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Anti-viral resistance in 2009 A/H1N1 flu - historical compilation of news
Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news
via NS1 -
You may also note that several of the new Australia sequences from the beginning of the pandemic are marked as ?deceased?. None of the deceased cases show sequences that have RBD revisions.
One RBD revision is found in the new batch with 225N on Victoria2125 sampled 2009-11-08 from a 33Y.
Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news
hat tip Makoto -
2 New more cases of tamiflu resistance in Japan - 54 cases total.
It is found by two Tamiflu resistant influenza virus examples inside a prefecture.
<!-- grok target title end --> 2010.2.24 18:33 <!-- grok target body start --> Saitama Prefecture announced on the 24th that the virus that there is a tolerance in flu treatment "Tamiflu" had been found from boy (5) in woman (28) in the tail city after it was infected with new influenza and Kumagaya City at the end of last year. It becomes that a Tamiflu resistant virus was found in four examples inside a prefecture and becomes 54 examples domestically.
The symptom such as the joint pains went out according to the prefecture on November 29 after about one week though the woman was taking Tamiflu because the family was infected with new influenza. There is a symptom of heat and the cough on December 4, and the symptom has not been improved to the boy though it is hospitalized on the fifth and treatment with Tamiflu was received. Heat fell on the 12th and it left on the 17th hospital.
National Institute of Infections Diseases confirmed the virus gathered from two people was a Tamiflu resistant virus on the 23rd. It is said that the possibility that the virus mutates in the inside of the body is high according to the prefecture.
Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news
26 February 2010 -- For this reporting week (18 - 24 February 2010), 5 new sporadic cases of oseltamivir resistant pandemic influenza A (H1N1) 2009 viruses have been reported. It brings the cumulative total to 253 so far. All have the H275Y substitution and are assumed to remain sensitive to zanamivir.
WHO region: AFRO:0, EMRO:1, EURO:82, PAHO:73, SEARO:0, WPRO:97
Tamiflu resistance in A/H1N1 flu - historical compilation of news
hat tip Makoto -
61st confirmed case of tamiflu resistance -
New influenza: The death man in Kurume:First Tamiflu resistant virus confirmation /Fukuoka inside a prefecture.
Kurume City announced on the 26th that it was infected with new influenza and infected with the resistant virus for which the treatment Tamiflu did not work easily last month of man (56) who had died. The example of confirming this virus is the first time in 61 and the prefecture in the whole country.
The man consulted a physician generation of heat according to the city public health center on December 23 last year, the hospital in the city was consulted a physician on the 24th, and it was diagnosed as influenza. Tamiflu is prescribed and it is hospitalized while recuperating home on the 28th due to pneumonia. It died by the respiratory failure on January 18.
〔 Chikugo version 〕
Mutation A/H1N1 virus, resistant to Tamiflu
Tests confirm the change so far has been defined "not serious".
Wed, 03/03/2010 - 05:06
The official says the vaccination is going well. Photo: H?ctor T?llez / Archive Mexico.- The Ministry of Health reported the first mutation detected in the influenza A/H1N1 virus in the position of H274Y in neuraminidase gene (NA) in a patient ten months old, who survived the disease but showed resistance to the antiviral oseltamivir (Tamiflu).
The infant "is good, with mild cough and runny nose alone, according to the report he released his mother by telephone on March 1.
The Institute of Epidemiological Diagnosis and Reference (INDRE) conducted laboratory tests using PCR in real time, and confirmed the mutation, so far has been defined not serious.
"This finding does not change the treatment policy in the future, since it is the only strain found resistant of 420 sequenced, which means less resistance to .25%."
The SSA has not reported whether this case could trigger a wave of people infected oseltamivir resistance, and so must use the accumulated reserve in case of zanamivir resistance.
Little is originally from Ecatepec, Mexico state, was admitted on January 4 Pediatric Hospital La Villa, for mild respiratory distress syndrome, malnutrition grade one and bronchiolitis. She was discharged after showing satisfactory progress smoothly.
Joined ten days later to Children's Hospital of Mexico "Federico Gomez", diagnosed with severe pneumonia, moderate malnutrition and influenza-like illness.
After control was achieved, was taken to Children's Hospital in the town to continue treatment, where he was discharged on Feb. 3.
The federal government recognized a serious case of H1N1 mutation, as in Norway and, therefore, began to shape a "small strategic reserve" of over 100 thousand zanamivir treatment in case of detection of patients resistant to Tamiflu .
"If there was a mutation that causes a resistance to Tamiflu, an antiviral drug would be changed for another. Mexico is ready with an alternate booking more than 100 thousand zanamivir treatment is still small, but we would cope. At this point we are not facing that situation, "noted Alejandro Macias, national commissioner for the care of influenza.
In turn, the Director National Institute of Epidemiological Diagnosis and Reference, Celia Alpuche, said the Mexican case of severe mutation corresponds to the second patient treated at INER in April when the pandemic began.
A few months ago, WHO issued an alert and suggested to Norway, Brazil, China, Japan, Ukraine, USA and Mexico, where mutations have been reported, carrying out more detailed summaries and sequencing, in order to determine whether or not more virulent .
Dismissing raise alert
? ? ? The Federal Ministry of Health ruled that in March, as forecast, raise the alert for the H1N1 pandemic contingency because it continues to increase, more mild aunquede, the number of infections: 71 thousand 90 cases, and 88 thousand deaths (nine more than the previous report).
Jose Angel Cordova, Secretary of Health, explained that almost a year after the outbreak of the pandemic by the new virus called H1N1, high transmissibility, but with minor consequences and not so serious for most, the Audit Committee Epidemiological evaluated even if it is time to lift the health contingency.
Meanwhile, the municipal government will continue with the alert to respond to outbreaks of H1N1, so you will expand the vaccination campaign Metrobus stations and some trolleybus, in order to reach more segments of the population. (Mexico ? Blanca Valadez and Miriam Castillo)
Ssa 423 suspected cases of A H1N1 mutation Health Secretary Jose Angel Cordova, notes that since the beginning of the epidemic to date have applied more than one million anti-viral treatments
Ruth Rodriguez
El Universal
MEXICO CITY Wednesday, 03 marzo of 2010
11:02
Jose Angel Cordova Villalobos, Secretary of Health, confirmed the first case of a person in Mexico where the AH1N1 influenza virus mutated and became resistant to antiviral treatment.
The official did not rule out the possibility of more cases in the country.
Against this background, said the virus could mutate at any time and cause serious problems.
Hence, he added, the importance that people be vaccinated to be protected.
He said the case of small 10-month-old, which was confirmed mutation of influenza virus a week ago, is the first of 423 cases of suspected mutation, which scored a low rate.
Cordova Villalobos said that since the beginning of the epidemic to date have been applied over a million of antiviral therapies and has only one instance of resistance, which is the girl who was hospitalized in the town hospital and subsequently readmitted.
He said that to reduce the chances of resistance to oseltamivir, for the past six months has begun to implement in the medical units Zanamivir the second antiviral treatment have to attack the influenza virus.
On the application of vaccines, Cordova said that until last Friday was administered six million 700 thousand vaccines and is expected to conclude this weekend pair with eight million.
In this sense confided that for April and May will have already implemented 20 million vaccines.
He reported that so far there are 90 thousand deaths.
Health more mutations discarded as A H1N1
Undersecretary of Health, Gabriel O 'Shea Cuevas said the need for annual vaccine is changed seasonally.
Sun, 07/03/2010 - 13:22
Continue with prevention. Photo: Magali Lopez
Following the case of mutation of the H1N1 virus in a baby of 10 months of this municipality, Undersecretary of Health in the state, Gabriel O 'Shea Cuevas pointed the need for annual vaccine is changed seasonally.
He explained that some mutations make it resistant to drugs such as this little one in Mexico, 21 in the U.S. and 50 in Europe.
"Apparently there are about 250 patients worldwide who have resistance to the antiviral oseltamivir, but very good response with zanamivir, which is the second option, and we have a guard of 10 thousand doses for these cases, so that people should not worry.
The state official clarified that the mutated virus does not mean it to be more aggressive just means there is resistance to medications.
"The best measure to combat it is to vaccinate as immunity levels achieved are very high and acceptable."
Cuevas O'Shea spoke "the percentage of mutated virus resistance is 0.25 percent, but we are in complete epidemiological surveillance to confirm the existence of similar cases.
He recalled that the sample of girls of 10 months was analyzed by the National Institute of Epidemiological Diagnosis and Reference (INDRE) together with other 420 who had negative results of mutation.He said providing for the application of one million 400 thousand shots in the State of Mexico at the end of the National Vaccination Week, which would correspond to 74 percent of the doses received in the entity.
He said the case of the girl discharged last month, shows that the mutation of the virus is minimal, "since the disease was controlled and is alive.
"Initially the baby was treated in the pediatric Villa, where he had been diagnosed I had bronchitis, a few days was discharged with antibiotic treatment, but returned after 10 days with a picture of pneumonia was severe and when the interned at Children's Hospital, where fortunately left stable. "
Final Report Confirms A Cluster of Oseltamivir (Tamiflu)-Resistant H1N1 Influenza at Duke Hospital
An outbreak last fall of oseltamivir (Tamiflu)-resistant H1N1 influenza at Duke University Hospital may have been the result of viral transmission between patients.
Four patients in a hematology-oncology ward at Duke Hospital became symptomatic of fever and respiratory symptoms during a six-day period from Oct. 6-11, 2009. They were subsequently diagnosed with oseltamivir-resistant H1N1 Influenza. All four patients were ill with underlying severely compromised immune systems and other complex medical conditions.
Duke and a team of experts from the Centers for Disease Control and Prevention (CDC) and the State of North Carolina Public Health Department collaborated to investigate the nature of these cases. Their findings were presented at the Fifth Decennial International Conference on Healthcare-Associated Infections on March 20 in Atlanta, Ga.
?We found that the oseltamivir-resistant H1N1 influenza were isolated to the four patients. There was no evidence of spread to additional patients or caregivers on the affected ward,? said Luke Chen, M.D., an infectious diseases specialist at Duke University Medical Center.
The team carried out an epidemiologic investigation and extensively reviewed patients? medical records, infection control measures, and interviewed visitors and health care personnel.
?We were not able to establish that health care workers or visitors had a role in the transmission.?
?We found that our infection control plans were properly implemented,? Chen said. ?The compliance to hand hygiene is monitored by objective auditors at Duke Hospital. The hand hygiene compliance on the affected ward was greater than 92 percent during the study period ? much higher than reports from other institutions. We also implemented contact isolation in addition to droplet precautions for severely immunocompromised patients. At the time of the four infections, the hospital was also operating with a visitor restriction policy, which recommended visits only from adult members of the patient?s immediate family or designated caregivers.?
Among hospitalized patients, influenza can often be hidden under other conditions and the suspicion for influenza might be low because many patients have other medical problems that could be causing their fever or respiratory symptoms, according to Chen.
?One key thing we can learn from this outbreak is that all clinicians and health care workers should suspect the diagnosis of influenza even among very ill patients, who have multiple medical problems,? Chen said. ?We should include influenza in the diagnostic thought process early on and act on it by doing specific tests and placing these patients in appropriate isolation prior to obtaining the results of these tests.?
Tamiflu resistance in A/H1N1 flu - historical compilation of news
Pediatr Infect Dis J. 2010 Apr;29(4):385-386.
Development of Oseltamivir Resistance During Oseltamivir Therapy in a Child With Severe 2009 H1N1 Influenza.
Glikman D, Zonis Z, Hindyieh M, Ram D, Mandelboim M, Mendelson E, Engelhard D.
Infectious Diseases Unit (Glikman) Pediatric Intensive Care unit Western Galilee Hospital Nahariya, Israel (Zonis) Central Virology Laboratory Public Health Services Israel Ministry of Health Tel-Hashomer, Israel Chaim Sheba Medical Center (Hindyieh, Ram, Mandelboim) Central Virology Laboratory Public Health Services Israel Ministry of Health Chaim Sheba Medical Center Tel-Hashomer, Israel The Israeli Management Team of Epidemics (Mendelson) Department of Pediatrics Hadassah University Hospital The Israeli Management Team of EpidemicsThe Ministry of HealthJerusalem, Israel (Engelhard).
PMID: 20351533 [PubMed - as supplied by publisher]
Tamiflu resistance in A/H1N1 flu - historical compilation of news
Pediatr Infect Dis J. 2010 Apr;29(4):384.
First Isolation of a Oseltamivir-Resistant Influenza A (H1N1) Strain in Argentina.
Can? A, Casanueva E, Iolster T, Sticco N, Richards L, Sosa P, Pontoriero A, Avaro M, Zcech A, Carabajal E, Campos A, Baumeister E, Diez MA, Rojas M, Rivarola MR.
Infectious Diseases Section Department of Pediatrics (Can?, Casanueva) Pediatric Intensive Care Unit (Iolster) Department of Pediatrics (Sticco) Bone Marrow Trasplantation Unit Hospital Universitario Austral (Richards, Sosa) Respiratory Viruses Service Department of Virology National Institute of Infectious Diseases (ANLIS) "Carlos Malbr?n" Buenos Aires, Argentina (Pontoriero, Avaro, Zcech, Carabajal, Campos, Baumeister) Virology Laboratory Department of Virology (Diez, Rojas) Department of Pediatrics Hospital Universitario Austral Derqui-BuenosAires, Argentina (Rivarola).
PMID: 20351531 [PubMed - as supplied by publisher]
Oseltamivir-resistant pandemic (H1N1)2009 in Yemen - case report
Published on: 2010-05-08
During the influenza season of 2007-08, oseltamivir-resistant influenza A (H1N1) viruses emerged in several countries in Europe, North America, and Asia. Despite substantial prevalence of oseltamivir-resistant viruses, few data are available on the clinical profile of subjects infected with these viruses.
Objectives: to describe the first oseltamivir-resistant (H1N1) influenza virus pandemic 2009 from the Eastern Mediterranean Region including Yemen and to determine the evidence by clinical presentation of children infected with these oseltamivir - resistant viruses.Methodology: History, physical examination and laboratory investigations including Complete Blood Count, chest x-ray, blood cultures, CSF examination, LFTs, RFTs, blood for sugar, H1N1 test and oseltamivir resistance test.
Results: Nasal swabs indicated positivity on both H1N1 test and the RNP gene (Human R Nase P gene that serves as internal positive control for Human RNA. Both clinical specimens presented the mutation S31N in the M2 gene associated with resistance to adamantanes and H274Y in NA gene associated with resistance to oseltamivir.
This was the first diagnosed case of resistance to oseltamivir in Yemen and also it is the first reported case of oseltamivir resistance virus in the Eastern Mediterranean Region.
Conclusion: The pattern of resistance found in the oseltamivir resistant isolate collected from Yemen is the same as has been reported elsewhere in other WHO regions. Clinical description and outcomes are not different from what is described elsewhere.
Two extra mutations set the stage for the seasonal influenza virus to evolve into a form that now resists three of the four drugs designed to fight it, researchers reported on Thursday.
Health
Their study, published in the journal Science, provides a way for scientists to keep an eye out for dangerous mutations in new flu viruses, including the ongoing pandemic of H1N1 swine flu.
Only four drugs are on the market to treat flu and two, the adamantines, are useless against virtually all circulating strains because the viruses have evolved resistance.
Tamiflu, known generically as oseltamivir, is the current drug of choice. It comes as a pill made by Roche AG under license from Gilead Sciences. GlaxoSmithKline makes an inhaled drug that works in a similar manner called Relenza, or zanamivir generically.
Both can help reduce flu symptoms if taken quickly and can keep the most vulnerable patients out of the hospital, or keep them alive if they are severely ill. But two years ago the common circulating strain of seasonal H1N1 developed resistance to Tamiflu.
Doctors were surprised, because the mutation that help the virus evade the effects of Tamiflu also usually made it a weak virus that did not infect or spread well.
"People have known about this H274Y mutation for over a decade, but the mutation seemed to interfere with the virus's ability to replicate and be transmitted," Jesse Bloom of the California Institute of Technology, who led the study, said in a statement.
"Something happened to make the Tamiflu-resistant virus also capable of replicating and spreading like wild-type flu viruses."
Bloom and Dr. David Baltimore, an expert on AIDS and on the genetic functions of cells and viruses at Caltech, led a study to find out how this happened.
They found two other mutations in the virus allowed it not only to evade the effects of Tamiflu but to survive and spread.In addition, the mutations took place before the third and final mutation allowing the virus to evade the drugs. This means that scientists can monitor flu viruses for the initial two mutations to give early warning that they are about to become drug resistant.
This is important in planning for both seasonal influenza and pandemics. Seasonal flu kills between 250,000 and 500,000 people every year globally.
H1N1 swine flu may have been just slightly more deadly -- statistics will take years to gather -- but it affects younger adults and children in contrast to seasonal flu, which kills more elderly people.
Currently swine flu is easily treated by Tamiflu but that could change at any time.
So doctors need drugs on hand to save lives and if one drug will be useless, they need to know that because flu must be treated within days of onset for treatment to be useful.
Earlier on Thursday the World Health Organization said the H1N1 pandemic was not yet over although its most intense activity has passed in many parts of the world.
(Reporting by Maggie Fox, editing by Philip Barbara)
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