO fears Tamiflu resistance may be more widespread than officially reported.
Going by available data, majority of the resistant cases were reported where oseltamivir was given as preventive medication to people exposed to the flu but who had not tested positive themselves. Some cases were a result of treatment of mild illness as well as "immuno-compromised" patients or persons whose immune systems were working imperfectly.

India has so far not reported such a mutation. ICMR director general Dr V M Katoch told TOI, "We have been constantly sequencing genes in H1N1 to mark any form of mutation. However, we have still not found a case of oseltamivir resistant H1N1 virus."

He added, "Fear of resistance is why we are so careful about Tamilfu's availability to the public and its use in management of H1N1 infected or suspected patients. Tamilfu is now only available in select hospitals so that we can keep a record of the treatment."

Meanwhile, the decision on exit screening was taken in a meeting between the director general of health services and the Haj Committee of India on Saturday.

Till now, India has only been carrying out screening of passengers arriving at the country's 22 international airports.

Saudi Arabia has announced that it will require a health certificate for all pilgrims to Mecca, showing they are not suffering from normal flu. In the meeting on Saturday, the health ministry said that in the next 10 days, it would provide the Haj committee and states with the prototype of India's flu free certificate that every pilgrim will have to get stamped after a check-up by designated doctors.

The certificate will state that the pilgrim isn't suffering from seasonal flu or has H1N1 symptoms.

Speaking to TOI from Mumbai, CEO of India's Haj committee Mohammad Owais said, "A high-level expert committee has been formed to see whether all Indian pilgrims can be given a 42-day regimen of Tamilfu as a form of protection. The committee will see what the drug's side effects will be if used for so long and whether it is a feasible proposition."

http://timesofindia.indiatimes.com/NEWS/India/12-countries-report-Tamiflu-resistant-H1N1/articleshow/4952430.cms

[Commonground]

Re: 12 countries report Tamiflu-resistant H1N1

ICMR director general Dr V M Katoch told TOI, "We have been constantly sequencing genes in H1N1 to mark any form of mutation. However, we have still not found a case of oseltamivir resistant H1N1 virus."

He added, "Fear of resistance is why we are so careful about Tamilfu's availability to the public and its use in management of H1N1 infected or suspected patients. Tamilfu is now only available in select hospitals so that we can keep a record of the treatment."

vs.

Speaking to TOI from Mumbai, CEO of India's Haj committee Mohammad Owais said, "A high-level expert committee has been formed to see whether all Indian pilgrims can be given a 42-day regimen of Tamilfu as a form of protection. The committee will see what the drug's side effects will be if used for so long and whether it is a feasible proposition."

[Gert van der Hoek]

Tamiflu resistance in pandemic influenza - historical compilation of news

In Shiga Prefecture, a 5-year-old boy infected with swine flu showed signs of resistance toward Tamiflu, the prefecture said Saturday, becoming the fifth Tamiflu-resistant patient in the country.

Prefecture officials said the virus is likely to have mutated in his body.

Although the boy was given Tamiflu, he showed no signs of recovery and was admitted to a hospital, the officials said, adding he has now fully recovered from the virus.

http://search.japantimes.co.jp/cgi-bin/nn20090830a2.html

[Gert van der Hoek]

Tamiflu resistance in pandemic influenza - historical compilation of news

In Shiga Prefecture, a 5-year-old boy infected with swine flu showed signs of resistance toward Tamiflu, the prefecture said Saturday, becoming the fifth Tamiflu-resistant patient in the country.

Prefecture officials said the virus is likely to have mutated in his body.

Although the boy was given Tamiflu, he showed no signs of recovery and was admitted to a hospital, the officials said, adding he has now fully recovered from the virus.

http://search.japantimes.co.jp/cgi-bin/nn20090830a2.html

[Gert van der Hoek]

Re: Japan: boy is 5th case of Tamiflu resistant H1N1

2009.08.31

Five cases of pandemic Tamiflu-resistant H1N1 2009 virus

In Shiga Prefecture, has a pandemic resistant to full Tami H1N1 2009 (pandemic flu) virus is so identified. The newsletter was reported.
Pandemikkuuirusu domestic resistance to Tamiflu, the first five cases of Shiga Prefecture, Osaka far, Yamaguchi Prefecture, Tokushima Prefecture, Iwate Prefecture, has been confirmed. I picked up the article cited below associated newsletter.

Pandemikkuuirusu is growing nationwide infection will increase the probability of the emergence of resistant viruses Tami full dose of Tamiflu is increasing with more and more infected people.

So far, the virus each year is less toxic than 1,000 victims of seasonal flu fatalities is not about people. But you do not know how to be a mutation of the future expansion of infected people who are pregnant or have underlying diseases are said to still be at risk for serious complications.

For the occurrence of drug-resistant viruses and bacteria, but are not immune to avoid, and I will still worry.

Yet, to inhibit the activity of neuraminidase Relenza and Tamiflu is the same as resistant virus has not been confirmed, and ongoing development of antiviral drugs with different action points.

Nevertheless, the few effective means of Tamiflu anti-flu is used to care I want.
So I can do, when the infection temporarily, until there are no more likely to infect other people to rid the body of the virus, and you only sit in the room.

The new resistant flu virus in check = Shiga, Shiga Prefecture,Japan <br /> 5 of the 30 cases before the Sun, from pandemic influenza patients, anti-influenza drug "Tamiflu" and said the virus was confirmed to be resistant. The resistant virus was found in 5 of domestic cases.

According to the County, five year-old boy patient. Mon 8 to develop because the symptoms did not improve the administration of Tamiflu, was hospitalized on other medical institutions. The boy has already been discharged from hospital. The onset is around that, that after taking Tamiflu and improve symptoms.

2009/08/30 / Newsletter

Confirm flu-resistant virus in Iwate = new domestic cases of four <br /> Iwate Prefecture on March 30, from patients with pandemic influenza, anti-influenza drug "Tamiflu" and said the virus was confirmed to be resistant. Resistant virus was found in Osaka, Yamaguchi, Tokushima, Japan following the first four cases. According to the County Health Department, the patient has already recovered, to spread around is not allowed.

According to police, because this patient came around pandemic influenza patients received Tamiflu as a prophylaxis for close contacts. But then develop the first symptoms of pandemic flu and fever. County reported to the government, the analysis of virus samples from the National Institute of Infectious Diseases. Believed that the virus mutates in the body of a patient infected with a virus resistant to other people who had not.

http://shizuoka.cocolog-nifty.com/gard/2009/08/h1n1-2009-7757.html

[wotan]

Re: PAHO rejects report of resistant H1N1 cases on US-Mexico border

The truth comes out. Texas reports two cases of Tamiflu resistance:

http://www.flutrackers.com/forum/showthread.php?p=288514#post288514

[wotan]

Re: CDC lists 7 cases of Tamiflu resistant viruses

Link to Texas surveillance report:

Texas Influenza Surveillance Report
2008-2009 Season/MMWR Week 32

http://www.dshs.state.tx.us/idcu/disease/influenza/surveillance/2009/CurrentFlu.pdf

2 out of 5 samples were resistant, 5 is not much, but 2 out of 5 is much?

Since the pandemic began Texas has tested a total of 5 viruses for resistance. So, using the dishonest math so widespread in this pandemic, a lot of people have worthless tamiflu prescriptions.

[Gert van der Hoek]

Re: CDC lists 7 cases of Tamiflu resistant viruses

Since the pandemic began Texas has tested a total of 5 viruses for resistance. So, using the dishonest math so widespread in this pandemic, a lot of people have worthless tamiflu prescriptions.

Questioning Tamiflu seriously and monitoring the resistance OK, it seems a little early to say oseltamivir is worthless ?

There must be hundreds or thousands of samples to be tested?

[wotan]

Re: CDC lists 7 cases of Tamiflu resistant viruses

Questioning Tamiflu seriously and monitoring the resistance OK, it seems a little early to say oseltamivir is worthless ?

There must be hundreds or thousands of samples to be tested?

I said using the same dishonest math. The kind of math that says we estimate 800,000 cases but only have "50" deaths to illustrate that this is not a potentially severe pandemic. Officially, the rate of resistance in Texas is 40%.

[Gert van der Hoek]

Re: CDC lists 7 cases of Tamiflu resistant viruses

Officially, the rate of resistance in Texas is 40&#37;.

Yes.

For visitors: more discussion and background in this thread: http://www.flutrackers.com/forum/sho...d.php?t=119042

[Mamabird]

Re: PAHO rejects report of resistant H1N1 cases on US-Mexico border

The truth comes out. Texas reports two cases of Tamiflu resistance:

http://www.flutrackers.com/forum/sho...514#post288514

Great invesitigative work, W. We may have to make you a Texas Ranger.

Let's keep an eye out for the sequences to see what this puppy looks like.

[Laidback Al]

Tamiflu resistance in pandemic influenza - historical compilation of news

Tamiflu Resistance -- WHO update August 21, 2009

WHO has also been notified of 12 cases of oseltamivir resistant virus. These isolates have a mutation in the neuraminidase (referred to as H275Y) that confers resistance to oseltamivir, though the viruses remain sensitive to zanamivir. Of these 8 have been associated with oseltamivir post exposure prophylaxis, one with treatment of uncomplicated illness, and two have been from immunocompromised patients receiving oseltamivir treatment. These isolated cases have arisen in different parts of the world (Japan 4, USA 2, China, Hong Kong SAR China 2, and 1 in Denmark, Canada, Singapore and China), and there are no epidemiological links between them. There is also no evidence of onward transmission from these cases.

Here is a preliminary list of H1N1 cases reported from around the world as resistant to Tamiflu roughly sorted by date. First reported url link is generally provided. The number in parentheses following the location is the number of resistant cases. Sequence numbers are provided for some of the cases.

<st1:country-region w:st="on">Japan</st1:country-region>, <st1:city w:st="on"><st1:place w:st="on">Osaka</st1:place></st1:city> (1) (May, 2009) (A/Osaka/180/2009?)

http://www.flutrackers.com/forum/showthread.php?t=121517

<o:p> </o:p>
<st1:country-region w:st="on">USA</st1:country-region>, <st1:state w:st="on">Hawaii</st1:state> (1) (May 26, 2009) (<st1:country-region w:st="on"><st1:place w:st="on">Singapore</st1:place></st1:country-region>) (A/Singapore/57/2009?)

http://www.recombinomics.com/News/08090903/H274Y_Singapore_Hawaii.html

<o:p> </o:p>
Demark, (1) (June 9,2009) (A/Denmark/528/2009)

http://www.flutrackers.com/forum/showpost.php?p=257317&postcount=7

<o:p> </o:p>
<st1:country-region w:st="on">USA</st1:country-region>, <st1:place w:st="on"><st1:city w:st="on">San Francisco</st1:city>, <st1:state w:st="on">California</st1:state></st1:place> (1) (July 3, 2009) (Hong Kong)

http://www.flutrackers.com/forum/showpost.php?p=259678&postcount=1

<o:p> </o:p>
<st1:place w:st="on">Hong Kong</st1:place> (1) (July 3, 2009)

http://www.flutrackers.com/forum/showpost.php?p=260569&postcount=1

<o:p> </o:p>
<st1:country-region w:st="on">Viet Nam</st1:country-region>, <st1:city w:st="on"><st1:place w:st="on">Hanoi</st1:place></st1:city> (2) (July 9, 2009)

http://www.flutrackers.com/forum/showpost.php?p=263660&postcount=6

<o:p> </o:p>
<st1:country-region w:st="on"><st1:place w:st="on">Japan</st1:place></st1:country-region>, Yamaguchi (1) (July, 2009?) (A/Yamaguchi/22/2009)

http://www.flutrackers.com/forum/showpost.php?p=270251&postcount=18

<o:p> </o:p>
<st1:place w:st="on">Hong Kong</st1:place>, Eastern District (1) (July 15, 2009)

http://www.flutrackers.com/forum/showpost.php?p=281081&postcount=1

<o:p> </o:p>
<st1:country-region w:st="on">Canada</st1:country-region>, <st1:state w:st="on"><st1:place w:st="on">Quebec</st1:place></st1:state> (1) (July 22, 2009)

http://www.flutrackers.com/forum/showpost.php?p=270251&postcount=18

<o:p> </o:p>
<st1:country-region w:st="on">Japan</st1:country-region>, <st1:city w:st="on"><st1:place w:st="on">Tokushima</st1:place></st1:city> (1) (July 26, 2009)

http://www.flutrackers.com/forum/showthread.php?t=118137

<o:p> </o:p>
<st1:country-region w:st="on">USA</st1:country-region>, <st1:place w:st="on"><st1:state w:st="on">North Carolina</st1:state></st1:place> (2) (July, 2009)

http://www.flutrackers.com/forum/showpost.php?p=284360&postcount=3

<o:p> </o:p>
<st1:country-region w:st="on"><st1:place w:st="on">Thailand</st1:place></st1:country-region> (1?) (August 4, 2009)

http://www.flutrackers.com/forum/showthread.php?t=120147

<o:p> </o:p>
<st1:country-region w:st="on">USA</st1:country-region>, <st1:place w:st="on"><st1:city w:st="on">Seattle</st1:city>, <st1:state w:st="on">Washington</st1:state></st1:place> (2) (August 14, 2009)

http://www.flutrackers.com/forum/showpost.php?p=281311&postcount=1

<o:p> </o:p>
<st1:country-region w:st="on">China</st1:country-region>, <st1:place w:st="on"><st1:placename w:st="on">Pingtung</st1:placename> <st1:placetype w:st="on">County</st1:placetype></st1:place> (1) (August 17, 2009)

http://www.flutrackers.com/forum/showpost.php?p=288381&postcount=237

<o:p> </o:p>
<st1:country-region w:st="on">USA</st1:country-region>, <st1:place w:st="on"><st1:state w:st="on">California</st1:state></st1:place>, northern (1) (August 28, 2009)
<o:p> </o:p>
<st1:country-region w:st="on">USA</st1:country-region>, <st1:state w:st="on"><st1:place w:st="on">Texas</st1:place></st1:state> (2) (August, 2009)

http://www.dshs.state.tx.us/idcu/disease/influenza/surveillance/2009/CurrentFlu.pdf

<o:p> </o:p>
<st1:place w:st="on"><st1:country-region w:st="on">Japan</st1:country-region></st1:place>, Shiga (1) (August 31, 2009)

http://www.flutrackers.com/forum/showpost.php?p=288401&postcount=261

http://www.flutrackers.com/forum/showpost.php?p=288403&postcount=264

<o:p> </o:p>

Corrections and additions welcome.

[Gert van der Hoek]

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Apparently another case is found: # 13 Edit: it seems the number of resitant cases is closer to 20, looking at this thread.

SEPTEMBER 7, 2009, 5:26 A.M. ET

Roche: Pandemic H1N1 Virus Remains Fully Sensitive To Tamiflu


BASEL (Dow Jones)--The new A/H1N1 pandemic swine flu virus remains fully sensitive to Tamiflu, the antiviral drug of Swiss pharmaceutical company Roche Holding AG (ROG.VX), David Reddy, head of the company's pandemic task force, said Monday.

"13 isolated cases of resistance to the pandemic 2009 virus have been reported, but there's no evidence of onward transmission of the virus," Reddy said at a press briefing.

Roche is the maker of the antiviral drug Tamiflu, which relieves flu symptoms.

http://online.wsj.com/article/BT-CO-20090907-703874.html