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Oseltamivir-Resistant Influenza Virus A (H1N1), Europe, 2007?08 Season (EID, Abstract, edited)
[Original Full Document: LINK. EDITED.]
DOI: 10.3201/eid1504.081280
Suggested citation for this article: Meijer A, Lackenby A, Hungnes O, Lina B, van der Werf S, Schweiger B, et al. Oseltamivir-resistant influenza A (H1N1) virus, Europe, 2007?08 season. Emerg Infect Dis. 2009 April; [Epub ahead of print]
Oseltamivir-Resistant Influenza Virus A (H1N1), Europe, 2007?08 Season
Adam Meijer, Angie Lackenby, Olav Hungnes, Bruno Lina, Sylvie van der Werf, Brunhilde Schweiger, Matthias Opp, John Paget, Jan van de Kassteele, Alan Hay, and Maria Zambon, on behalf of the European Influenza Surveillance Scheme(1)
Author affiliations:
Netherlands Institute for Health Services Research, Utrecht, the Netherlands (A. Meijer, J. Paget); National Institute for Public Health and the Environment, Bilthoven, the Netherlands (A. Meijer, J. van de Kassteele); European Surveillance Network for Vigilance against Viral Resistance (A. Lackenby, B. Lina, S. van der Werf, A. Hay, M. Zambon); Health Protection Agency, London, UK (A. Lackenby, M. Zambon); Norwegian Institute of Public Health, Oslo, Norway (O. Hungnes); Centre National de R?f?rence des Virus Influenza (R?gion Sud), Lyon, France (B. Lina); Centre National de R?f?rence des Virus Influenza (R?gion Nord), Paris, France (S. van der Werf); Robert Koch Institute, Berlin, Germany (B. Schweiger); Laboratoire National de Sant?, Luxembourg, Luxembourg (M. Opp); and World Health Organization Collaborating Centre Medical Research Council/National Institute of Medical Research, London, UK (A. Hay)
(1) European Influenza Surveillance Scheme members, 2007?08 season: P. Lachner, T. Popow-Kraupp, R. Strauss (Austria); B. Brochier, M. Sabbe, I. Thomas, V. Casteren, F. Yane (Belgium); T. Georgieva, M. Kojouharova, R. Kotseva, A. Kurchatova (Bulgaria); B. Aleraj, V. Drazenovic (Croatia); D. Bagatzouni-Pieridou, A. Elia (Cyprus); M. Havlickova, J. Kyncl (Czech Republic); S. Glismann, A. Mazick, L. Nielsen (Denmark); D.M. Fleming, A. Lackenby, J. Watson, M. Zambon (England); O. Sadikova, I. Sarv (Estonia); T. Ziegler (Finland); J.-M. Cohen, V. Enouf, B. Lina, A. Mosnier, M. Valette, S. van der Werf (France); U. Buchholz, W. Haas, B. Schweiger (Germany); A.G. Kossivakis, V. Kyriazopoulou-Dalaina, A. Mentis, G. Spala (Greece); G. Berencsi, A. Csoh?n, I. Jankovics (Hungary); S. Coughlan, L. Domegan, M. Duffy, M. Joyce, J. O?Donnell, D. O'Flanagan (Ireland); F. Ansaldi, P. Crovari, I. Donatelli, F. Pregliasco (Italy); R. Nikiforova, I. Van Velicko, N. Zamjatina (Latvia); A. Griskevicius, N. Kupreviciene, G. Rimseliene (Lithuania); J. Mossong, M. Opp (Luxembourg); C. Barbara, T. Melillo (Malta); A. Arkema, T. Meerhoff, W.J. Paget, K. van der Velden, (EISS-CC, the Netherlands), F. Dijkstra, G. Donker, J.C. de Jong, A. Meijer, G. Rimmelzwaan, M. van der Sande, B. Wilbrink (the Netherlands); P. Coyle, H. Kennedy, H. O?Neill (Northern Ireland); O. Hungnes, B. Iversen (Norway); L. Brydak, M. Romanowska (Poland); I.M. Falc?o, J.M. Falc?o, H. Rebelo de Andrade (Portugal); V. Alexandrescu, E. Lupulescu (Romania); W. Carman, R. Gunson, J. Kean, J. McMenamin (Scotland); N. Milic, J. Nedeljkovic (Serbia); H. Blaskovicova, Z. Kristufkova, M. Sl?cikov? (Slovakia); K. Prosenc, M. Socan (Slovenia); I. Casas, A. Larrrauri, S. de Mateo, R. Ortiz de Lejarazu, P. P?rez-Bre?a, T. Pumarola Su??, T. Vega Alonso (Spain); M. Brytting, A. Linde, P. Penttinen, S. Rubinova (Sweden); Y. Thomas, M. Witschi (Switzerland); N. Yilmaz (Turkey); M. Aranova, A. Mironenko (Ukraine); A. Hay (United Kingdom); and R. Jones, D. Thomas (Wales).
In Europe, the 2007?08 winter season was dominated by influenza virus A (H1N1) circulation through week 7, followed by influenza B virus from week 8 onward. Oseltamivir-resistant viruses A (H1N1) (ORVs) with H275Y mutation in the neuraminidase emerged independently of drug use. By country, the proportion of ORVs ranged from 0% to 68%, with the highest proportion in Norway. The average weighted prevalence of ORVs across Europe increased gradually over time, from near 0 in week 40 of 2007 to 56% in week 19 of 2008 (mean 20%). Neuraminidase genes of ORVs possessing the H275Y substitution formed a homogeneous subgroup closely related to, but distinguishable from, those of oseltamivir-sensitive influenza viruses A (H1N1). Minor variants of ORVs emerged independently, indicating multiclonal ORVs. Overall, the clinical effect of ORVs in Europe, measured by influenza-like illness or acute respiratory infection, was unremarkable and consistent with normal seasonal activity.
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[Original Full Document: LINK. EDITED.]
DOI: 10.3201/eid1504.081280
Suggested citation for this article: Meijer A, Lackenby A, Hungnes O, Lina B, van der Werf S, Schweiger B, et al. Oseltamivir-resistant influenza A (H1N1) virus, Europe, 2007?08 season. Emerg Infect Dis. 2009 April; [Epub ahead of print]
Oseltamivir-Resistant Influenza Virus A (H1N1), Europe, 2007?08 Season
Adam Meijer, Angie Lackenby, Olav Hungnes, Bruno Lina, Sylvie van der Werf, Brunhilde Schweiger, Matthias Opp, John Paget, Jan van de Kassteele, Alan Hay, and Maria Zambon, on behalf of the European Influenza Surveillance Scheme(1)
Author affiliations:
Netherlands Institute for Health Services Research, Utrecht, the Netherlands (A. Meijer, J. Paget); National Institute for Public Health and the Environment, Bilthoven, the Netherlands (A. Meijer, J. van de Kassteele); European Surveillance Network for Vigilance against Viral Resistance (A. Lackenby, B. Lina, S. van der Werf, A. Hay, M. Zambon); Health Protection Agency, London, UK (A. Lackenby, M. Zambon); Norwegian Institute of Public Health, Oslo, Norway (O. Hungnes); Centre National de R?f?rence des Virus Influenza (R?gion Sud), Lyon, France (B. Lina); Centre National de R?f?rence des Virus Influenza (R?gion Nord), Paris, France (S. van der Werf); Robert Koch Institute, Berlin, Germany (B. Schweiger); Laboratoire National de Sant?, Luxembourg, Luxembourg (M. Opp); and World Health Organization Collaborating Centre Medical Research Council/National Institute of Medical Research, London, UK (A. Hay)
(1) European Influenza Surveillance Scheme members, 2007?08 season: P. Lachner, T. Popow-Kraupp, R. Strauss (Austria); B. Brochier, M. Sabbe, I. Thomas, V. Casteren, F. Yane (Belgium); T. Georgieva, M. Kojouharova, R. Kotseva, A. Kurchatova (Bulgaria); B. Aleraj, V. Drazenovic (Croatia); D. Bagatzouni-Pieridou, A. Elia (Cyprus); M. Havlickova, J. Kyncl (Czech Republic); S. Glismann, A. Mazick, L. Nielsen (Denmark); D.M. Fleming, A. Lackenby, J. Watson, M. Zambon (England); O. Sadikova, I. Sarv (Estonia); T. Ziegler (Finland); J.-M. Cohen, V. Enouf, B. Lina, A. Mosnier, M. Valette, S. van der Werf (France); U. Buchholz, W. Haas, B. Schweiger (Germany); A.G. Kossivakis, V. Kyriazopoulou-Dalaina, A. Mentis, G. Spala (Greece); G. Berencsi, A. Csoh?n, I. Jankovics (Hungary); S. Coughlan, L. Domegan, M. Duffy, M. Joyce, J. O?Donnell, D. O'Flanagan (Ireland); F. Ansaldi, P. Crovari, I. Donatelli, F. Pregliasco (Italy); R. Nikiforova, I. Van Velicko, N. Zamjatina (Latvia); A. Griskevicius, N. Kupreviciene, G. Rimseliene (Lithuania); J. Mossong, M. Opp (Luxembourg); C. Barbara, T. Melillo (Malta); A. Arkema, T. Meerhoff, W.J. Paget, K. van der Velden, (EISS-CC, the Netherlands), F. Dijkstra, G. Donker, J.C. de Jong, A. Meijer, G. Rimmelzwaan, M. van der Sande, B. Wilbrink (the Netherlands); P. Coyle, H. Kennedy, H. O?Neill (Northern Ireland); O. Hungnes, B. Iversen (Norway); L. Brydak, M. Romanowska (Poland); I.M. Falc?o, J.M. Falc?o, H. Rebelo de Andrade (Portugal); V. Alexandrescu, E. Lupulescu (Romania); W. Carman, R. Gunson, J. Kean, J. McMenamin (Scotland); N. Milic, J. Nedeljkovic (Serbia); H. Blaskovicova, Z. Kristufkova, M. Sl?cikov? (Slovakia); K. Prosenc, M. Socan (Slovenia); I. Casas, A. Larrrauri, S. de Mateo, R. Ortiz de Lejarazu, P. P?rez-Bre?a, T. Pumarola Su??, T. Vega Alonso (Spain); M. Brytting, A. Linde, P. Penttinen, S. Rubinova (Sweden); Y. Thomas, M. Witschi (Switzerland); N. Yilmaz (Turkey); M. Aranova, A. Mironenko (Ukraine); A. Hay (United Kingdom); and R. Jones, D. Thomas (Wales).
In Europe, the 2007?08 winter season was dominated by influenza virus A (H1N1) circulation through week 7, followed by influenza B virus from week 8 onward. Oseltamivir-resistant viruses A (H1N1) (ORVs) with H275Y mutation in the neuraminidase emerged independently of drug use. By country, the proportion of ORVs ranged from 0% to 68%, with the highest proportion in Norway. The average weighted prevalence of ORVs across Europe increased gradually over time, from near 0 in week 40 of 2007 to 56% in week 19 of 2008 (mean 20%). Neuraminidase genes of ORVs possessing the H275Y substitution formed a homogeneous subgroup closely related to, but distinguishable from, those of oseltamivir-sensitive influenza viruses A (H1N1). Minor variants of ORVs emerged independently, indicating multiclonal ORVs. Overall, the clinical effect of ORVs in Europe, measured by influenza-like illness or acute respiratory infection, was unremarkable and consistent with normal seasonal activity.
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