Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

[Commonground]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

yes, Alaska Denise, that explains it. Thanks.

[AlaskaDenise]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

If she was traveling as part of a group that was larger than her family, others in that group may have been ill, so they tested the whole group.


.

[Commonground]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

OK. If she was asymptomatic, why was she intercepted at the airport? It was routine testing. Don't understand.

ETA: It was a lie?

[HenryN]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

<TABLE dir=ltr border=1 cellSpacing=0 cellPadding=7 width=831><TBODY><TR><TD height=0 vAlign=top width="13%">

98

</TD><TD height=0 vAlign=top width="13%">F/36
</TD><TD height=0 vAlign=top width="13%">Asymptomatic
</TD><TD height=0 vAlign=top width="13%">Returned from San Francisco with mother and
</TD><TD height=0 vAlign=top width="13%">Imported
</TD><TD height=0 vAlign=top width="13%">Singapore Airlines(flight no SQ1) Arrived on June 11
</TD><TD height=0 vAlign=top width="13%">Daughter (confirmed patient), mother, two sisters , a brother
</TD><TD height=0 vAlign=top width="13%">Ping Tin Estate

</TD></TR></TBODY></TABLE>

The above data indicates the patient with Tamiflu resistant H1N1 was ASYMPTOMATIC!

[HenryN]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

<TABLE class=tableBlue border=0 cellSpacing=0 cellPadding=0 width="100&#37;"><TBODY><TR><TD colSpan=2>04th July 2009 - Saturday - Flight Number SQ1 / Aircraft (B777-300ER)

</TD></TR><TR><TD colSpan=2><TABLE class=tableWhite width="100%"><TBODY><TR class=tableBlue><TD></TD><TD>Airport</TD><TD>Scheduled Time</TD><TD>Actual Time</TD><TD>Estimated Time</TD><TD>Status</TD></TR><TR><TD>Departure From </TD><TD>San Francisco (SFO) </TD><TD>01:05 (-1) </TD><TD>00:56 (-1) </TD><TD></TD><TD>Departed </TD></TR><TR><TD>Arrival In </TD><TD>Hong Kong (HKG) </TD><TD>06:35 </TD><TD></TD><TD>06:01 </TD><TD>Not Yet Arrived </TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>

[HenryN]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

The virus was isolated from the specimen taken from a 16-year-old girl coming from San Francisco. She was intercepted by Port Health Office at the Hong Kong International Airport on June 11 upon arrival. The girl was then admitted to Queen Mary Hospital for isolation. She was tested positive to HSI but opted not to take tamiflu. She had mild symptoms and was eventually discharged upon recovery on June 18.

[HenryN]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

<TABLE dir=ltr border=1 cellSpacing=0 cellPadding=7 width=114><TBODY><TR><TD height=0 vAlign=top>

daughter (confirmed patient) on June 11
Admitted to United Christian Hospital (UCH) on June 12

</TD></TR></TBODY></TABLE>

[HenryN]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

<TABLE dir=ltr border=1 cellSpacing=0 cellPadding=7 width=831><TBODY><TR><TD height=0 vAlign=top width="13%">

98

</TD><TD height=0 vAlign=top width="13%">

F/36

</TD><TD height=0 vAlign=top width="13%">

Asymptomatic

</TD><TD height=0 vAlign=top width="13%">

Returned from San Francisco with mother and

</TD><TD height=0 vAlign=top width="13%">

Imported

</TD><TD height=0 vAlign=top width="13%">

Singapore Airlines(flight no SQ1) Arrived on June 11

</TD><TD height=0 vAlign=top width="13%">

Daughter (confirmed patient), mother, two sisters , a brother

</TD><TD height=0 vAlign=top width="13%">

Ping Tin Estate

</TD></TR></TBODY></TABLE>

[HenryN]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

The seventh case is a 15-year-old girl studying in the United States. She returned to Hong Kong via Tokyo on June 11 by taking a flight of Northwest Airlines (flight no. NW7). She sat in row 33 of the flight.

She developed sore throat on June 11 and fever on the next day. She was admitted to UCH on June 12 for isolation.

http://www.chp.gov.hk/content.asp?la...d=17457&id=116

Flight Schedule 1 <!--flight_option--><!-- begin_flignt_no -->
Flight: NW 344 <!-- flight_no -->
<LABEL><FORM style="MARGIN-BOTTOM: 0px" method=post name=FlifoForm0 action=/cgi-bin/flifo2.pro><INPUT value=344 type=hidden name=flight> <INPUT value=02JUL type=hidden name=day> </FORM>View Flight Status </LABEL><!-- view_status -->



<!-- begin_leg -->Departs: San Francisco-Int'l, CA (SFO) <!-- dep_airport -->at 12:30AM <!-- dep_time -->
Arrives: Detroit-Wayne County Int'l, MI (DTW) <!-- arr_airport -->at 07:56AM <!-- arr_time -->
<!-- begin_flignt_no --> Flight: NW 25 <!-- flight_no -->
<LABEL><FORM style="MARGIN-BOTTOM: 0px" method=post name=FlifoForm1 action=/cgi-bin/flifo2.pro><INPUT value=25 type=hidden name=flight> <INPUT value=02JUL type=hidden name=day> </FORM>View Flight Status </LABEL><!-- view_status -->



<!-- begin_leg -->Departs: Detroit-Wayne County Int'l, MI (DTW) <!-- dep_airport -->at 03:20PM <!-- dep_time -->
Arrives: Tokyo-Narita, Japan (NRT) <!-- arr_airport -->at 05:05PM <!-- arr_time -->
<!-- begin_flignt_no --> Flight: NW 29 <!-- flight_no -->
<LABEL><FORM style="MARGIN-BOTTOM: 0px" method=post name=FlifoForm2 action=/cgi-bin/flifo2.pro><INPUT value=29 type=hidden name=flight> <INPUT value=02JUL type=hidden name=day> </FORM>View Flight Status </LABEL><!-- view_status -->



<!-- begin_leg -->Departs: Tokyo-Narita, Japan (NRT) <!-- dep_airport -->at 06:50PM <!-- dep_time -->
Arrives: Hong Kong-Int'l, Hong Kong (HKG) <!-- arr_airport -->at 10:20PM +1

[HenryN]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

The seventh case is a 15-year-old girl studying in the United States. She returned to Hong Kong via Tokyo on June 11 by taking a flight of Northwest Airlines (flight no. NW7). She sat in row 33 of the flight.

She developed sore throat on June 11 and fever on the next day. She was admitted to UCH on June 12 for isolation.

http://www.chp.gov.hk/content.asp?lang=en&info_id=17457&id=116

[HenryN]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

The seventh imported case involved a 10-year-old girl. She returned to Hong Kong from San Francisco by taking a flight of Singapore Airlines (flight no. SQ1) on June 11. She sat in row 50 of the flight.

http://www.chp.gov.hk/content.asp?lang=en&info_id=17467&id=116

[gjs47]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

At this time there appears to be one reliable and accessible source of correct information on what's really going on. If that's really the case, protecting that source and supply would be a priority.

We watched the spread of the current version, even as it affected your school district and locale. You kept an continuous update on the current status at that time.

Are you prepared to sip? If so, and knowing the changing situation and it's pending possibilities and/or probabilities, at what point are you going to sip? Are you going to send an advisory to notify others that you have made that decision?

Thank you for all you do and say.

[HenryN]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

Here;s data for Hawaii at Genbank. One NA sequence that was just deposited from a collection in April

LOCUS GQ338360 1410 bp cRNA linear VRL 01-JUL-2009
DEFINITION Influenza A virus (A/Hawaii/09/2009(H1N1)) segment 6 neuraminidase
(NA) gene, complete cds.
ACCESSION GQ338360
VERSION GQ338360.1 GI:243031419
DBLINK Project:37813
KEYWORDS .
SOURCE Influenza A virus (A/Hawaii/09/2009(H1N1))
ORGANISM Influenza A virus (A/Hawaii/09/2009(H1N1))
Viruses; ssRNA negative-strand viruses; Orthomyxoviridae;
Influenzavirus A.
REFERENCE 1 (bases 1 to 1410)
AUTHORS Garten,R.
TITLE Direct Submission
JOURNAL Submitted (01-JUL-2009) Centers for Disease Control and Prevention,
NCIRD/Influenza Division/VSDB, Centers for Disease Control and
Prevention, Atlanta, 1600 Clifton Road, N.E., Atlanta, GA 30333,
USA
COMMENT Swine influenza A (H1N1) virus isolated during human swine flu
outbreak of 2009. For more information, see http://www.cdc.gov/.

Some of the information does not have GenBank feature identifiers
and is being provided in the comment section.

##EpifluData-START##
Isolate A/Hawaii/09/2009
Subtype H1N1
Segment_name NA
Host_gender F
Host_age 37
Passage_history C1
Antigen_character A/California/07/2009-LIKE (H1N1)V
Adamantane_resistance resistant
Zanamivir_resistance sensitive
Oseltamivir_resistance sensitive
Country USA
State/Province Hawaii state
Collection_day 30
Collection_month 4
Collection_year 2009
Isolate_note Comment: Human case of 2009 H1N1 swine
influenza.
EPI_accession EPI184367
Lineage swl
##EpifluData-END##
FEATURES Location/Qualifiers
source 1..1410
/organism="Influenza A virus (A/Hawaii/09/2009(H1N1))"
/mol_type="viral cRNA"
/strain="A/Hawaii/09/2009"
/serotype="H1N1"
/host="Homo sapiens; gender F; age 37"
/db_xref="taxon:656491"
/segment="6"
/country="USA: Hawaii state"
/collection_date="30-Apr-2009"
gene 1..1410
/gene="NA"
CDS 1..1410
/gene="NA"
/codon_start=1
/product="neuraminidase"
/protein_id="ACS94509.1"
/db_xref="GI:243031420"
/translation="MNPNQKIITIGSVCMTIGMANLILQIGNIISIWISHS IQLGNQN
QIETCNQSVITYENNTWVNQTYVNISNTNFAAGQSVVSVKLAGNSSLCPV GGWAIYSK
DNSVRIGSKGDVFVIREPFISCSPLECRTFFLTQGALLNDKHSNGTIKDR SPYRTLMS
CPIGEVPSPYNSRFESVAWSASACHDGINWLTIGISGPDNGAVAVLKYNG IITDTIKS
WRNNILRTQESECACVNGSCFTVMTDGPSNGQASYKIFRIEKGKIVKSVE MNAPNYHY
EECSCYPDSSEITCVCRDNWHGSNRPWVSFNQNLEYQIGYICSGIFGDNP RPNDKTGS
CGPVSSNGANGVKGFSFKYGNGVWIGRTKSISSRNGFEMIWDPNGWTGTD NNFSIKQD
IVGINEWSGYSGSFVQHPELTGLDCIRPCFWVELIRGRPKENTIWTSGSS ISFCGVNS
DTVGWSWPDGAELPFTIDK"
ORIGIN
1 atgaatccaa accaaaagat aataaccatt ggttcggtct gtatgacaat tggaatggct
61 aacttaatat tacaaattgg aaacataatc tcaatatgga ttagccactc aattcaactt
121 gggaatcaaa atcagattga aacatgcaat caaagcgtca ttacttatga aaacaacact
181 tgggtaaatc agacatatgt taacatcagc aacaccaact ttgctgctgg acagtcagtg
241 gtttccgtga aattagcggg caattcctct ctctgccctg ttggtggatg ggctatatac
301 agtaaagaca acagtgtaag aatcggttcc aagggggatg tgtttgtcat aagggaacca
361 ttcatatcat gctccccctt ggaatgcaga accttcttct tgactcaagg ggccttgcta
421 aatgacaaac attccaatgg aaccattaaa gacaggagcc catatcgaac cctaatgagc
481 tgtcctattg gtgaagttcc ctctccatac aactcaagat ttgagtcagt cgcttggtca
541 gcaagtgctt gtcatgatgg catcaattgg ctaacaattg gaatttctgg cccagacaat
601 ggggcagtgg ctgtgttaaa gtacaacggc ataataacag acactatcaa gagttggaga
661 aacaatatat tgagaacaca agagtctgaa tgtgcatgtg taaatggttc ttgctttact
721 gtaatgaccg atggaccaag taatggacag gcctcataca agatcttcag aatagaaaag
781 ggaaagatag tcaaatcagt cgaaatgaat gcccctaatt atcactatga ggaatgctcc
841 tgttatcctg attctagtga aatcacatgt gtgtgcaggg ataactggca tggctcgaat
901 cgaccgtggg tgtctttcaa ccagaatctg gaatatcaga taggatacat atgcagtggg
961 attttcggag acaatccacg ccctaatgat aagacaggca gttgtggtcc agtatcgtct
1021 aatggagcaa atggagtaaa aggattttca ttcaaatacg gcaatggtgt ttggataggg
1081 agaactaaaa gcattagttc aagaaacggt tttgagatga tttgggatcc gaacggatgg
1141 actgggacag acaataactt ctcaataaag caagatatcg taggaataaa tgagtggtca
1201 ggatatagcg ggagttttgt tcagcatcca gaactaacag ggctggattg tataagacct
1261 tgcttctggg ttgaactaat cagagggcga cccaaagaga acacaatctg gactagcggg
1321 agcagcatat ccttttgtgg tgtaaacagt gacactgtgg gttggtcttg gccagacggt
1381 gctgagttgc catttaccat tgacaagtaa

</PRE></P>

[HenryN]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

I don't see any reports saying she was a resident of California. She could have been from HK and was visiting San Francisco. If she traveled with a group, someone else in that group could have infected her.

For that matter she could have been from anywhere and simply had a layover in San Francisco before traveling to HK.

.

Lost of woulda couldas shoulda's but ZERO sequences. Although Denmark, Japan, and Hong Kong have all described the resistance, none have sequences on deposit. San Francisco to Kong Kong is a long plane ride and others could have been infected in flight.

It is past time to step up sequencing and data release. California sequences from CDC seem to be from patients infected in April.

There is a serious data lag with MAJOR database holes, even in the US.

I STRONG suspect H274Y is widespead and silently spreading in mild cases, including the US where mild cases are NOT even tested at this point.

[AlaskaDenise]

Re: Hong Kong: Detection of human swine influenza virus resistant to Tamiflu in person from USA

It's highly probable she could be traveling HK to CA to HK. Also, Toronto to SF to HK, or Cancun to SF to HK. Or HK to west coast cruise to SF to HK.

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