Journal of Infection
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doi:10.1016/j.jinf.2011.08.005 | How to Cite or Link Using DOI
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Pandemic (H1N1) 2009 Virus Infection: Persistent Viral Shedding after Oseltamivir Treatment

Sawan Kanchanaa, Supannakhon Kanchanaa, Charas Chuntrakula, Kumthorn Malathumb, Slinporn Prachayangprechac and Yong Poovorawanc, Corresponding Author Contact Information, E-mail The Corresponding Author

a Thungsong Hospital, Nakhon Srithammarat, Thailand

b Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

c Center of Excellence in clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Accepted 4 August 2011.
Available online 9 August 2011.


To study pandemic (H1N1) 2009 virological outcomes after Oseltamivir treatment in confirmed cases of pandemic (H1N1) 2009 virus infections. A hospital-based cohort study was conducted in south Thailand, between June and September 2009.

Throat nasal swab specimens were tested by real-time reverse transcriptase polymerase chain reaction (rRT-PCR) for pandemic (H1N1) 2009.All 357 confirmed cases (122 inpatients, 235 outpatients), whose received a 5-day Oseltamivir treatment. Post-treatment virological follow-up was performed in 91 eligible cases. The NA gene was screened for the H275Y mutation responsible for Oseltamivir resistance.

Thirty-three of 91 patients (36%) had underlying diseases. The duration from the onset of illness to the detection of virus ranged 1-14 days (median 3 days). The rRT- PCR was positive on day 5 of treatment in 24 of 91 patients (26%). Patients with underlying diseases had a higher proportion of post-treatment positive test than those without underlying diseases (15/33 vs 9/58). The rRT- PCR-confirmed viruses detected in all 125 throat swab specimens did not show evidence suggesting Oseltamivir-resistance.

Prolonged presence of pandemic (H1N1) 2009 detected by rRT-PCR was found. An extended course of antiviral treatment should be considered in patients with underlying diseases and severe clinical symptoms.