Japan Reports Tamiflu-Resistant H1N1 Influenza Case

[yielddude]

Japan Reports Tamiflu-Resistant H1N1 Influenza Case -KyodoLast update: 7/2/2009 11:09:40 AMDOW JONES NEWSWIRES The health ministry said Thursday it has detected a genetic mutation of the new H1N1 strain of influenza A that is resistant to the anti-flu drug Tamiflu, the first such virus in Japan, the Kyodo News service reported. The Health, Labor and Welfare Ministry said the Tamiflu-resistant virus was detected in a man infected with the new influenza in Osaka Prefecture, Kyodo reported. -Dow Jones Newswires; 201-938-5500 (END) Dow Jones NewswiresJuly 02, 2009 11:09 ET (15:09 GMT)

 

[yielddude]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

Japan finds first case of H1N1 resistant to Tamiflu
Thu Jul 2, 2009 11:19am EDT

TOKYO, July 2 (Reuters) - Japan has confirmed its first case of a genetic mutation of the new H1N1 influenza that shows resistance to antiviral drug Tamiflu, a health ministry official said on Thursday.
Takeshi Enami, an official at the health ministry, said that the patient's sensitivity to Tamiflu had yet to be tested.

The patient, who was confirmed in May with the H1N1 strain of the flu in the Osaka prefecture of western Japan, has recovered since then and that no cases of the new flu have been confirmed around the patient, Enami said.

He could not confirm the age or the sex of the patient. (Reporting by Yoko Kubota; Editing by Alex Richardson)

http://www.reuters.com/article/marketsNews/idUST25492220090702

 

[St Michael]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

Related thread:

First isolation of a secondary oseltamivir-resistant A(H1N1)v strain in Denmark (ECDC, edited)

One must wonder if this news is related to the recent fire sale of Tamiflu to third world nations:

Roche To Broaden Tamiflu Access

 

[Shannon Bennett]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

LOL (ruefully) Yes, I wondered the same thing St. Michael. Time to unload those stocks.

 

[Mamabird]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

In Osaka, the patient apparently had been diagnosed with Swine Flu before the administering of Tamiflu. See below:

"New swine flu fears: Drug-resistant strain of H1N1 mutation discovered
Agence France Presse

Thursday, July 2nd 2009, 12:43 PM

A genetic mutation of swine flu that is resistant to the anti-viral Tamiflu has been discovered in Japan, the first such case in the country, the health ministry said.

It was found in a patient who had been given Tamiflu since first being diagnosed with H1N1 around two weeks ago, Kyodo news agency reported Thursday, citing the Health, Welfare and Labour Ministry."

http://www.nydailynews.com/news/us_...train_of_h1n1_discovered.html#ixzz0K84oXRSL&D




So, perhaps we will have a before and after genetic sequence of NA for comparative purposes.

In any event, these "isolated" incidents are already getting tiresome.

 

[St Michael]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

They seem to be using the WHO/Roche's Danish Tamiflu resistance talking points:

Japan finds first case of H1N1 resistant to Tamiflu
Thu Jul 2, 2009
By Yoko Kubota

TOKYO (Reuters) - Japan has confirmed its first case of a genetic mutation of the new H1N1 flu virus that shows resistance to Tamiflu, the main antiviral flu drug, a health ministry official said on Thursday.

But they said the mutated virus does not appear to be spreading and they see no immediate threat to public health.

They found the drug-resistant virus in a patient who was given Tamiflu to prevent infection but who developed symptoms anyway, the health ministry's Takeshi Enami said.

The World Health Organization has declared a pandemic is under way from the virus, known as swine flu.

One of the biggest fears is that it will change into a form that resists the effects of the two main antiviral drugs, Tamiflu, made by Switzerland's Roche AG and GlaxoSmithkline's Relenza.

Seasonal flu is no longer affected by older flu drugs and certain strains resist Tamiflu's effects, leaving doctors with fewer options for protecting the most vulnerable patients.

Enami said it was not clear if Tamiflu would have helped the patient, whose age and sex were not given.

The patient was given Relenza and recovered, and does not appear to have infected anyone else.

Kyodo News Agency reported that the patient is a female teacher in her 40s.

Tamiflu, known generically as oseltamivir, and Relenza, known generically as zanamivir, can be used to prevent infection if given early enough. Both can treat flu but Tamiflu is often preferred because it is a tablet, while Relenza must be delivered using an inhaler.

"As of now, we have decided that this does not have a great impact in terms of public health," Enami said.

Only one other case of Tamiflu-resistant H1N1 flu has been found, in a patient in Denmark. WHO officials said the case was isolated.

Flu viruses are notoriously mutation-prone and flu experts say it would not be at all surprising if this new H1N1 flu developed resistance.

"It was not something not to be expected," Roche spokeswoman Martina Rupp said. "This is line with what we already know from clinical trials."

Japan has confirmed 1,351 cases of the H1N1 flu to Wednesday, the health ministry website showed. The World Health Organization has confirmed more than 77,000 cases of the new H1N1 flu and 332 deaths. But U.S. officials say there are likely at least a million cases there alone.

(Additional reporting by Paul Arnold in Zurich; Editing by Maggie Fox)

 

[St Michael]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

Tamiflu-resistant swine flu patient found in Japan: govt
Thursday, July 2, 2009 - 20:21
AFP News Briefs List

A genetic mutation of swine flu that is resistant to the anti-viral Tamiflu has been discovered in Japan, the first such case in the country, the health ministry said.

It was the second reported case of Tamiflu resistance linked to swine flu in less than a week.

The latest case was found in a patient who had been given the drug since first being diagnosed with A(H1N1) around two weeks ago, Kyodo news agency reported Thursday, citing the Health, Welfare and Labour Ministry.

The patient -- a woman in Osaka prefecture -- was recovering after having been given Ralenza, an alternative anti-flu medication, the report said.

A spokeswoman for Swiss pharmaceuticals giant Roche, which makes Tamiflu, said the company had been informed of the case and called it "normal."

"It is absolutely normal," she said, adding that "0.4 percent of adults develop resistance" to Tamiflu.

She said the case does not indicate Tamiflu has become less effective against swine flu.

Danish authorities announced earlier this week they had discovered resistance to Tamiflu in a female patient. Ralenza was also used successfully to treat her.

According to the latest World Health Organization figures, Japan has 1,266 reported cases of swine flu, but has so far recorded no fatalities.

 

[kiwibird]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

May is a long time ago.

The patient, who was confirmed in May with the H1N1 strain of the flu in the Osaka prefecture of western Japan, has recovered since then and that no cases of the new flu have been confirmed around the patient, Enami said.

 

[gsgs]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

The latest case was found in a patient who had been given the drug since first being diagnosed with A(H1N1) around two weeks ago, Kyodo news agency reported Thursday,

> whose age and sex were not given.
...
> Kyodo News Agency reported that the patient is a female teacher in her 40s.

 

[HenryN]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

In Osaka, the patient apparently had been diagnosed with Swine Flu before the administering of Tamiflu. See below:

"New swine flu fears: Drug-resistant strain of H1N1 mutation discovered
Agence France Presse

Thursday, July 2nd 2009, 12:43 PM

A genetic mutation of swine flu that is resistant to the anti-viral Tamiflu has been discovered in Japan, the first such case in the country, the health ministry said.

It was found in a patient who had been given Tamiflu since first being diagnosed with H1N1 around two weeks ago, Kyodo news agency reported Thursday, citing the Health, Welfare and Labour Ministry."

http://www.nydailynews.com/news/us_...train_of_h1n1_discovered.html#ixzz0K84oXRSL&D




So, perhaps we will have a before and after genetic sequence of NA for comparative purposes.

In any event, these "isolated" incidents are already getting tiresome.

This will also be H274Y and if it was in the initial sample, prior to treatment, then the acquisition (independent of recent treatment, will have been confirmed, Roche's handwaving notwithstanding).

 

[wotan]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

This will also be H274Y and if it was in the initial sample, prior to treatment, then the acquisition (independent of recent treatment, will have been confirmed, Roche's handwaving notwithstanding).

Unfortunately they don't seem to mention if they have samples from before Tamiflu treatment with which to perform the necessary testing.

 

[HenryN]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

Unfortunately they don't seem to mention if they have samples from before Tamiflu treatment with which to perform the necessary testing.

Yes they have the sample (and probably the sequence) because the patient was diagnosed with H1N1 BEFORE treatment. Thus, the sample that was H1N1 positive was collected PRIOR to treatment (and if that sample has H274Y, the swine H1N1 with H274Y is evolutionarily fit).

 

[wotan]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

Yes they have the sample (and probably the sequence) because the patient was diagnosed with H1N1 BEFORE treatment. Thus, the sample that was H1N1 psoitive was collected PRIOR to treatment (and if that sample has H274Y, the swine H1N1 with H274Y is evolutionarily fit).

But would the sample have been discarded between then and now? I don't know the protocols for this in the US, let aloe Japan.

 

[Toaster2]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

H274Y also in Washington :
http://www.flutrackers.com/forum/showthread.php?p=259429#post259429

NOTE: seasonal flu, not novel H1N1

 

[HenryN]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

Concern over case of drug resistant swine flu

2. July 2009 19:30

The influenza A H1N1 (swine flu) outbreak has now spread to almost all corners of the world - the last update, # 56, from the World Health Organisation (WHO) says there are now a grand total of 77,201 confirmed cases including 311 deaths.

That update, issued on the 1st of July, is of course already out of date as more cases are being reported on a daily basis.
According to the WHO the U.S. leads with 27,717 cases including 127 deaths, Mexico has had 8,680 cases including 116 deaths, Canada 7,983 cases including 25 deaths, Chile 6,211 cases including 12 deaths, the UK 6,538 cases including 3 death and Australia 4,090 cases including 7 deaths.
The WHO says the first H1N1 infection found to be resistant to the antiviral drug Tamiflu has occurred but is an isolated case and at present has no implications for public health.
The global pandemic of swine flu has to date been treatable with the drug Tamiflu and the WHO says the discovery of a patient in Denmark whose infection did not respond to the drug, does not mean the severity of the virus has increased.
Danish officials say the patient was found to be infected with a virus strain that had mutated to a form resistant to Tamiflu, but the alternative drug Relenza was effective - flu viruses are known to mutate regularly and can develop resistance to drugs at any time.
The WHO does say however that health authorities must remain alert and not become complacent as the virus can change at any time but that resistance to Tamiflu has been previously documented in the deadly bird flu virus H5N1 and seasonal H1N1 flu.
The WHO says the H1N1 virus must be monitored continuously - the WHO's global influenza surveillance network linking laboratories in 97 countries will see to that but the WHO says current recommendations for the use of antivirals will not be changed at present.
The pandemic flu alert has been raised by the WHO to its highest level of 6, signifying that the first influenza pandemic since 1968 is under way and some experts have expressed concern that Tamiflu might be less effective than Relenza following widespread reports of resistance to Tamiflu by seasonal H1N1 flu, a distant relative of the new swine flu virus.
The U.S. Centers for Disease Control and Prevention (CDC) also says that the isolated case in Denmark did not merit a change in the recommended use of Tamiflu as it remains a relatively mild influenza.
It is estimated that at least 20 companies are currently making flu vaccines some of which are expected to be available in the coming months.http://www.news-medical.net/news/20090702/Concern-over-case-of-drug-resistant-swine-flu.aspx

 

[HenryN]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

Concern over case of drug resistant swine flu

2. July 2009 19:30

The WHO says the first H1N1 infection found to be resistant to the antiviral drug Tamiflu has occurred but is an isolated case and at present has no implications for public health.
months.http://www.news-medical.net/news/20090702/Concern-over-case-of-drug-resistant-swine-flu.aspx

H1N1 in Japan didn't get the WHO memo (and clearly doesn't read press releases).

 

[HenryN]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

The translation at this site indicates the resistance was H274Y (aka H275Y) and was detected in a patient receiving prophylatic Tamiflu in May

http://translate.google.com/transla...&hl=en&lr=&rlz=1T4GGLL_enUS326US326&tbs=qdr:d

 

[HenryN]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

The tarnsaltion at this site indicates the resistance was H274Y (aka H275Y) and was detected in a patient receiving prophylatic Tamiflu in May

http://translate.google.com/transla...&hl=en&lr=&rlz=1T4GGLL_enUS326US326&tbs=qdr:d

報道関係者 各位大阪府におけるオセルタミビル（商品名：タミフル）耐性を示す遺伝子変異が検出された新型インフルエンザウイルスについて○ 大阪府から、タミフル耐性を示すH275Y の遺伝子変異を持つ新型インフルエンザウイルスが分離されたとの報告がありましたので、その概要について、別紙のとおり、情報提供します。​

Oseltamivir in Osaka Press Release (Products: Tamiflu) for the avian flu virus was detected indicating the mutant gene from Osaka ○ resistance, indicating that the H275Y Tamiflu-resistant isolates with a mutated avian flu virus genes were reported on the Summary, as attached, to provide information.

○ このウイルスについては、今後、WHO 協力センターである国立感染症研究所において、薬剤感受性試験等が実施される予定です。​

○ The virus, now, WHO, National Institute of Infectious Diseases in collaboration center, is scheduled to be implemented and drug susceptibility testing.

○ 我が国においては、全国で約500 箇所の医療機関の協力を得て実施しているウイルスサーベイランス等により、今後、新型インフルエンザウイルスについて、遺伝子変異による薬剤耐性がみられていないか把握することとしています。​

○ In Japan, about 500 nationwide surveillance by the virus are carried out in cooperation with the medical institution where the future for the new influenza virus, and not knowing what is expected from the drug-resistant gene mutation .

○ なお、タミフルに対する耐性を持つ遺伝子変異は、ウイルスの重篤度（病原性）には直接影響を及ぼすものではないとされています。​

○ In addition, gene mutations that are resistant to Tamiflu, the severity of the virus (pathogenic) is a direct influence is not.

大阪府におけるオセルタミビル（商品名：タミフル）耐性を示す遺伝子変異が検出された新型インフルエンザウイルスの概要１．​

Oseltamivir in Osaka (product name: Tamiflu) Description of a new flu virus was detected in a mutant gene be resistant.

患者の概要○ 大阪府に在住の患者から、タミフル耐性を示す遺伝子変異を持つ新型インフルエンザウイルスを検出。​

○ Description of patients from patients living in Osaka, with the avian flu virus resistant to Tamiflu indicates the gene mutation.

○ この方は、５月１５日に発症し、５月１７日に新型インフルエンザの患者であることが確定した患者の濃厚接触者。​

○ If this is to begin on May 15, May 17, concentrated contacts of patients confirmed that the avian flu patients.

○ ５月１８日からタミフルの予防投与（１０日間）が行われていたところ、​

○ 5 prophylactic administration of the drug from the Monday 18 days (10 days) were made,

５月２４日から微熱があり、５月２８日発熱相談センターに連絡し、５月２９日に新型インフルエンザと診断。​

May 24 with a fever on May 28 to contact the Counseling Center, fever, and on May 29 in the diagnosis of avian flu.

５月２９日から５日間ザナミビル（商品名：リレンザ）により治療を受け、回復。​

Sunday May 29 from 5-day Zanamivir (Product name: Relenza) treated by recovery.

○ 患者から採取された検体について、大阪府立公衆衛生研究所において、​

○ The samples were collected from patients in the Osaka Prefectural Institute of Public Health,

ウイルスを分離・培養した後、遺伝子配列を確認したところ、６月１８日、​

After separation of the virus culture, the gene sequence was confirmed, June 18,

タミフル耐性を示すH275Y の遺伝子変異が確認された。​

Be resistant to Tamiflu H275Y mutant gene was confirmed.

○ なお、５月１５日に発症した患者のウイルス株についても同様の分析が行われているが、タミフル耐性を示す遺伝子変異は確認されなかった。​

○ In addition, the May 15 analysis has been similar for patients who develop the virus strain, indicating the mutant gene was confirmed Tamiflu resistant.

○ その後、ご家族を含めた周囲への感染拡大は認められていない。​

○ then spread to the surrounding, including the Family is not approved.

○ 大阪府立公衆衛生研究所によって実施されたノイラミニダーゼ（NA）遺伝子の一部（250bp)の解析によると、当該遺伝子に突然変異（point​

○ neuraminidase was carried out by the Osaka Prefectural Institute of Public Health (NA) part of the gene (250bp) and the analysis of mutations in the gene (point

mutation）を生じたものであり、季節性インフルエンザ（Ａ/Ｈ１Ｎ１；​

mutation) which arises, seasonal influenza (A/H1N1;

ソ連型） との交雑により生じたものではないとのこと。​

Soviet-type) which is caused by hybridization of the year.

○ ６月３０日の欧州疾病管理センター（ECDC）の発表によると、デンマークにおいて、海外渡航歴のある新型インフルエンザ患者の濃厚接触者として、タミフルの予防投与を受けていた方が、タミフル投与後５日目にインフルエンザ様症状が出たため検査を行い、新型インフルエンザに感染したことが判明。​

○ 6 Monday 30 of the European Center for Disease Control (ECDC) said, in Denmark, as the avian flu patients contact the rich history of travel abroad, who had prophylactic administration of Tamiflu, the drug administration 5 The tests for flu-like symptoms after day, is found to be infected with avian flu.

その後、薬剤耐性の状況を確認したところ、タミフル耐性の遺伝子変異が認められたとされている。​

Then I check the status of drug-resistant, and has been recognized that drug-resistant mutation.

○ 本事例について、ECDC は、タミフルが投与されている患者からタミフル耐性の遺伝子変異を示すウイルスが分離されることは、季節性インフルエンザにおいても観察されている現象であり、今回のタミフル耐性を示すインフルエンザウイルスについて、周囲の者への感染が確認されていないことから、公衆衛生上の危険はないものと考えられると評価している。​

○ For this case, ECDC will never be shown to isolate the virus-resistant gene mutations full TAMI patients are given Tamiflu, a phenomenon that is observed in the seasonal flu, Tamiflu will be resistant For influenza virus, has not been confirmed to be infected by the surrounding public health risk and are not considered.

※ なお、ECDC の同報告書では、日本において、タミフルによる治療を受けている季節性インフルエンザに感染した子供を調べたところ、その１６​

※ In addition, ECDC's report, in Japan, found that children infected with seasonal flu are being treated by a full TAMI, the 16

パーセントからタミフル耐性を示すウイルスが分離されたが、その感染性は低いものであったという研究結果が紹介されている 。​

The virus was separated from the TAMI shows the percent of full immunity, the infection is introduced, studies that were low.​

 

[HenryN]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

Ministry of Health on July 2, showing in Osaka H275Y Tamiflu resistance has been separated with a mutated avian flu virus genes.

タミフル耐性の遺伝子変異はデンマークで報告されているが、国内では初となる。​

Tamiflu-resistant gene mutations have been reported in Denmark, is the first in the country.

発表によると、患者は、5月15日に発症し、5月17日に新型インフルエンザに感染していることが確定した患者の濃厚接触者だった。​

According to the patients, 15 developed symptoms on May Day, May 17 was concentrated contacts of patients confirmed to have infected with avian flu.

5月18日からタミフルの予防投与（10日間）を受けていたが、5月24日から微熱が出、5月28日に発熱相談センターに連絡後、翌29日に新型インフルエンザと診断された。​

May 18, the prophylactic administration of Tamiflu (10 days) had, out May 24 from a fever, and on May 28 after contact with fever consultation centers, day 29, was diagnosed with avian flu on Sunday .

同日から、リレンザによる治療を受け回復したという。​

On the same day, told the treatment Relenza.

この患者から採取された検体を大阪府公衆衛生研究所で検査したところ、6月18日にタミフル耐性を示すH275Yの遺伝子変異が確認された。​

I checked with the Osaka Public Health Institute in samples from patients, the June 18 show a resistance to Tamiflu H275Y mutant gene was confirmed.

なお、家族を含めた周囲への感染拡大は認められていない。​

The infection spread to the surrounding, including the family is not approved.

また、5月15日に発症した患者のウイルス株についても検査したが、こちらは変異が見つからなかった。​

The May 15 was also tested in patients who develop the virus strain, the mutation is not found.

大阪府立公衆衛生研究所の解析によると、今回の遺伝子変異は、当該遺伝子に突然変異（point mutation）を生じたものであり、季節性インフルエンザ（A/H1N1、ソ連型） との交雑により生じたものではないとしている。​

According to the analysis of the Osaka Prefectural Institute of Public Health, the mutated gene, the gene mutation (point mutation) which arises, seasonal influenza (A/H1N1, type the Soviet Union) due to hybridization with It is not.

今後、国立感染症研究所において薬剤感受性試験等が実施される予定。​

Do you plan to implement and drug susceptibility testing in the National Institute of Infectious Diseases.

なお、厚労省は「タミフル耐性を示す遺伝子変異は、ウイルスの重篤度（病原性）には直接影響を及ぼすものではないとされる」との見解を示している。​

The ministry is "drug-resistant gene mutations indicate the severity of the virus (pathogenic) is a direct influence is not," said that.

海外では、欧州疾病管理センター（ECDC）が6月30日、デンマークで、新型インフルエンザウイルスにタミフル耐性の遺伝子変異が認められたと発表した。​

Overseas, European Center for Disease Control (ECDC) on June 30, in Denmark, and its recognition of genetically mutated avian flu virus resistant to Tamiflu.

患者は、海外渡航歴のある新型インフルエンザ患者の濃厚接触者で、タミフルの予防投与を受けていた。​

Patients are concentrated in the contacts of patients with a history of avian flu overseas travel, had a preventive dose of Tamiflu.

タミフル投与後5日目にインフルエンザ様症状が出たため検査を行ったところ、新型インフルエンザに感染したことが分かった。​

5 after administration of drug testing is done for the flu-like symptoms after day, it was found infected with avian flu.

その後、薬剤耐性の状況を確認したところ、耐性の遺伝子変異が検出されたという。​

Then I check the status of drug resistance, gene mutation was found resistant.

こちらのケースでも、周囲への感染が確認されていないことから、公衆衛生上の危険はないものと考えられている。​

In this case, it is not around to confirm the infection, public health risk is not considered.

■厚労省のリリース・大阪府におけるオセルタミビル（商品名：タミフル）耐性を示す遺伝子変異が検出された新型インフルエンザウイルスについて​

■ oseltamivir in the office of the Ministry of Labor released Osaka thickness (Products: Tamiflu) for the avian flu virus was detected indicating the resistant gene mutation

http://translate.google.com/transla...&hl=en&lr=&rlz=1T4GGLL_enUS326US326&tbs=qdr:d

 

[HenryN]

Re: Japan Reports Tamiflu-Resistant H1N1 Influenza Case

<TABLE class=lan18 border=0 cellSpacing=0 cellPadding=0 width="97%" align=center><TBODY><TR><TD class=hei22 height=25 vAlign=bottom>Japan reports first case of Tamiflu-resistant H1N1 flu
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2009-07-03 09:10:07 </TD><TD class=hui12 width="26%" align=middle> </TD><TD class=hui12 width="12%" align=middle>

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TOKYO, July 3 (Xinhua) -- Japanese has detected the first genetic mutation of the new H1N1 strain of influenza A that develops resistance to the anti-flu drug Tamiflu, the health ministry said late Thursday.

The Tamiflu-resistant virus was detected in a woman in her 40s infected with the new influenza in Osaka Prefecture, it said.
The ministry added she is already recovering after being administered Relenza, another anti-flu drug.
The female patient had been administered Tamiflu since May 18 as a preventive measure after she was found to have had close contact with another confirmed infected patient the previous day. She was confirmed infected with A/H1N1 influenza on May 28. An analysis of a virus taken from her detected the genetic mutation that does not respond to Tamiflu on June 18. The first case of HINI that showed resistance to Tamiflu was reported in Denmark at the end of last month.

http://news.xinhuanet.com/english/2009-07/03/content_11644518.htm

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