Anti-viral resistance in 2009 A/H1N1 flu - historical compilation of news

Celvin11 · Dec 2, 2009

Tamiflu resistance in A/H1N1 flu - historical compilation of news

Tamiflu resistance in A/H1N1 flu - historical compilation of news

Tamiflu-resistant patients in Maryland and Virginia

By Michael Laris
Washington Post Staff Writer
Wednesday, December 2, 2009; 3:55 PM

Two swine flu patients in Maryland and one in Virginia were hospitalized with a form of the virus resistant to a commonly used medicine, prompting infectious disease specialists to call for renewed caution even as the intensity of the pandemic nationwide has declined.

http://www.washingtonpost.com/wp-dyn/content/article/2009/12/02/AR2009120202759.html

Giuseppe · Dec 3, 2009

Tamiflu resistance in A/H1N1 flu - historical compilation of news

Tamiflu resistance in A/H1N1 flu - historical compilation of news

Emergence of Oseltamivir-Resistant Pandemic H1N1 Virus during Prophylaxis (N Engl J Med., edited)

Emergence of Oseltamivir-Resistant Pandemic H1N1 Virus during Prophylaxis

   
To the Editor:

Neuraminidase inhibitors (oseltamivir and zanamivir) are recommended for treatment of severe illness caused by the 2009 pandemic influenza A (H1N1) virus, and their use has also been advocated for postexposure prophylaxis in high-risk persons.1 We report the emergence of an oseltamivir-resistant virus in a familial cluster of infections with the 2009 H1N1 virus. 

In a 13-year-old boy with asthma, infection with the 2009 H1N1 virus developed and was confirmed by reverse-transcriptase polymerase-chain-reaction (RT-PCR) testing of a nasopharyngeal aspirate. Administration of oseltamivir (60 mg twice a day for 5 days for this boy who weighed 32 kg) was begun, and the patient was discharged home the same day. Simultaneous with treatment of the index patient, postexposure prophylaxis with oseltamivir (75 mg once a day for 10 days) was prescribed to all household contacts (the boy's 59-year-old father, who had chronic obstructive pulmonary disease and was taking prednisone at a dose of 5 mg daily; 50-year-old mother; and 15-year-old and 18-year-old sisters). Approximately 24 hours after oseltamivir prophylaxis was begun, influenza-like symptoms developed in the father (...). On day 8 of oseltamivir prophylaxis, the father consulted his general practitioner because of persistent cough. A nasopharyngeal aspirate collected at that time was positive for the 2009 H1N1 virus, according to RT-PCR testing and culture. The father had an uneventful clinical course, and a nasopharyngeal aspirate sampled at the end of his illness was negative for the 2009 H1N1 virus. Influenza-like symptoms did not develop in any other household contacts.

The 2009 H1N1 viral isolate collected from the index patient before oseltamivir therapy was susceptible to oseltamivir (50% inhibitory concentration, 0.27 nM) and zanamivir (50% inhibitory concentration, 0.18 nM), whereas the father's 2009 H1N1 viral isolate was resistant to oseltamivir (50% inhibitory concentration, >400 nM) but susceptible to zanamivir (50% inhibitory concentration, 0.12 nM). Complete 2009 H1N1 virus genomes of the father's virus (GenBank accession number, FN434454 [GenBank] ) differed from the index patient's virus (GenBank accession number, FN434445 [GenBank] ) by only one substitution (H275Y) in the neuraminidase protein. The role of the H275Y substitution was assessed by generating recombinant neuraminidase proteins.2 The mutant neuraminidase protein was more resistant to oseltamivir than was the wild-type protein by a factor of more than 400, confirming the phenotypic results.

Our results indicate that the same neuraminidase mutation (H275Y) is associated with oseltamivir resistance not only in seasonal H1N13 and avian H5N14 viruses but now also in 2009 pandemic H1N1 strains. We hypothesize that the presence of subtherapeutic levels of oseltamivir at a time when viral replication had already begun was an important factor that led to the emergence of the resistant virus in the father of our index patient. Other oseltamivir-resistant strains of 2009 H1N1 virus detected during postexposure prophylaxis have been reported to the World Health Organization.5

These observations support the need for limiting the indications for postexposure prophylaxis. It also seems reasonable to rapidly convert prophylactic (once daily) regimens to therapeutic (twice daily) regimens as soon as influenza-like symptoms develop in a patient receiving prophylactic treatment. Monitoring for the H275Y mutation during outbreaks of 2009 H1N1 virus is important in order to rapidly identify transmission events that could lead to large-scale dissemination of an oseltamivir-resistant 2009 H1N1 virus, similar to what occurred with recent H1N1 virus seasonal strains.3 
 
 
Mariana Baz, M.Sc.
Yacine Abed, Ph.D. 
Jesse Papenburg, M.D. 
Xavier Bouhy, B.Sc. 
Marie-Ève Hamelin, Ph.D.
Guy Boivin, M.D. 
Centre Hospitalier Universitaire de Québec
Quebec, QC, Canada 
guy.boivin@crchul.ulaval.ca<script type="text/javascript"></script>
[SIZE=-1]Financial and other disclosures provided by the authors are available with the full text of this letter at NEJM.org. [/SIZE]
[SIZE=-1]This letter (10.1056/NEJMc0910060) was published on November 11, 2009, at NEJM.org. [/SIZE]
[FONT=arial, helvetica][SIZE=+1]
References[/SIZE][/FONT]

Updated interim recommendations for the use of antiviral medications in the treatment and prevention of influenza for the 2009-2010 season. Atlanta: Centers for Disease Control and Prevention. (Accessed November 9, 2009, at http://www.cdc.gov/h1n1flu/recommendations.htm.)
Abed Y, Goyette N, Boivin G. A reverse genetics study of resistance to neuraminidase inhibitors in an influenza A/H1N1 virus. Antivir Ther 2004;9:577-581. [Web of Science][Medline]
Dharan NJ, Gubareva LV, Meyer JJ, et al. Infections with oseltamivir-resistant influenza A(H1N1) virus in the United States. JAMA 2009;301:1034-1041. [Free Full Text]
de Jong MD, Tran TT, Truong HK, et al. Oseltamivir resistance during treatment of influenza A (H5N1) infection. N Engl J Med 2005;353:2667-2672. [Free Full Text]
Antiviral use and the risk of drug resistance: pandemic (H1N1) 2009 briefing note 12. Geneva: World Health Organization, September 25, 2009. (Accessed November 9, 2009, at http://www.who.int/csr/disease/swineflu/notes/h1n1_antiviral_use_20090925/en/index.html.).

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estacion · Dec 3, 2009

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Catalunya recorded its first case of resistance to antiviral
December 2, 2009.

Catalunya has recorded its first case of a patient with influenza A resistant to an antiviral, but has been discharged and is being studied, according to Europa Press sources have confirmed to the Regional Ministry of Health.

BARCELONA, 2 (EUROPA PRESS)

Catalunya has recorded its first case of a patient with influenza A resistant to an antiviral, but has been discharged and is being studied, according to Europa Press sources have confirmed to the Regional Ministry of Health.

The same sources explained that all cases of new viruses that are serious, undergoing some study to detect whether there is resistance to antivirals.

The Conselleria stated that this is an isolated case and that the patient has been discharged from hospital.

(EUROPA PRESS CATALUNYA)

Source: Qu?
http://translate.google.es/translat...stra-primer-caso-resistencia.html&sl=es&tl=en

Celvin11 · Dec 3, 2009

Re: Netherlands: Man dies of Tamiflu resistant swine flu

Re: Netherlands: Man dies of Tamiflu resistant swine flu

Netherlands reports mutant swine flu death

http://www.physorg.com/news179059662.html

Netherlands reports mutant swine flu death
December 3, 2009 Dutch authorities said Thursday a patient infected by a mutant strain of the swine flu virus had died.

Harald Wychgel, spokesman for the Dutch Institute for Health and the Environment, told AFP that there had been a "minor change in the virus to make it resistant to Tamiflu," a key treatment for influenza.

"The patient was already seriously ill and being treated for that. He was infected by the Mexican flu and developed a resistance to Tamiflu," Wychgel told AFP.

The Dutch ANP news agency said the man had died in hospital in the northern city of Groningen, adding that two more patients in the Netherlands had shown resistance to Tamiflu.

It is the fifth fatal case of mutated A(H1N1) flu in Europe, after two in France and two in Norway.

The World Health Organisation said last month that a similar mutation had been observed in Brazil, China, Japan, Mexico, where the swine flu pandemic began, Ukraine, and the United States, as early as April.

Italy also reported a non-fatal case on Monday.

"The mutations appear to occur sporadically and spontaneously. To date, no links between the small number of patients infected with the mutated virus have been found and the mutation does not appear to spread," a WHO statement said on November 20.

The WHO also underlined that there was no evidence of more infections or more deaths as a result, while the mutated virus remained sensitive to antiviral drugs used to treat severe flu, oseltamivir (Tamiflu) and zanamivir (Relenza).

Scientists fear that mutations in flu viruses could cause more virulent and deadly pandemic flu. The global health watchdog reiterated a call for close monitoring.

"Although further investigation is under way, no evidence currently suggests that these mutations are leading to an unusual increase in the number of H1N1 infections or a greater number of severe or fatal cases," it added.

(c) 2009 AFP

Tonka · Dec 3, 2009

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

http://oncetv-ipn.net/noticias/index.php?modulo=despliegue&dt_fecha=2009-12-03&numnota=39

Increased cases of H1N1 resistant to antiviral: WHO
Date: December 3, 2009
Reporter: News Writing Eleven
Source: Eleven News

The World Health Organization (WHO) recognized that cases of influenza A virus to the antiviral Oseltamivir-resistant H1N1 has increased from 57 to 96 in the last two weeks.

The international body ruled that these effects could pose a danger to public health.

He said a third of these cases were in patients with weakened immune systems for blood disorders by treatment with cancer chemotherapy or after receiving a transplant

Gert van der Hoek · Dec 4, 2009

Re: Netherlands: Two die of Tamiflu resistant swine flu

Re: Netherlands: Two die of Tamiflu resistant swine flu

Snip from weekly update RIVM (Dutch CDC) :

6 Tamiflu resistant patients - not related - 2 deaths - no wild virus, but Tamiflu induced - did not spread.

december 4, 2009

Until this week in the Netherlands diagnosed 6 patients, including 3 this week, with a pandemic A (H1N1) influenza virus which is resistant to the anti-viral drug Tamiflu (oseltamivir) that such patients are treated.

In all 6 cases no indication that it is naturally resistant viruses but that resistance has arisen due to the (long) treatment with Tamiflu.

The patients have a prolonged shedding of the influenza virus, in 5 of 6 patients probably due to an impaired immune defenses of these patients.

Two of the patients with underlying disease for which they were treated with chemotherapy are now deceased.

Around the 6 patients have so far no laboratory confirmed cases of transmission of resistant influenza virus found.

http://www.rivm.nl/cib/binaries/H1N1overzicht_tcm92-61018.pdf

sharon sanders · Dec 4, 2009

Tamiflu resistance in A/H1N1 flu - historical compilation of news

Tamiflu resistance in A/H1N1 flu - historical compilation of news

2009-12-04

Spain Introduces 2 November Sequences with Cross-Segment Pairing from Fatal Cases in the Ukraine

The HA and NA cross segment pairing of silent polymorphisms noted on the four fatal 225G cases from the Ukraine has now been tracked to 29 sequences around the globe on a cumulative study showing a quantifiable density in Spain.

HA:syn413K encoded from A1281G, AAa->AAg *
NA:syn407V encoded from T1221C, GTt->GTc *

* SNP Matches the 4 fatal flashfire cases

The most recent public database entries at GenBank are from Spain and were sampled in November 2009.

HA and NA CatNS7362 TamiFlu Resistant
HA and NA CatS1827

This background appears to be fertile ground and receptive to both major polymorphisms of interest today:

HA 225G correlated with deep lung damage and one "low reactor" vaccine antisera challenge result
NA 275Y conferring TamiFlu Resistance

The depth of this background continues to increase with 2 TamiFlu Resistant strains reported in 2 days. The persistance of this cross segment correlation may signal a viral genetic acquisition response to widespread TamiFlu usage. These silent polymorphisms are suggestive of an intermediate stage that is moving in the direction of antiviral resistance and continued Receptor Binding Domain revisions due to antiviral blanketing.

Commonground · Dec 5, 2009

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

2 Drug-Resistant H1N1 Cases Reported In Pa.

Dec 4, 2009 8:21 pm US/Eastern

PITTSBURGH (KDKA) -The standard treatment for H1N1 is anti-flu drug Tamiflu, so when cases of Tamiflu-resistant H1N1 turn up, it is concerning.

There are two cases in our state. Public health officials and hospitals have a plan, if they're faced with a local case.

"Tamiflu has been our mainstay of therapy. And yes, as we get more and more resistance, we do have some concerns about that," says Dr. Bruce Dixon, of the Allegheny County Health Department.

The state lab has been testing whether the virus samples it receives would respond to this drug.

"They've detected two cases in the state, in the eastern part of the state, and I don't think that's unexpected. We're seeing growing numbers in the country of resistant viruses showing up, and we know flu mutates quite readily," Dr. Dixon continues.

A series of steps would be taken should there be a local patient with drug-resistant virus.

In the hospital, some aspects would be the same as if they were dealing with a regular strain.

"The isolation we would use for any influenza case would be the same, people wearing gloves, and surgical masks when they're seeing the patients, everybody would already be in a private room," explains Dr. Amesh Adalja, a critical care medicine fellow at UPMC.

The treatment, though, would be different with an alternate anti-flu drug -- Relenza. It is typically inhaled, but when a patient is very ill, it has to be given by vein and that requires special permission from the hospital and the drug company.

"There's no evidence that this virus causes any more damage than the regular one. The prognosis may be a little worse because it's harder to get effective antiviral treatment to this patient," says Dr Adalja.

The health department would also take action.

"We look carefully to see if there are other family members that are ill, if there are other friends in their immediate circle of acquaintances who have gotten infected," Dixon said. "We do that regularly with the severe cases of H1N1."

The health department is reminding people that they will be holding an H1N1 vaccine clinic again this weekend. The vaccine will help prevent Tamiflu resistant cases in general, by cutting down on the number of people with H1N1 all together.

sharon sanders · Dec 5, 2009

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Modeling gene sequences over time in 2009 H1N1 Influenza A Virus populations

Natalia Goni

, Alvaro Fajardo

, Gonzalo Moratorio

, Rodney Colina

and Juan Cristina

Virology Journal 2009, 6:215doi:10.1186/1743-422X-6-215
<table cellpadding="0" cellspacing="0"> <tbody> <tr> <td>
</td></tr><tr> <td>Published:</td> <td>4 December 2009</td> </tr> </tbody> </table>Abstract (provisional)

Background

A sudden emergence of Influenza A Virus (IAV) infections with a new pandemic H1N1 IAV is taking place since April of 2009. In order to gain insight into the mode of evolution of these new H1N1 strains, we performed a Bayesian coalescent Markov chain Monte Carlo (MCMC) analysis of full-length neuraminidase (NA) gene sequences of 62 H1N1 IAV strains (isolated from March 30th to by July 28th, 2009) . Results: The results of these studies revealed that the expansion population growth model was the best to fit the sequence data. A mean of evolutionary change of 7.84 x 10-3 nucleotide substitutions per site per year (s/s/y) was obtained for the NA gene. A significant contribution of first codon position to this mean rate was observed.

Maximum clade credibility trees revealed a rapid diversification of NA genes in different genetic lineages, all of them containing Oseltamivir-resistant viruses of very recent emergence.

Mapping of naturally occurring amino acid substitutions in the NA protein from 2009 H1N1 IAV circulating in 62 different patients revealed that substitutions are distributed all around the surface of the molecule, leaving the hydrophobic core and the catalytic site essentially untouched.

Conclusions: High evolutionary rates and fast population growth have contributed to the initial transmission dynamics of 2009 H1N1 IAV. Naturally occurring substitutions are preferentially located at the protein surface and do not interfere with the NA active site. Antigenic regions relevant for vaccine development can differ from previous vaccine strains and vary among patients.

http://www.virologyj.com/content/6/1/215

sharon sanders · Dec 8, 2009

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Oseltamivir resistance is spreading world wide.

Please do not depend on this drug (Tamiflu).

Swine flu - A/H1N1 is not going away. It continues to evolve.

http://www.flutrackers.com/forum/showpost.php?p=326052&postcount=119

Ronan Kelly · Dec 9, 2009

Tamiflu resistance in A/H1N1 flu - historical compilation of news

Tamiflu resistance in A/H1N1 flu - historical compilation of news

Drug resistant H1N1 virus found in Delaware
Wednesday, December 9th, 2009

By: Mark Eichmann
meichmann@whyy.org

While the overall number of H1N1 cases nationwide has been on the decline in recent weeks, health officials are concerned that the virus could mutate to resist anti-viral medication.

The Centers for Disease Control confirmed that a 52-year-old Kent County man who died from complications of H1N1 last month had a strain that showed resistance to antiviral medication. It's the first such case found in Delaware that didn't respond to Tamiflu treatment. State health officials say the victim had a number of underlying health problems that made his fight against H1N1 complicated even without the resistance to antiviral medication.

Director of the Delaware Division of Public Health Dr. Karyl Rattay says the resistance can cause a number of other complications which would require increased treatment efforts. "Someone might be more likely to become dehydrated, so they might need IV fluids. They might be more likely to get a bacterial infection, and if it became widespread, we would certainly expect more deaths."

After examining more than 15-hundred specimens nationwide, the CDC has identified just 15 cases that were resistant to antiviral medication. While the resistant cases represent just one percent of those that were tested, the CDC is asking states to continue sending samples. Their main concern is making sure the drug resistant version of the virus doesn't grow more widespread.

http://whyy.org/cms/news/health-science/2009/12/09/drug-resistant-h1n1-virus-found-in-delaware/25004

Gert van der Hoek · Dec 15, 2009

Re: Japan - H1N1 - 6-year-old girl is 22nd Tamiflu resistant patient

Re: Japan - H1N1 - 6-year-old girl is 22nd Tamiflu resistant patient

Seems to be medicine induced

New Flu - Tamiflu resistant - 22nd case from six-years old girl

2009.12.15 17:15

It was announced that the gene mutation that showed the tolerance to the treatment Tamiflu had been confirmed to the virus that gathered new influenza from developing girl (6) as for Mie Prefecture Yokkaichi City on the 15th. Eyes of the example of country 22 according to the Ministry of Health, Labour and Welfare.

It develops on the 16th and it is hospitalized according to the same city though the girl had been taking Tamiflu since October 8 because there was a new influenza infected person in the family.

It left on the 23rd hospital. The gene mutation turned out in the virus inspection afterwards. The infection spread to surroundings is not confirmed.

http://www.excite-webtl.jp/world/en...wb_lp=JAEN&wb_dis=2&wb_submit=+%96%7C+%96%F3+

thanks to Makoto

sharon sanders · Dec 17, 2009

Tamiflu resistance in A/H1N1 flu - historical compilation of news

Tamiflu resistance in A/H1N1 flu - historical compilation of news

via email -

South Korea Reports Death From Tamiflu-Resistant Swine Flu
2009-12-17 06:28:32.171 GMT

By Kyung Bok Cho
Dec. 17 (Bloomberg) -- A South Korean infant died on Dec. 1
from swine flu resistant to Roche Holding AG?s antiviral drug
Tamiflu, the nation?s health ministry said.
The 1-year-old girl, who had brain damage, showed no
response to Tamiflu treatments administered from Nov. 16, even
after the dosage was doubled from Nov. 22, according to an e-
mailed statement today. Tests showed the virus had the H275Y
mutation that makes it resistant to the drug, the ministry said.
It?s the world?s first reported death from a Tamiflu-
resistant strain of swine flu, Yonhap News said.

sharon sanders · Dec 18, 2009

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

"A total of 44 cases of oseltamivir resistant 2009 influenza A (H1N1) viruses have been identified in the United States since April 2009, including 15 newly identified cases since last week."

http://www.cdc.gov/flu/weekly/

sharon sanders · Dec 18, 2009

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Florida1 said:
"A total of 44 cases of oseltamivir resistant 2009 influenza A (H1N1) viruses have been identified in the United States since April 2009, including 15 newly identified cases since last week."

http://www.cdc.gov/flu/weekly/

The key word here is "identified". It does not say total.

Gert van der Hoek · Dec 18, 2009

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Florida1 said:
"A total of 44 cases of oseltamivir resistant 2009 influenza A (H1N1) viruses have been identified in the United States since April 2009, including 15 newly identified cases since last week."

http://www.cdc.gov/flu/weekly/

This quote seems important too:

Of the 44 total cases identified, 27 patients had documented exposure to oseltamivir through either treatment or chemoprophylaxis, 15 patients are under investigation to determine exposure to oseltamivir, and two patients had no documented oseltamivir exposure.
Occasional development of oseltamivir resistance during treatment or prophylaxis is not unexpected.

So at least 2 patients were resistant without having Tamiflu.

They were infected through other patients in the hospital, or at home? Or wildtype? More details would be appreciated.

Commonground · Dec 18, 2009

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

First Tamiflu-resistant H1N1 case in Utah detected

Rare strain ? Only 29 cases -- excluding Utah man -- have been reported nationally.

By Lisa Rosetta
The Salt Lake Tribune

Updated: 12/18/2009 06:20:02 AM MST

Public health officials announced Thursday they have detected the first case of Tamiflu-resistant H1N1 flu in Utah this season.

A Salt Lake County man over the age of 65, with chronic health conditions, was hospitalized earlier this fall with H1N1 and has since been released, said Utah Department of Health spokesman Tom Hudachko.

It wasn't until Thursday morning that the Centers for Disease Control and Prevention (CDC) notified the state that the man's strain is resistant to Tamiflu, a commonly prescribed antiviral drug.

So far the Tamiflu-resistant strain doesn't seem to be circulating in the community, said state epidemiologist Robert Rolfs. Even if it were, those who have been vaccinated for H1N1 flu have protection against it. This particular mutation hasn't changed the virus enough to allow it to resist vaccine-induced antibodies.

Rolfs said getting a high rate of the general population vaccinated is important because it reduces the transmission of the virus and its opportunities to mutate. The health department, however, estimates only 13 percent to 15 percent of Utahns have been innoculated.

"We'd like that number to be closer to 30 or 40 percent to get the type of immunity in the population we'd really need to slow down or prevent a third wave from occurring," Hudachko said.

Tom Skinner, a spokesman for the CDC, said since April there have been only 29 documented cases :magnify:-- excluding the Utah man -- ofTamiflu-resistant H1N1 in the U.S. Of those, 19 people took Tamiflu to prevent or treat the flu; two did not; and the rest were still being investigated.

The occasional development of resistance to Tamiflu during treatment is not unexpected, he said.

While detecting Tamiflu-resistant strains is important, the CDC would only be concerned if it saw "sustained transmission from person to person going on in multiple places around the country -- that's the kind of clustering we're looking for and we just haven't seen that," Skinner said.

People infected with a Tamiflu-resistant strain can be treated with another antiviral drug, Relenza, though some are too sick to inhale it, he said. Another option is Peramivir, though it has been approved by the Food and Drug Administration only for emergency use. Since the outbreak began, the CDC has received about 1,000 requests to use the drug, which is given intravenously. Its effectiveness is still being studied.

Flu-like activity in Utah has decreased for the seventh consecutive week, but it is still above the statewide epidemic threshold of 1.1 percent of clinic visits, according to the health department's latest report.

There have been a total of 25 H1N1-related deaths this season, including a woman between the ages of 50 and 64 who died last week, the Southwest Utah Health District reported. Hospitalizations due to both H1N1 and the seasonal flu have hit 857, which is 16 more than last week.

The state has now received approximately half of all the H1N1 vaccine it is scheduled to get; as of Dec. 9, an estimated 371,532 doses had been given out. All but two local health departments -- Bear River and Southeast -- are offering the vaccine to the general public.

http://www.flutrackers.com/forum/showthread.php?p=330123#post330123

estacion · Dec 18, 2009

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

According to ECDC Weekly Influenza Newsletter of Dec. 18th, 5 more patients in Netherlands were diagnosed with a mixture of resistant and wild-type A(H1N1)v influenza viruses summing 11 in total to date, of which 4 died

Comments on virological data provided by countries in week 50/2009
The Netherlands
By week 50 in the Netherlands, 11 patients were diagnosed with a mixture of oseltamivir resistant and wild-type A(H1N1)v influenza viruses in one respiratory specimen during oseltamivir therapy, indicating resistance emerged during therapy and not by infection with a resistant virus. Nine of the patients were immunosuppressed due to chemotherapy/immunosuppressive therapy, of which four died. Contact tracing identified no cases of onward transmission of the oseltamivir-resistant viruses.

Source ECDC:
http://ecdc.europa.eu/en/activities...SN_Weekly_Influenza_Surveillance_Overview.pdf

Commonground · Dec 19, 2009

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Re: Tamiflu resistance in A/H1N1 flu - historical compilation of news

Vietnam

18/12/2009

Vietnam: Save the lives of patients co-infected with H1N1 influenza and SXH [Dengue Hemorrhagic Fever]

Patients was 9 years old girls, Thu Duc district, hemorrhagic fever on the 6th, being treated at a local hospital. Patients do not reduce fever, vascular collapse or be attached hospital moved patients to Children's Hospital 2 ..

Many patients with severe hemorrhagic fever is in the emergency room
Children's Hospital has two tests and positive results for girls influenza A/H1N1. Patients have breathing machine breathing machine NCPAP (continuous positive air through the nose), doctors use tamiflu Nursery 2 days but no results.

Doctors must use more drugs Zanamivir (Relenza) for the patients are stable and then must use a special antibiotic treatment of pneumonia and multiple anti-infection. Results after 2 weeks of treatment, the patient has recovered well and was discharge home.

Dr. Chau Vietnamese warning, in some of today's hospitalized patients with dengue fever reduced the number of cases but admitted the worse. We every day in science only a few dozen dengue patients but six ca weight lying in the emergency departments of science, two patients lying in serious scientific resuscitation in shock due to severe emergency, a new death ca .

http://www.flutrackers.com/forum/showpost.php?p=330043&postcount=7

sharon sanders · Dec 19, 2009

Re: Japan - H1N1 - man (49) from Nagoya City is 116th death

Re: Japan - H1N1 - man (49) from Nagoya City is 116th death

Japan - #116 death is confirmed to be tamiflu resistant case.

Tami full immunity, the confirmation of four cases in Aichi

2009年12月19日

December 19, 2009

愛知県は１８日、新型インフルエンザに感染して死亡した名古屋市内の男性会社員（４９）から、治療薬のタミフルが効きにくい新型ウイルスを確認したと発表した。

May 18, Aichi Prefecture, Nagoya-year-old man who died in the pandemic influenza infection (49), the new virus announced it had confirmed the effectiveness of Tamiflu drug resistant.

タミフル耐性ウイルスの確認は全国で２６例目、県内では４例目。

Tamiflu-resistant virus was confirmed in 26 of cases nationwide, in the prefecture of four cases.

死亡した人から確認されたのは初めて。

People were confirmed dead from the first time.

県によると、男性は急性白血病やサイトメガロウイルス肺炎などの持病があった。

According to the County, the man had a chronic disease such as acute leukemia and cytomegalovirus pneumonia.

１０月２５日に発症し、Ａ型陽性を確認。

He developed symptoms on October 25th Sun, A positive-type check.

タミフルやリレンザを処方されたが発熱を繰り返し、１２月１日に新型インフルエンザと診断されて入院したが、同１５日に急性肺炎で死亡が確認された。

Fever was repeatedly prescribe Tamiflu and Relenza, December 1 had been diagnosed with pandemic influenza hospitalization days, were confirmed killed in the 15 days of acute pneumonia.

http://www.chunichi.co.jp/article/feature/swine/list/200912/CK2009121902000208.html

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Editor-in-Chief & President

Editor-in-Chief & President

Retired 2020

In Memoriam - Editor, Senior Moderator

Editor-in-Chief & President

Editor-in-Chief & President

Editor-in-Chief & President

In Memoriam - Editor, Senior Moderator

Senior Moderator

Well-known member

Senior Moderator

Editor-in-Chief & President