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

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

    April 24, 2009

    <nyt_headline version="1.0" type=" ">Unusual Strain of Swine Flu Is Found in People in 2 States </nyt_headline>

    <nyt_byline version="1.0" type=" ">By DONALD G. McNEIL Jr.
    </nyt_byline><nyt_text>An unusual strain of swine flu is circulating among people in the Southwest but is not known to have caused any deaths, the Centers for Disease Control and Prevention said Thursday.

    The agency, which has found only seven cases, expects to find more now that it has begun looking intensively for them.

    “We don’t yet know the extent of the problem,” said Dr. Anne Schuchat, the director of respiratory diseases for the agency, “but we don’t think this is a time for major concern.”

    Five of the people infected were in Imperial and San Diego Counties in California and two were in San Antonio. They were 9 to 54 years old.

    None had any contact with pigs, and in two sets of cases — involving a father and daughter and two 16-year-old schoolmates — those infected had contact with each other. That convinced the authorities that the virus was being transmitted from person to person.

    The seven people were apparently infected from late March to mid-April. Only one was hospitalized, and all recovered.

    The A (H1N1) flu strain they had was quite unusual, said Dr. Nancy Cox, the chief of the agency’s flu division. It contained gene segments from North American swine, bird and human flu strains as well as one from Eurasian swine.

    Like some human strains, it is resistant to two older flu drugs, amantadine and rimantadine. It is not resistant to Tamiflu or Relenza. However, Tamiflu resistance is common in the H1N1 human flu strain circulating this year, so the swine strain could become resistant to Tamiflu if the viruses mixed in humans or, possibly, in pigs.

    Swine flus rarely infect humans. There have been about a dozen cases since 2005, but almost all were in farm workers or others in contact with pigs.

    In 1976, there was a cluster of swine flu cases among soldiers at Fort Dix, in New Jersey, one of whom died. That led to a rush to make a new vaccine and administer it to 40 million Americans. No epidemic materialized, but thousands of people claimed that the vaccine had given them Guillain-Barr&#233; syndrome, which can cause lethargy or paralysis. The episode led to the resignation of the director of the disease control center, and the agency has been wary of causing panic over influenza cases ever since.

    The unusual strain this year was noticed, Dr. Schuchat said, only because the agency was trying out a new diagnostic test at a Navy laboratory and doing more testing than usual through a new Border Infectious Disease Surveillance Project along the Mexican border.

    Officials at the public health agency in Canada said their Mexican counterparts had warned them this week of a “relatively high” fatality rate for people in Mexico who have had respiratory illnesses this season, some of whom had tested positive for flu. Asked about that, American officials said they had no information. A spokesman said the disease control center had asked Mexican officials to send samples for testing.

    The United States flu season is tailing off now. It has been relatively mild; the major surprise had been the widespread Tamiflu resistance in the circulating human H1N1 strain.

    Dr. Cox of the disease control center said officials did not yet know whether the flu shot this year protected against the new swine strain.


    <nyt_update_bottom></nyt_update_bottom>
    </nyt_text>

  • #2
    Re: WHO - Swine Influenza - Statements and statistics

    WHO. INFLUENZA- LIKE ILLNESS OUTBREAK IN THE US AND MEXICO (Transcript Press Conference, April 25, 2009)

    INFLUENZA- LIKE ILLNESS OUTBREAK IN THE US AND MEXICO

    [Full PDF document available at LINK. EDITED.]

    Transcript of GLOBAL TELEPHONE NEWS CONFERENCE wi t h Dr Ma r g a r e t Ch a n , Di r e c t o r -Ge n e r a l , Wo r l d He a l t h Or g a n i z a t i o n - 2 5 Ap r i l 2 0 0 9


    Snipped


    Journalist from Reuters in Geneva:
    Are you satisfied with the Mexican authorities have enough anti virals to address this outbreak and whether you fell that Tamiflu is going to be the answer to this and whether you have any indication that there is resistance to it among any population or any certain groups affected.

    Dr Chan:
    At this point time the resistance test that has been done by scientist demonstrated that this new virus is sensitive to also Tamiflu. I also had a discussion with the Minister of Health on the issue of medicine. They do have a sizeable supply themselves but of course depending on how the outbreak evolves, WHO stands ready along with international partners to support the government if it is required to acquire additional supply.


    *******

    Comment


    • #3
      Re: Canada: Farm worker with H1N1 may have infected pigs on Alberta farm

      Commentary

      Swine H1N1 Transmision From Human to Swine

      Recombinomics Commentary 07:10
      June 3, 2009

      The pigs in Alberta were thought to be infected by a farm worker who returned from Mexico on April 12 and began working on the farm two days later. Officials noticed the pigs had flu-like symptoms April 24, Evans said.

      Approximately 10 percent of the 2,200 pigs on the farm have been infected, Evans said.

      The above comments describe the transmission of the H1N1 swine flu from an infected farm worker to swine in Alberta, Canada. This efficient transmission from human to swine suggests that much of the speculation in the past week is overly optimistic.

      The virus is swine, WHO newspeak notwithstanding, and contains six swine gene segments as well as a human PB1 and an avian PB2 that have been in swine for more than a decade. Therefore, although swine to swine transmission is not unexpected, the transmission from human to swine is striking. The H1N1 is called swine H1N1 for scientific reason. It is not a “nickname” as some media accounts mis-report, but a descriptive name that defines its normal host. The species differences in sequence are easily determined, and species jumps are rare, but can be deadly. Usually the virus replicates most effectively in its host species.

      The jump to humans is cause for concern. The last time as swine flu jumped to human and was efficiently spread in the new host was in 1918.

      The fact that the virus can jump from human to swine as well as swine to humans suggests this virus is not going to fade away. It has already moved into the southern hemisphere. Suspect cases have been reported in Brazil, Australia, and New Zealand, where the seasonal flu season is just beginning.

      Co-circulation of human and swine H1N1 provide significant opportunities for adaptation to the human host via recombination. Two polymorphisms are already fixed in seasonal flu, H274Y for Tamiflu resistance, and E627K in PB2 which allows the virus to more efficiently replicate at lower temperatures.

      These changes can lead to adaptation in humans, as well antiviral resistance. Therefore, the evolution of the H1N1 over the summer will be closely monitored. The current H1N1 has already acquired tandem human H1N1 polymorphism in HA, which may have led to the species jump from swine to human.

      Thus, the efficient transmission from swine to human and vice versa, raises concerns that further adaptation to humans can lead to a fall pandemic similar to 1918. The species jump indicates the virus can adapt to a new host, and additional acquisitions over the summer continue to be a cause for concern.

      .
      "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

      Comment


      • #4
        CDC Telebriefing May 11, 2009, 1 p.m. ET


        CDC Telebriefing on Investigation of Human Cases of H1N1 Flu
        May 11, 2009, 1 p.m. ET

        Audio recording (MPEG)


        Dave Daigle: This is Dave Daigle from CDC Media Relations. Dr. Anne Schuchat from respiratory diseases will update us on the novel H1N1 outbreak.


        ***Snipped***


        Operator: The next is from Fred Mogul, WNYC. Your line is open.

        Fred Mogul: Yes, hello, Dr. Schuchat. It's a perennial in general question, but concern in a way, perhaps highlighted by the recent outbreak of H1N1 which is to say doctors prescribing, you know, antibiotics much of the year and in this case, antivirals and big rushes reported on pharmacies for Tamiflu. The CDC has been issuing guidelines and for many, many years has been trying to discourage this kind of behavior among physicians. I just wonder what you can say about past and current campaigns on that front.

        Anne Schuchat: You know, appropriate use of antibiotics and antiviral drugs is important. We want the medicines that we have to work when we need them and overuse or abuse of these medicines can contribute to resistance developing in some of the microbes. With the antiviral drugs that have been developed for influenza, the focus right now is on use and treatment and our guidance for this interim time, the H1N1 interim guidance focuses on treatment in persons who are presenting with severe illness or people with underlying medical conditions who might be at risk for a worst time for influenza, so, yes, we do think these are wonderful drugs to use appropriately, but the inappropriate use can contribute to resistance and to them not working when we really need them to.


        ####

        U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

        Comment


        • #5
          Tamiflu resistance in pandemic influenza - historical compilation of news

          Swine flu: Can science save us from the second wave?
          06 May 2009 by Debora MacKenzie


          **snipped**

          The problem with antivirals

          If the prospect of swine flu in its current form isn't worrisome, a drug-resistant strain emerging and going pandemic should be.

          Although the influenza A H1N1 strain now racing around the world is sensitive to two major flu antivirals, oseltamivir (Tamiflu) and zanamivir (Relenza), they put pressure on the virus to develop resistance. "The problem is you use, you lose," says Scott Layne, an epidemiologist at the University of California, Los Angeles.

          A big wake-up call came in the 2007-08 flu season when several strains of H1N1 evolved resistance to Tamiflu. Arnold Monto, an influenza specialist at the University of Michigan, Ann Arbor, says that tests had wrongly suggested that oseltamivir-resistant viruses would be crippled and unlikely to spread widely in humans.

          Now most human H1N1 strains are oseltamivir-resistant, and researchers worry that swine flu could follow suit, either by mutation or through swapping genes. "Commingling is a chilling thought," Layne says. Prudent use of drugs is no guarantee against resistance, Monto says. Resistant strains of human H1N1 developed in countries that skimp on oseltamivir.

          As with HIV, a drug cocktail is one option, as mutations conferring simultaneous resistance to multiple drugs are less likely. A mix of zanamivir and oseltamivir might not be effective, though, Layne cautions. The former works only in the lungs and the latter all over the body, so some flu virus would escape this double treatment.

          The flu outbreak may be winding down in Mexico and causing fewer deaths than feared, but health officials now fear that a more virulent version will return to kill millions

          Comment


          • #6
            Re: Australia defends swine flu cruise ship Pacific Dawn handling

            Fears home may breed superbug

            Kathleen Donaghey
            May 30th, 2009
            <!-- p> THE house of an Oxenford family which contracted both swine flu and influenza A on the Pacific Dawn cruise ship could be the perfect breeding ground for a superbug. </p -->

            THE house of an Oxenford family which contracted both swine flu and influenza A on the Pacific Dawn cruise ship could be the perfect breeding ground for a superbug.

            Nick and Kiralea Campbell are recovering from swine flu in quarantine at home while their children have contracted influenza A.

            Scientists have warned if the two viruses mix it could lead to an aggressive new superbug or, at the very least, one that is resistant to Tamiflu.

            Swine flu and the seasonal flu have been confirmed on the Pacific Dawn cruise.

            Gold Coast influenza expert Professor Mark von Itzstein yesterday described the situation as 'a dangerous environment'.

            Prof von Itzstein said the house would be a 'melting pot' that could lead to a virus rapidly morphing.

            He said people in this situation should be kept in hospital as a matter of priority.

            "If you start co-infecting each other with a different virus, that's the mixing pot," said Prof von Itzstein. "Personally I think if there is, in the same family, two influenza viruses ... they should be placed as a higher risk family.

            "These people should be quarantined in a hospital somewhere," he said.

            Prof von Itzstein said the two viruses could either 're-assort' to create a superbug, or, if the influenza A strain was resistant to Tamiflu, make a superbug also resistant to the anti-viral drug.

            Prof von Itzstein said all governments should be considering the scenario.

            However, if the family was properly quarantined and did not come into contact with any other people, then he said the risks were 'negligible'.

            Fears of a new superbug in Australia have been mounting as the winter season approaches and more people start taking Tamiflu.

            The drug is solely produced by the pharmaceutical company Roche which in recent years had predicted falls in sales. Tamiflu has already been proven useless against several human flu strains, except swine flu, while the drug Relenza, created by Prof von Itzstein works against all flus.

            Australia has more Tamiflu stockpiled than Relenza.

            Mrs Campbell said no one at Queensland Health warned the family of the risks of having the different illness mixing at home.

            "They haven't mentioned that it could change into something more," said Mrs Campbell.

            "I don't think they know what to expect to be honest. They were unprepared and unsure of the outcome to be honest."

            Queensland Health was unable to comment last night.

            Bond University Professor Chris Del Mar said there was potential in Australia for swine flu developing resistance to Tamiflu.

            Prof Del Mar will fly to Geneva in June as Australia's only scientific representative at an upcoming World Health Organisation convention on swine flu.

            For two days a team of experts will develop a set of guidelines to tackle the spread.

            Prof Del Mar said he was concerned Australia and other countries were being 'too liberal' in the use of Tamiflu.

            Some health authorities interstate and overseas have been handing out the drug to school children who may have been exposed but weren't sick.

            "It might be a very good thing if we're all sick and dying. I'm not sure if we should be using it on people at the same school as someone infected," he said.

            Meanwhile, Australia's National Health and Research Council yesterday announced $7 million for groups wanting to undertake research into swine flu.

            Prof von Itzstein, who heads Griffith University's Institute for Glycomics, said his team would apply so they could study the flu's susceptibility to antiviral medications and its capacity to change.

            Comment


            • #7
              Re: NZ Swine flu tally 258

              Swine flu mutation, drug resistance feared



              The Press


              Last updated 05:00 22/06/2009
              Share

              Swine flu may become resistant to Tamiflu if it mingles with one of this season's influenza strains, experts warn.
              World-renowned Canterbury virologist Dr Lance Jennings said one of the two strains of seasonal influenza circulating this year was resistant to Tamiflu.
              It was possible this resistant strain would mutate with the influenza A (H1N1) virus and affect Tamiflu's ability to medicate swine flu, Jennings said.
              "Viruses do mutate ... The only thing we can do is be prepared."
              If swine flu became resistant to Tamiflu, New Zealand had stocks of another drug, Relenza, that could combat influenza, he said. Relenza was developed before Tamiflu and its chemical makeup made it tougher for viruses to develop resistance.

              "If A (H1N1) became resistant to Tamiflu, that would be bad. But the worst-case scenarios are Avian flu mutating, so it can spread between humans, or the swine flu developing into a more deadly form," Jennings said.
              Environmental Science and Research virologist Sue Huang, head of the World Health Organisation national influenza centre in Upper Hutt, also voiced concerns.
              "Viruses are notoriously unpredictable and strains change constantly ... if there was mixing of the novel virus with other A/H1N1 strains circulating, such as in a person infected with both strains, the novel virus could take on resistant characteristics," she said.

              Seriously ill swine flu patients flocked to Canterbury's new influenza centre over the weekend. More than 142 people had visited the Christchurch assessment centre since it opened on Friday. All were "reasonably or seriously" unwell, with symptoms such as high fever, rasping coughs and breathing problems, centre managers said.
              Yesterday, the Ministry of Health said a rise in cases of serious illness was inevitable. The number of confirmed cases nationwide is 258 an increase of 42 since Friday. More than 200 of those cases had been reported in the past week, mainly in the three major cities.

              Last night Canterbury had 67 confirmed cases. However, there was only one other case in the Nelson-Marlborough region in the South Island.
              Canterbury Primary Pandemic Group co-ordinator Phil Schroeder said the screening centre was seeing only those with more serious flu symptoms.
              Concerned Cantabrians had been calling the free information and triage line, meaning only those who needed to see a doctor came to the centre, he said.
              A 30-year-old woman remained in a critical condition in Wellington Hospital last night with swine flu, and underlying medical problems.

              Ministry of Health director of public health Dr Mark Jacobs said while most cases had been mild to moderate, over the coming weeks and months there would be a big increase in the number and severity of cases
              People who did not have serious symptoms should stay at home and leave health services for those who needed them most.
              If you think you have swine flu, ring 0800 373



              As i have said before the NZ govt has only stockpiled tamiflu and recently aquired 125,000 courses of relenza - which won't go far - at this point in time relenza is available thru private sector at Lee and Hart pharmacy in warkworth nth of auckland. they will post it to you - you will need a presciption from your Dr - to get this - you will need to be showing symptoms or be planning an overseas trip. Worthwhile taking with you incase the much expected tamiflu resistant mutation is aquired - hospitals all full and you are basically on your own.

              Comment


              • #8
                Tamiflu resistance in pandemic influenza - historical compilation of news

                Thomson Reuters empowers professionals with cutting-edge technology solutions informed by industry-leading content and expertise.

                Australia, NZ, Taiwan, Singapore order Relenza-GSK
                29 Jun 2009 07:57:29 GMT
                Source: Reuters
                SINGAPORE, June 29 (Reuters) - The governments of Australia, New Zealand, Taiwan and Singapore have bought GlaxoSmithKline's <GSK.L> Relenza flu treatment since the H1N1 outbreak began in April, a top GSK official said on Monday.

                GSK Asia Pacific director Christophe Weber told Reuters the firm had advised governments to keep the inhaled Relenza drug at 30-50 percent of their overall flu drug stockpiles, which mainly comprise the Tamiflu capsule made by competitor Roche <ROG.VX>.

                "There have been some publications showing that there is some level of resistance developed for Tamiflu," Weber said on the sidelines of a GSK media seminar in Singapore.

                "In case there will be more resistance to Tamiflu, and Relenza will be a good alternative," he said.

                Weber declined to say amount or value of orders by the four countries, saying he would rather those governments disclosed their orders themselves.

                Glaxo's partner Biota Holdings <BTA.AX>, which originally developed the medicine and earns a 10 percent royalty on Australian sales, said in May that Canberra had bought an additional 1.6 million courses at A$43 million ($33.7 million).

                On completion of the supply contract, the Australian National Medical Stockpile will hold 3.4 million courses of Relenza, or 33 percent of the country's total stockpile of antiviral flu drugs.

                The World Health Organisation (WHO) declared the first 21st century flu pandemic this month and advised governments to prepare for a long battle against the new H1N1 flu virus.

                As of June 26, it had killed 306 worldwide with the number of confirmed cases of H1N1 at least 67,072.

                The flu has spread widely after emerging in April in Mexico and the United States. The WHO warned the pandemic could last a year or two. (Reporting by Nopporn Wong-Anan; Editing by Alex Richardson)

                AlertNet news is provided by
                "The only security we have is our ability to adapt."

                Comment


                • #9
                  Tamiflu resistance in pandemic influenza - historical compilation of news

                  caution - google translated

                  The first case in the world of resistance to influenza drug Tamiflu in people with influenza H1N1 has been found in Denmark.


                  Dane resistant to Tamiflu

                  29. June 2009

                  The first case in the world of resistance to influenza drug Tamiflu in people with influenza H1N1 has been found in Denmark.

                  The person is now healthy, and there is no further evidence of infection with resistant virus, according to Statens Serum Institut.

                  Comment


                  • #10
                    Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

                    Dane resistant to pandemic medicine

                    / Ritzau /

                    Last updated on Monday 29th June 2009, 15:30

                    The first case in the world of resistance to influenza drug Tamiflu in people with influenza H1N1 has been found in Denmark. The person is now healthy, and there is no further evidence of infection with resistant virus, according to Statens Serum Institut.

                    The infection had been in close contact with another infected person, and was therefore prevented treatment with Tamiflu. Yet the person had flu symptoms and are instead treated with another type of flu drugs, Relenza. World Health Organization Calls for the Danish case for more attention to the possibility of development of resistance in the virus.

                    It is not unusual for a flu virus mutating spontaneously and in a press release calls the Statens Serum Institut is "well known and expected." They also emphasized that it does not pose a threat to public health. /

                    Comment


                    • #11
                      Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

                      Articles say no spreading of this resistant strain was found.

                      Articles also say the man was treated with Tamiflu first, but kept displaying symptoms, than he was treated with Relenza. And was cured.

                      Comment


                      • #12
                        Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

                        Official press release, credits theforeigner for the link.

                        caution google translated, please correct if translation is wrong.


                        29. June 2009 -

                        Resistance of pandemic influenza A H1N1v detected in Denmark

                        The first case of resistance to oseltamivir (Tamiflu ?) in the pandemic influenza A H1N1v found in Denmark. This is the first identified cases worldwide.

                        It is well known and expected that influenza virus can mutate spontaneously. Resistance has not changed the virus' ability to infect or cause disease, the assessment is that they are a relatively mild flu.

                        The person is now healthy, and there is no further evidence of infection with resistant virus. The infection was in preventative treatment with oseltamivir (Tamiflu ?) because of close contact with a case that was infected abroad.

                        Yet he had flu symptoms. A test showed that the person was infected with influenza A H1N1v. Further studies at Statens Serum Institut has now shown that the virus has mutated. It is resistant to the antiviral agent oseltamivir (Tamiflu ?), while zanamivir (Relenza ?) can continue to be used for treatment.


                        World Health Organization Calls on the basis of the Danish case for increased attention to the possibility of development of resistance in the pandemic influenza A H1N1v.

                        A similar development of resistance to oseltamivir (Tamiflu ?) is also seen in the winter influenza A H1N1, which has circulated the past two winter seasons.

                        Each fund in Denmark is mentioned not unexpected. It does not constitute a risk to public health and does not need to change the recommendations for the use of oseltamivir (Tamiflu ?).

                        In Denmark the situation continues to follow closely in the monitoring of disease incidence and investigation of all isolated influenza A H1N1v.

                        Comment


                        • #13
                          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.

                          Comment


                          • #14
                            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&#180;t be sure which it is). After 5 days treatment with Tamiflu, the person suddenly got sick with H1N1, but it didn&#180;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&#180;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.






                            Dansker er resistent overfor Tamiflu



                            En dansker er som den f&#248;rste 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 f&#248;rste person i verden, der er resistent overfor medicinen oseltamivir, der s&#230;lges under navnet Tamiflu og blandt andet har vist sig virksom mod svineinfluenzaen H1N1.

                            Det er det f&#248;rste tilf&#230;lde af resistens overfor medicinen p&#229; verdensplan. Det er forventeligt, at influenzavirus kan mutere spontant. Resistensen har ikke &#230;ndret H1N1-virus’ evne til at smitte eller fremkalde sygdom, meddeler instuttet.

                            - B&#229;de bakterier og vira kan mutere og blive resistente. Og det er alts&#229; det, der er sket her, bekr&#230;fter administrerende direkt&#248;r p&#229; Statens Serums Institut Nils Strandberg.

                            - Vedkommende var til at begynde med slet ikke syg. Den p&#229;g&#230;ldende var i forebyggende behandling med Tamiflu, fordi vedkommende havde v&#230;ret i t&#230;t kontakt med en svineinfluenza-ramt i udlandet. Da der var g&#229;et fem dage med Tamiflu, blev personen s&#229; pludselig syg med H1N1, men det s&#229; ikke ud til, at medicinen virkede. Det viste sig s&#229; via pr&#248;ver her og i England, at personen var blevet resistens, fort&#230;ller Nils Strandberg.

                            Uheldigt for alvorligt syge
                            I stedet blev patienten behandlet med medicinen Relenza.

                            - Vi kan gl&#230;de 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 l&#230;ngere kan betragtes som et sikkert middel mod svineinfluenza?

                            - Ja, det er bekymrende, hvis Tamiflu ikke virker p&#229; de mest udsatte grupper. Men der er stadig noget at g&#248;re, hvis en svagelig patient bliver smittet med H1N1. Der er jo et andet stof, som man kan bruge.

                            Skruer ned for forebyggende brug
                            If&#248;lge Nils Strandberg vil fundet af den resistente dansker betyde, at l&#230;gerne fremover vil blive mere tilbageholdende med at bruge Tamiflu forebyggende - med mindre der alts&#229; ligefrem er tale om meget syge og skr&#248;belige patienter.

                            - Hvorfor er det netop en dansker, der bliver den f&#248;rste resistente influenza-patient?

                            - Det beror nok mest p&#229; et tilf&#230;lde. Vi har et godt system, hvor vi er gode til at overv&#229;ge situationen.

                            Episoden sl&#229;r fast, at influenza-virus kan mutere, og at Tamiflu p&#229; ingen m&#229;de kan betragtes som mirakelmedicin. Tamiflu kan i forvejen ikke kurere influenza, men medicinen kan neds&#230;tte symptomerne og forkorte forl&#248;bet.

                            Epidemi til efter&#229;ret
                            Selv om sommeren, udend&#248;rslivet og de lukkede skoler er ensbetydende med mindre influenzasmitte i Danmark, vil danskernes rejseaktivitet sommeren over betyde, at der bliver sl&#230;bt mere smitte til landet.

                            - Vi skal formodentlig frem til det sene efter&#229;r eller vinter, f&#248;r vi kan risikere en H1N1-epidemi herhjemme. Men det beh&#248;ver ikke at give problemer, da det stadig er en ret mild influenzatype, siger Nils Standberg.

                            Comment


                            • #15
                              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

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