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Two Tamiflu-resistant swine flu cases reported in Washington
Re: Two Tamiflu-resistant swine flu cases reported in WA
To my knowledge none of the other instances of Tamiflu resistance have been in people with immune system problems, but it seems very likely that segment of the population has received a fair amount of Tamiflu. Really, what is the likelihood that two people in the same county developed it spontaneously?
Wotan (pronounced Voton with the ton rhyming with on) - The German Odin, ruler of the Aesir.
I am not a doctor, virologist, biologist, etc. I am a layman with a background in the physical sciences.
To my knowledge none of the other instances of Tamiflu resistance have been in people with immune system problems, but it seems very likely that segment of the population has received a fair amount of Tamiflu. Really, what is the likelihood that two people in the same county developed it spontaneously?
As the frequency of detection / reporting increases, the likelihood that these acquistions are due to random mutations becomes increasingly remote. The best data for the silent spread actually is the Singapore patient, which was said to be sensitive in the initial test, which was on May 28. The resistance was on a May 30 sample, too soon for "spontaneous" generation.
H274Y is clearly spreading silently, and detection rates will increase (which will be very clear very soon, unless the data is withheld, as was announced by WHO earlier this week).
any such reassortment is dangerous since it could change virulence.
e.g. it could acquire PB1 with a functional PB1-F2
reassortment means prolonged evolution. Once it goes loose
the virus may get other ideas how to change
It "could" do a lot of things. However, swine H1N1 that acquires human N almost always also acquires human H. In Sasketchewan, 2 or 3 farm workers were infected with a triple reassortant that was Tamiflu resistance because the virus had acquired the N1 from Bisbane/59, which had H274Y. However, it also acquired H1 from Brisbane/59, so the resulting virus had a human H1N1 serotype, but a pandemic strain is defined by a new serotype. Brisbane/59 H1N1 is not new (and most humans have immunity by virtue of earlier H1N1 seasonal flu infections and earlier vaccination with Brisbane/59 H1N1).
Re: Two Tamiflu-resistant swine flu cases reported in WA
usually all sorts of reassortments do happen, there are many examples.
I wouldn't rely on HA and NA going to gether.
They didn't in the 1968 pandemic nor in human/swine H1N2
Re: Two Tamiflu-resistant swine flu cases reported in WA
Here's a timeline for when the resistance appeared:
1. On May 31, he developed symptoms. Virus showed susceptibility in samples taken on June 4 but resistance in those taken on June 11, July 14 & 30.
On August 6, pyrosequencing at CDC of viral RNA from a specimen collected on June 4 revealed susceptibility to oseltamivir. However, pyrosequencing of a follow-up specimen collected on July 30 indicated oseltamivir resistance, based on detection of the H275Y mutation
On August 10, CDC received previously collected virus isolates from the patient for pyrosequencing on August 11, which confirmed the previous results. A novel influenza A (H1N1) virus isolate from a specimen collected on May 31 was identified as susceptible to oseltamivir by pyrosequencing at CDC, but viruses isolated from specimens collected on June 11 and July 14 had the H275Y mutation, indicating oseltamivir resistance.
2. June 21, she developed symptoms. Virus showed susceptibility in samples taken on June 21 but resistance in those taken on July 14 & 28.
On August 6, CDC determined that pyrosequencing of viral RNA from the first clinical specimen collected on June 21 did not detect the H275Y mutation. However, the mutation was detected by pyrosequencing of viral RNA from a nasal wash specimen collected on July 28. Treatment of the patient with oseltamivir was discontinued when results became available.
On August 10, CDC received other previously collected virus isolates from this patient for testing, and pyrosequencing of a virus isolated from a specimen collected on July 14 had the H275Y mutation, confirming oseltamivir resistance.
The salvage of human life ought to be placed above barter and exchange ~ Louis Harris, 1918
usually all sorts of reassortments do happen, there are many examples.
I wouldn't rely on HA and NA going to gether.
They didn't in the 1968 pandemic nor in human/swine H1N2
The H1N2 in human or swine H1N2 are both human. 1968 didn't involve swine genes.
Wrong. The acquiring a Brisbane/59 H and N would produce a strain similar to seasonal H1N1 (population would already have antibodies). Its hopes and dreams on steroid.
It has already happened in Saskatchewan with another triple reassortant.
I take it by this very surprising response that it is your view that the existing Swine Flu cannot reassort with Seasonal Flu to acquire only the NA segment making it Tamiflu resistant.
Otherwise, none of this makes any sense, or you have just misinterpreted the question posed.
Many of us in our responses agree with you on your recombination theory of Tamiflu resistance acquisition, but a reader would not necessarily get that impression by the way you respond to our posts on this forum. You simply say "no" or "wrong" to anything anyone else posts.
Re: Two Tamiflu-resistant swine flu cases reported in Washington
I admit to being confused even after Niman explained.
By the little summary I posted, I thought it was clear that the resistance developed "in" both people and was not the result of seasonal combining with panflu (or silent spreading). Considering that a certain percent of people will normally develop a resistance to Tamiflu, I just imagined this was much better than if it had combined.
The salvage of human life ought to be placed above barter and exchange ~ Louis Harris, 1918
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