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Source: http://timesofindia.indiatimes.com/...ive-despite-treatment/articleshow/4735786.cms
H1N1 patient tests positive despite treatment
4 Jul 2009, 0554 hrs IST, Pushpa Narayan, TNN
CHENNAI: The case of a 29-year-old man, who continued to remain H1N1 positive even after weeks of treatment in the city, has doctors and health department officials in a tizzy. Experts now fear that this could be an indication of the virus either having mutated or developed resistance to the standard anti-viral drug, Tamiflu.
Mutation and drug resistance have been major challenges in dealing with viruses across the world. The present strain, A(H1N1), developed from an earlier type which caused the Spanish flu that claimed several million lives in 1918.
What has added to the confusion in health circles here is that the man was discharged from the Communicable Diseases Hospital in Tondiarpet, where he was quarantined. Officials at the hospital said they had decided to discharge him based on a fax message they received from the National Institute of Communicable Diseases (NICD). "Though his throat swabs continue to show positive, he was not showing any clinical symptoms
. We told him not to step out of his residence for at least a week. We have advised him to stay away from the rest of his family members, particularly his pregnant wife," said Chennai Corporation health officer Dr B Kuganantham.
But the directorate of public health is panicky. "We are upset that the NICD has directly contacted the hospital without keeping the government in the loop. The viral status of the patient is still positive, possibly because of a mutation or drug resistance. He could be a carrier who can spread the infection to other people. It is a bad idea to send him back," said director of public health Dr S Elango.
On June 18, the man and his wife landed in the city from the US and were quarantined for symptoms of H1N1 flu at CDH. Two days later, NICD and National Institute of Virology in Pune confirmed that the couple were positive. They were given the drug of choice, Tamiflu. A week later, the hospital authorities sent throat swabs for a second round of test. While the woman's result was negative, the man continued to be positive. He was started on the second course of the same drug but remained positive at the end of the second week as well.
Dr Elango urged Indian Council of Medical Research Director General Dr Vishwa Mohan Katoch to carry out a viral genome sequencing from the man's sample since there are fears of the virus having changed. "Katoch was in agreement to this, but NICD officials seemed to have jumped the gun," Dr Elango said. NICD officials refused to comment.
Katoch told Times of India that though the laboratories have been on the lookout for any changes in the virus, they have found none till now. "Most infected patients are responding well to the drug," he said.
Meanwhile, the French nationals quarantined in CDH and two other patients quarantined in the Government General Hospital tested negative. So far, the state health department had quarantined more than 60 patients and sent samples of 54 patients. Of these, nine were tested positive and the result of one is pending.
H1N1 patient tests positive despite treatment
4 Jul 2009, 0554 hrs IST, Pushpa Narayan, TNN
CHENNAI: The case of a 29-year-old man, who continued to remain H1N1 positive even after weeks of treatment in the city, has doctors and health department officials in a tizzy. Experts now fear that this could be an indication of the virus either having mutated or developed resistance to the standard anti-viral drug, Tamiflu.
Mutation and drug resistance have been major challenges in dealing with viruses across the world. The present strain, A(H1N1), developed from an earlier type which caused the Spanish flu that claimed several million lives in 1918.
What has added to the confusion in health circles here is that the man was discharged from the Communicable Diseases Hospital in Tondiarpet, where he was quarantined. Officials at the hospital said they had decided to discharge him based on a fax message they received from the National Institute of Communicable Diseases (NICD). "Though his throat swabs continue to show positive, he was not showing any clinical symptoms
. We told him not to step out of his residence for at least a week. We have advised him to stay away from the rest of his family members, particularly his pregnant wife," said Chennai Corporation health officer Dr B Kuganantham.
But the directorate of public health is panicky. "We are upset that the NICD has directly contacted the hospital without keeping the government in the loop. The viral status of the patient is still positive, possibly because of a mutation or drug resistance. He could be a carrier who can spread the infection to other people. It is a bad idea to send him back," said director of public health Dr S Elango.
On June 18, the man and his wife landed in the city from the US and were quarantined for symptoms of H1N1 flu at CDH. Two days later, NICD and National Institute of Virology in Pune confirmed that the couple were positive. They were given the drug of choice, Tamiflu. A week later, the hospital authorities sent throat swabs for a second round of test. While the woman's result was negative, the man continued to be positive. He was started on the second course of the same drug but remained positive at the end of the second week as well.
Dr Elango urged Indian Council of Medical Research Director General Dr Vishwa Mohan Katoch to carry out a viral genome sequencing from the man's sample since there are fears of the virus having changed. "Katoch was in agreement to this, but NICD officials seemed to have jumped the gun," Dr Elango said. NICD officials refused to comment.
Katoch told Times of India that though the laboratories have been on the lookout for any changes in the virus, they have found none till now. "Most infected patients are responding well to the drug," he said.
Meanwhile, the French nationals quarantined in CDH and two other patients quarantined in the Government General Hospital tested negative. So far, the state health department had quarantined more than 60 patients and sent samples of 54 patients. Of these, nine were tested positive and the result of one is pending.
