• FluTrackers.com Inc. does not provide medical advice. Information on this web site is collected from various internet resources, and the FluTrackers board of directors makes no warranty to the safety, efficacy, correctness or completeness of the information posted on this site by any author or poster. The information collated here is for instructional and/or discussion purposes only and is NOT intended to diagnose or treat any disease, illness, or other medical condition. Every individual reader or poster should seek advice from their personal physician/healthcare practitioner before considering or using any interventions that are discussed on this website. By continuing to access this website you agree to consult your personal physican before using any interventions posted on this website, and you agree to hold harmless FluTrackers.com Inc., the board of directors, the members, and all authors and posters for any effects from use of any medication, supplement, vitamin or other substance, device, intervention, etc. mentioned in posts on this website, or other internet venues referenced in posts on this website.
  • We are not asking for any donations. Do not donate to any entity who says they are raising funds for us.

Denmark - Dane with novel H1N1 found resistant to Tamiflu

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

It was not found in the treated patient.

Doesn't statement of contact with another patient and prevented Tamiflu treatment mean that the second person was treated with Relenza becasue tamiflu resistance was found in H1N1 in first person?

The articles are not a 100% clear. The way I understand it is this:

a man who was in contact with an infected person was treated with Tamiflu, but still kept having symptoms. Apparently a sample was taken and tested.
Relenza did the job Tamiflu supposed to do.

No mentioning of testresults of the first person.
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

Reading the original danish news (It's very similar to swedish) they say that the person which the mutation had been found in had been in close contact with another infected person and was therefore put on preventive tamiflu but still developed symptoms, so he was instead treated with relenza and recovered. Doesn't mention much details beyond that.
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

The articles are not a 100% clear. The way I understand it is this:

a man who was in contact with an infected person was treated with Tamiflu, but still kept having symptoms. Apparently a sample was taken and tested.
Relenza did the job Tamiflu supposed to do.

No mentioning of testresults of the first person.

I read the statement of

"The infected Dane had been in close contact with another infected person, and was therefore prevented treatment with Tamiflu."

to mean that the first person was found to have Tamiflu resistant H1N1, so when the second person was infected, he (the second person) was treated with Relenza instead of Tamiflu and was cured.
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

I read the statement of

"The infected Dane had been in close contact with another infected person, and was therefore prevented treatment with Tamiflu."

to mean that the first person was found to have Tamiflu resistant H1N1, so when the second person was infected, he (the second person) was treated with Relenza instead of Tamiflu and was cured.

No, to original press release says that the person which they found the mutation in first had been treated by preventive tamiflu and when he still developed symptoms they switched to relenza.

"Den smittede dansker havde været i tæt kontakt med en anden smittet person og var derfor i forebyggede behandling med Tamiflu. Alligevel fik personen influenzasymptomer og er i stedet behandlet med en anden type influenzamedicin, Relenza"
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

Reading the original danish news (It's very similar to swedish) they say that the person which the mutation had been found in had been in close contact with another infected person and was therefore put on preventive tamiflu but still developed symptoms, so he was instead treated with relenza and recovered. Doesn't mention much details beyond that.

Thanks Aruna!
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

No, to original press release says that the person which they found the mutation in first had been treated by preventive tamiflu and when he still developed symptoms they switched to relenza.

"Den smittede dansker havde været i tæt kontakt med en anden smittet person og var derfor i forebyggede behandling med Tamiflu. Alligevel fik personen influenzasymptomer og er i stedet behandlet med en anden type influenzamedicin, Relenza"
Thanks, then this sounds like the first case of resisatnce in H5N1 in Vietnam (sister of infected patient was given prophylactic dose, which led to resistance and she recovered when dose was increased to treatment dose). This would not demonstrate that resistant H1N1 was fit (but would indicate that Tamiflu blankets, as well as widespread use of Tamiflu WILL be a problem).
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

http://www.ssi.dk/sw174.asp?PAGE=1&ArtNo=3651423

That is the original press release from the danish version of cdc, it's a bit more detailed.

Says as before, person was in close contacted with another dane who had tested positive and was given tamiflu, got sick and tested positive for h1n1, was treated with relenza and has now fully recovered. Further analyze found that the virus had mutated and was resistant to tamiflu but not relenza. Says their evaluation of mutation shows no difference in terms virulence or severity. Says it's common knowledge that flu viruses can spontaneously mutate but there are no sign of further spread of the mutated virus and no reason to change the treatment guidelines for the flu. The head of cdc says in another article they don't expect that the mutation "exists anymore" but doesn't rule out there will be other mutations in the future.
 
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.

http://www.ssi.dk/sw174.asp?PAGE=1&ArtNo=3651423
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

Thanks Aruna!

I have a pause, and didn't saw all the already present answers, before I posted my previous questions.

Wow folks, you screen, drag, answer and type posts warp-speed! Thanks and bravo'.
(how many stunts you have :))

So the last wide bulet "faked".
Tamiflu bye, bye.

Interesting would be how many "close infected patients" have the new mutation now.
 
Last edited:
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

"The infected Dane had been in close contact with another infected person, and was therefore prevented treatment with Tamiflu."


What is the meaning of this, why it is important to wrote "with another infected person" - does it mean that this "infected person" have a new flu form already known to be tamiflu resistant and because of this they start an Relenza-only treatment?

If not, why they start an Relenza-only treatment on an patient previously supposedly non treated with Tamiflu, did they miss the first 2 days (which somewhere stated to be best also for Relenza(?)),
or what?

Any more details?

He was in close contact with another person who had been sick and was put on tamiflu before he had any symptoms as a preventive messure, when he got sick and tested positive for h1n1 despite the tamiflu treatment he was given relenza. (Here in Scandinavia they still put everyone in contact with a positive case on tamiflu)
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

Roche says 1st case of H1N1 resistance to Tamiflu

29 Jun 2009 14:54:14 GMT

Source: Reuters

ZURICH, June 29 (Reuters) - A patient with H1N1 influenza in Denmark showed resistance to Roche Holding AG's <ROG.VX> antiviral Tamiflu, a company executive said on Monday.

"This is the first case we have of it in H1N1," David Reddy, Roche's pandemic taskforce leader, told reporters on a conference call.

http://www.alertnet.org/thenews/newsdesk/WEA8792.htm
 
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.

http://www.reuters.com/article/marketsNews/idUSLT21784420090629
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

<a rel="nofollow" href="http://www.recombinomics.com/News/06290902/Pandemic_H1N1_Resistance.html">Commentary</a>
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

Roche Executive: Tamiflu Is Still Working In Swine Flu

ZURICH -(Dow Jones)- Roche Holding AG (ROG.VX) Monday said that its drug Tamiflu still works in the currently spreading swine flu virus, and that a patient in Denmark who had developed resistance to the drug had done so during treatment.

"Such a development had to be expected, and is no surprise from a scientific point of view," David Reddy, Roche's Pandemic Taskforce leader told journalists on a conference call.

This is a case of so-called drug-induced resistance, which is rare, but it was known from clinical studies that this can happen, Reddy said. Drug-induced resistance occurs when a patient who is taking the drug develops resistance. It differs from naturally incurring resistance, where a virus strain in itself isn't responding to the drug.

This isn't the case here, meaning that Tamiflu is still working against swine flu, and Roche thus expects the World Health Organisation to continue to back the use of the drug, Reddy said.

http://english.capital.gr/news.asp?id=765631
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

UNE 29, 2009, 11:31 A.M. ET

Roche's Tamiflu Still Works In Swine Flu Despite Denmark Case


By Anita Greil

Of DOW JONES NEWSWIRES

ZURICH (Dow Jones)--Roche Holding AG (ROG.VX) said Monday that a patient in Denmark developed resistance to Tamiflu, but that the drug is still effective in the circulating H1N1 swine flu virus.

"Such a development had to be expected, and is no surprise from a scientific point of view," David Reddy, Roche's Pandemic Taskforce leader told journalists on a conference call.

The Danish patient, who has since recovered, was taking the drug as a prevention to avoid the contraction of swine flu, Reddy said. He was probably already infected with the virus, and resistance to the drug emerged because he was given the lower prevention dose.

This is a case of so-called drug-induced resistance, which is rare, but it was known from clinical studies that this can happen, Reddy said. Around 0.4% of adults, and around 4% of children, were shown to develop resistance to Tamiflu in clinical studies, he said.

Drug-induced resistance occurs when a patient who is taking the drug develops resistance. It differs from naturally incurring resistance, where a virus strain in itself isn't responding to the drug. This had been the case with the winter flu virus that was spreading in Europe in 2008, he added.

This isn't the case here, meaning that Tamiflu is still working against swine flu, and Roche thus expects the World Health Organization to continue to back the use of the drug, Reddy said.

At some point, there will certainly be resistance to Tamiflu, said Birgit Kulhoff, pharmaceutical analyst in Zurich with private bank Rahn & Bodmer.

"Sooner or later there will be resistance, and I would expect that to happen when the swine flu virus starts mixing with seasonal flu viruses," she said.

As such, an isolated case in Denmark doesn't yet change the sales prospects of Tamiflu. "It would have been much more worrisome if we saw repeated cases of resistance in the Southern hemisphere, where it's winter now, and the viruses could mix," she said.

http://online.wsj.com/article/BT-CO-20090629-709515.html
 
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´t be sure which it is). After 5 days treatment with Tamiflu, the person suddenly got sick with H1N1, but it didn´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´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.




http://ekstrabladet.dk/kup/sundhed/article1188161.ece

Dansker er resistent overfor Tamiflu



En dansker er som den første 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 første person i verden, der er resistent overfor medicinen oseltamivir, der sælges under navnet Tamiflu og blandt andet har vist sig virksom mod svineinfluenzaen H1N1.

Det er det første tilfælde af resistens overfor medicinen på verdensplan. Det er forventeligt, at influenzavirus kan mutere spontant. Resistensen har ikke ændret H1N1-virus’ evne til at smitte eller fremkalde sygdom, meddeler instuttet.

- Både bakterier og vira kan mutere og blive resistente. Og det er altså det, der er sket her, bekræfter administrerende direktør på Statens Serums Institut Nils Strandberg.

- Vedkommende var til at begynde med slet ikke syg. Den pågældende var i forebyggende behandling med Tamiflu, fordi vedkommende havde været i tæt kontakt med en svineinfluenza-ramt i udlandet. Da der var gået fem dage med Tamiflu, blev personen så pludselig syg med H1N1, men det så ikke ud til, at medicinen virkede. Det viste sig så via prøver her og i England, at personen var blevet resistens, fortæller Nils Strandberg.

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

- Vi kan glæde 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 længere kan betragtes som et sikkert middel mod svineinfluenza?

- Ja, det er bekymrende, hvis Tamiflu ikke virker på de mest udsatte grupper. Men der er stadig noget at gøre, hvis en svagelig patient bliver smittet med H1N1. Der er jo et andet stof, som man kan bruge.

Skruer ned for forebyggende brug
Ifølge Nils Strandberg vil fundet af den resistente dansker betyde, at lægerne fremover vil blive mere tilbageholdende med at bruge Tamiflu forebyggende - med mindre der altså ligefrem er tale om meget syge og skrøbelige patienter.

- Hvorfor er det netop en dansker, der bliver den første resistente influenza-patient?

- Det beror nok mest på et tilfælde. Vi har et godt system, hvor vi er gode til at overvåge situationen.

Episoden slår fast, at influenza-virus kan mutere, og at Tamiflu på ingen måde kan betragtes som mirakelmedicin. Tamiflu kan i forvejen ikke kurere influenza, men medicinen kan nedsætte symptomerne og forkorte forløbet.

Epidemi til efteråret
Selv om sommeren, udendørslivet og de lukkede skoler er ensbetydende med mindre influenzasmitte i Danmark, vil danskernes rejseaktivitet sommeren over betyde, at der bliver slæbt mere smitte til landet.

- Vi skal formodentlig frem til det sene efterår eller vinter, før vi kan risikere en H1N1-epidemi herhjemme. Men det behøver ikke at give problemer, da det stadig er en ret mild influenzatype, siger Nils Standberg.
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

Mon, 16:16 29 Jun 2009 GMT

Denmark finds 1st case of H1N1 resistance to Tamiflu

29 Jun 2009 16:10:11 GMT

Source: Reuters

* Patient showed resistance to main antiviral flu drug

* Drug maker says resistance not unexpected


(Rewrites with Danish comment, adds details and background)

By Sam Cage and Teis Jensen

ZURICH/COPENHAGEN, June 29 (Reuters) - Scientists have established the first case of the new H1N1 influenza strain showing resistance to Tamiflu, the main antiviral flu drug, Danish officials and the manufacturer said on Monday.

"While receiving the drug, the patient appeared to develop resistance to it," David Reddy, Roche Holding AG's <ROG.VX> pandemic taskforce leader, told reporters on a conference call on a case observed in Denmark. "This is the first report we have of it in H1N1."

Common seasonal flu can resist Tamiflu and Reddy said a case of resistance in H1N1 -- also know as swine flu -- was not unexpected. Roche had been working on strategies to counter such a development.

The World Health Organization declared an influenza pandemic earlier this month and advised governments to prepare for a long-term battle against an unstoppable new flu virus. The WHO had no immediate comment on the case of Tamiflu resistance.

The United Nations agency raised its pandemic flu alert to phase 6 on a six-point scale, indicating the first influenza pandemic since 1968 is under way. [ID:nLC321991]

"The person is well now and no further contagion with the resistent virus has been detected," Denmark's State Serum Institute said in a statement.

Roche shares closed up 1.4 percent at 149 Swiss francs, outperforming a 0.7 percent firmer DJ Stoxx European drugs index <.SXDP>.

This case does not change the recommendation to use Tamiflu, the institute said.

The U.S. Centers for Disease Control and Prevention has expressed concern the new strain may mix with seasonal flu strains, which are still circulating.

The WHO has said Tamiflu was working against strains of the new H1N1 flu but some analysts have expressed concern it might be less effective than Relenza, GlaxoSmithKline's <GSK.L> inhaled drug, since there have been widespread reports of resistance by seasonal H1N1 flu.

The seasonal strain of H1N1 is a distant cousin of the swine flu and was widely resistant to Tamiflu this year. (Additional reporting by Paul Arnold; Editing by David Holmes)

http://www.alertnet.org/thenews/newsdesk/LT265113.htm
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

The two key qualifiers in the comments from Roche are "appeared" and "probably", indicating they have ZERO evidence that the patient was NOT infected with pandemic H1N1 with the "mutation" PRIOR to prophylactic treatment.
 
Re: Denmark - Dane with novel H1N1 found resistant to Tamiflu

After 5 days treatment with Tamiflu, the person suddenly got sick with H1N1, but it didn?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.

And how do we know they have not infected others? Were they quarantined?

And what are the odds of this resistance spontaneously arising elsewhere, even if this particular resistant virus was not communicated to others?
 
Back
Top