Re: Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus from 2009-2013 (epi curve)
WHO European Region 2012 (week 40) -2013 (week 20)
Summary, week 20/2013
Monitoring of susceptibility to antiviral drugs (Total of 13 viruses)
Cumulatively since week 40/2012, 13 countries (Denmark, Germany, Greece, Ireland, the Netherlands, Norway, Portugal, Romania, the Russian Federation, Spain, Sweden, Switzerland and the United Kingdom) have screened 1540 viruses for susceptibility to the neuraminidase inhibitors oseltamivir and zanamivir.
Of the 743 A(H1N1)pdm09 viruses tested, 730 showed susceptibility to both drugs while 13 viruses (2%) carried the neuraminidase H275Y amino acid substitution, causing resistance to oseltamivir.
Of these 13 viruses,
1 from the Russian Federation was detected in a hospitalized patient not exposed to oseltamivir through treatment;
1 from Germany was detected in a hospitalized patient with unknown exposure to the neuraminidase inhibitors;
2 viruses from the United Kingdom were detected in outpatients not exposed to oseltamivir through treatment;
6 viruses were detected in hospitalized patients exposed to oseltamivir through treatment (1 from Denmark, 4 from Germany and 1 from Sweden)
and 3 viruses were detected in hospitalized immunocompromised patients exposed to oseltamivir through treatment (2 from the Netherlands and 1 from Switzerland).
The 378 influenza A(H3N2) viruses tested showed susceptibility to both drugs. Of the 419 influenza B viruses tested, 418 showed susceptibility to both drugs; 1 virus showing reduced inhibition by oseltamivir, and normal inhibition by zanamivir, was detected in the United Kingdom in an outpatient without exposure to antiviral treatment. There is no indication of the spread of resistant viruses.
The 110 influenza A(H1N1)pdm09 and 55 influenza A(H3N2) viruses screened for susceptibility to adamantanes were found to be resistant.
• EuroFlu - Bulletin Review
•
http://www.euroflu.org/cgi-files/bulletin_v2.cgi
Retrospective summary of oseltamivir resistant A(H1N1)pdm09 virus with the H275Y in Europe: during weeks 20-15 2012-2013 by EURO Flu bulletin notification week and exposure, (n=13)
•Week 4: Netherlands 1, oseltamivir therapy (hospitalised immunocompromised patient was identified carrying an oseltamivir resistant A(H1N1)pdm09 virus with the H275Y amino acid substitution. This resistant variant emerged during oseltamivir therapy and was detected shortly after oseltamivir was stopped and before zanamivir therapy was started. The patient was also treated with antibiotics for pneumonia due to Haemophilus influenza, thereof improved rapidly and was discharged 20 days after onset of respiratory symptoms.')
•Week 8: Netherlands (1) and Switzerland (1) both were hospitalised immunocompromised patients exposed to oseltamivir through treatment
•Week 9: United Kingdom (2) - 2 viruses from the United Kingdom were detected in outpatient patients not exposed to oseltamivir through treatment.
•Week 10: 1 virus from the Russian Federation was detected in a hospitalised patient; 2 viruses from Germany were detected in hospitalised immunocompromised patients exposed to oseltamivir through treatment.
•Week 11: 1 virus from Denmark was detected in hospitalised immunocompromised patients exposed to oseltamivir through treatment
•Week 14: 1 virus from Sweden was detected in hospitalised immunocompromised patients exposed to oseltamivir through treatment
•Week 15: 3 viruses from Germany - 2 viruses from Germany were detected in hospitalized patients exposed to oseltamivir through treatment and ; 1 from Germany was detected in a hospitalised patient with unknown exposure to the neuraminidase inhibitors
Note: This report only reports 2 cases/viruses in United Kingdom however in the recent update there was 4 viruses note by HPA/PHE (writers ver. 1.4)
Public Health England: Surveillance of influenza and other respiratory viruses, including novel respiratory viruses, in the UK: Winter 2012-13
Clip:
Antiviral resistance
Since week 40 2012, four unlinked sporadic influenza A(H1N1)pdm09 viruses have been found to be resistant to oseltamivir at RVU and regional laboratories in England; two following treatment with oseltamivir, and two from patients without any treatment history. Additionally, one influenza B virus with an I221T amino acid substitution was detected in a community specimen, without antiviral exposure. This virus exhibits reduced susceptibility to oseltamivir but retains sensitivity to zanamivir. Globally, WHO have reported only very low numbers of oseltamivir and zanamivir resistant viruses detected during the season.
Surveillance of influenza and other respiratory viruses, including novel respiratory viruses, in the United Kingdom: Winter 2012/13 (PDF, 647 KB)
I won't be updating graph until January 2014 but this gives an updated view of oseltamivir- resistant in Europe by exposure during the 2012-13 Influenza season.
Remember there is a time lag of Euro Flu reports compared to MOH reports!
Once I finalised weeks per MOH notification I'll update timeline!
Remains a work in progress....
It happens!
ii=20266.