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PAHO rejects report of resistant H1N1 cases on US-Mexico border

Shiloh

Editor, Senior Moderator
Source: http://www.google.com/hostednews/afp/article/ALeqM5gZLouahbIkDtadGE3KnYOs5DuTtA

Tamiflu-resistant swine flu found on US-Mexico border

(AFP) ? 1 hour ago

LA JOLLA, California ? A strain of swine flu that is resistant to treatment with the drug Tamiflu has been discovered near the US-Mexican border, the Pan-American Health Organization (PAHO) said on Monday.

"We have found resistance to Tamiflu on the border. We have observed some cases, few to be sure, in El Paso and close to McAllen, Texas," said Maria Teresa Cerqueira, head of the local PAHO office.

Cases of A(H1N1) that were resistant to the anti-viral medicine have now been found in the United States, Canada, Denmark, Hong Kong and Japan.

Experts gathered in La Jolla, California on Monday to discuss the response to the outbreak, said the resistance was likely due to overuse of antivirals like Tamiflu.

"In the United States Tamiflu is sold with a prescription, but in Mexico and Canada it is sold freely and taken at the first sneeze. Then, when it is really needed, it doesn't work," said Cerqueira.

Roche, the manufacturer of Tamiflu, has said it expects a 0.5 percent rate of case resistance based on clinical trials.

Cerquiera said one patient diagnosed with a Tamiflu-resistant strain had been treated with Zanamivir -- an anti-viral made by GlaxoSmithKline -- and another was given no alternative medication. Both survived.

Since the swine flu outbreak emerged earlier this year it has killed 353 people in the United States and 146 in Mexico, according to authorities from each country.

A large proportion of nearly 1,000 recorded deaths around the world since the virus was first identified in Mexico in April have involved people with underlying medical conditions.

World Health Organization chief Margaret Chan has urged countries to boost their drug stockpiles amid warnings of the virus's continued spread.

"Manufacturing capacity for influenza vaccines is finite and woefully inadequate for a world of 6.8 billion people, nearly all of whom are susceptible to infection by this entirely new and highly contagious virus," Chan said on July 14.

A vaccine against the disease is currently being tested for safety and effectiveness, and is expected to be ready in the next two to four months, although the precise date is unclear.

US officials have recommended that children and pregnant women be among the groups first in line for swine flu shots, but said they were unlikely to have enough vaccine for everyone once the drug is ready to be rolled out.

Greece has announced it will vaccinate all its 11-million-strong population, the first country to introduce such a broad measure amid the current pandemic.

With such pledges emerging, developing nations have expressed concerns they will be left out, as richer nations race to build stock piles.

UN Secretary General Ban Ki-moon has said developing countries could need about one billion dollars by the end of the year to fund measures against the swine flu pandemic, especially vaccines.
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

Cerquiera said one patient diagnosed with a Tamiflu-resistant strain had been treated with Zanamivir -- an anti-viral made by GlaxoSmithKline -- and another was given no alternative medication. Both survived.

So much 'spin' here, I'm getting dizzy.
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

So much 'spin' here, I'm getting dizzy.
These cases are a two VERY distinct locations on US Mexico border where there have been recent outbreaks in Mexico. The fact that two cases are being reported simultaneously is SIGNIFICANT.
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

Source: http://www.google.com/hostednews/afp/article/ALeqM5gZLouahbIkDtadGE3KnYOs5DuTtA

Tamiflu-resistant swine flu found on US-Mexico border

"We have found resistance to Tamiflu on the border. We have observed some cases, few to be sure, in El Paso and close to McAllen, Texas," said Maria Teresa Cerqueira, head of the local PAHO office.
These two locations are at opposite ends of the Texas border with Mexico. It is unclear if these patients had been treated with Tamiflu. I strongly suspect that the one that recovered without "alternative" (instead of "additional") treatment was NOT treated with Tamiflu.
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

These two locations are at opposite ends of the Texas border with Mexico. It is unclear if these patients had been treated with Tamiflu. I strongly suspect that the one that recovered without "alternative" (instead of "additional") treatment was NOT treated with Tamiflu.

Check the wording again. They said "few cases" not two cases. Perhaps I am reading the text too closely, but the way it was written implies it may be more than 2. Also:

Cerquiera said one patient diagnosed with a Tamiflu-resistant strain had been treated with Zanamivir -- an anti-viral made by GlaxoSmithKline -- and another was given no alternative medication. Both survived.

Again, I may be reading plain English too literally, but they said "another", not "the other." People speaking in an official capacity really ought to be more careful with their wording.
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

Check the wording again. They said "few cases" not two cases. Perhaps I am reading the text too closely, but the way it was written implies it may be more than 2. Also:



Again, I may be reading plain English too literally, but they said "another", not "the other." People speaking in an official capacity really ought to be more careful with their wording.
I think that the wording is deliberately mushy because there are more than two, but they don't want to say that yet.
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

Check the wording again. They said "few cases" not two cases. Perhaps I am reading the text too closely, but the way it was written implies it may be more than 2. Also:



Again, I may be reading plain English too literally, but they said "another", not "the other." People speaking in an official capacity really ought to be more careful with their wording.
This is sounding MUCH like the initial cases in California, which were more than 100 miles apart, had NO linkage, and were reported SIMULTANEOUSLY.
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

Check the wording again. They said "few cases" not two cases. Perhaps I am reading the text too closely, but the way it was written implies it may be more than 2. Also:



Again, I may be reading plain English too literally, but they said "another", not "the other." People speaking in an official capacity really ought to be more careful with their wording.

Correct. Few is more than 2!
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

Correct. Few is more than 2!

Textual analysis from all the way back in High School English finally has a use. ;)
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

Check the wording again. They said "few cases" not two cases. Perhaps I am reading the text too closely, but the way it was written implies it may be more than 2. Also:



Again, I may be reading plain English too literally, but they said "another", not "the other." People speaking in an official capacity really ought to be more careful with their wording.
It also says the other patient had "diagnosed" Tamiflu resistance and was treated with Relenza. It doesn't say that the patient developed Tamiflu resistance. I suspect that testing is up because FIT Tamiflu resistance has been found.
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

Roche, the manufacturer of Tamiflu, has said it expects a 0.5 percent rate of case resistance based on clinical trials.

Niman,

Correct me if I am wrong but didn't the previous strain of H1N1 from last year have close to 100% Tamiflu Resistance?

If that is the case, this statement can't really be true can it?
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

Niman,

Correct me if I am wrong but didn't the previous strain of H1N1 from last year have close to 100% Tamiflu Resistance?

If that is the case, this statement can't really be true can it?

I think that refers to de novo development.
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

Niman,

Correct me if I am wrong but didn't the previous strain of H1N1 from last year have close to 100% Tamiflu Resistance?

If that is the case, this statement can't really be true can it?
The seasonal flu was at 100% resistant (had H274Y) but NOT linked to Tamifu use (which I suspect is the case in these patients).
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

<a rel="nofollow" href="http://www.recombinomics.com/News/08040901/H274Y_TX_Cases.html">Commentary</a>

.
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

<a rel="nofollow" href="http://www.recombinomics.com/News/08040901/H274Y_TX_Cases.html">Commentary</a>

Commentary

Tamiflu Resistant Pandemic H1N1 Cases in Texas

Recombinomics Commentary 03:14
August 4, 2009

"We have found resistance to Tamiflu on the border. We have observed some cases, few to be sure, in El Paso and close to McAllen, Texas," said Maria Teresa Cerqueira, head of the local PAHO office.

Cerquiera said one patient diagnosed with a Tamiflu-resistant strain had been treated with Zanamivir -- an anti-viral made by GlaxoSmithKline -- and another was given no alternative medication. Both survived.

The above comments describe at least two oseltamivir resistant patients along the Texas / Mexico border. The cases are at opposite ends of the border (see map) and raise concerns that the resistance developed in the absence of Tamiflu treatment. One patient had "diagnosed" resistance and was treated with Zanamivir, while the other wasn't treated with Zanamivir, leaving open the possibility that neither were treated with oseltamivir. Moreover, the wording left open the possibility that there were more than two patients, suggesting fit swine H1N1 with H274Y was circulating over a wide area.

The emergence of fit swine H1N1 with H274Y is not a surprise. A case has already been reported in <a rel="nofollow" href="http://www.recombinomics.com/News/07070901/H274Y_HK_Seq.html">Hong Kong</a> in a traveler from San Francisco. The precursor for this strain has been reported <a rel="nofollow" href="http://www.recombinomics.com/News/07100901/H274Y_Fit.html">worldwide</a>, although the only case reported in the US was in April in New Jersey, raising concerns that the fit strain was circulating silently, in part because the cases were mild and not being tested. The patient in Hong Kong, like one of the patients recovered without treatment with Relenza, indicating the cases were relatively mild.

The fact that these cases were reported simultaneously also raises concerns that a fit H274Y is circulating in the area.

Details on the number of cases, and release of sequences, would be useful.

.
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

I will repeat what the medical autorithy says up here in Quebec;

Before this case we found only 4 resistant on probably 1 millions cases

SNOWY
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

(Google translation)

Several patients were found to be resistant to antiviral near the border. "This is not a surprise, there was no worry," says Roche, which estimated that 0.5% rate of resistance.


Boxes of Tamiflu (Sipa)
Cases of resistance to Tamiflu, the main antiviral drug used against influenza A (H1N1), were found near the border between the United States and Mexico, said Monday 3 August the Pan American Health Organization (PAHO). "We found cases of Tamiflu resistance to the border. We have seen some cases, few of which we are confident, El Paso and around McAllen, Texas," said Dr. Maria Teresa Cerqueira, responsible local office of PAHO, at a conference on influenza A. The persons concerned cross the border regularly and were automédicamentées, says the doctor.


Cases "isolated"
"In the U.S., Tamiflu is a prescription but it is widely available in Mexico and Canada and took the first sneeze. And when it is really useful, it does not work anymore", said Maria Teresa Cerqueira. She explained that a patient with a strain of influenza A (H1N1) viruses resistant to Tamiflu has been treated positively to Zanamivir, another antiviral drug, and another patient received no other treatment. Both patients survived, she argued.
In July, a case of resistance to Tamiflu had been found in Canada. It was the first case in North America, according to Dr. Guy Boivin, Center hospitalier de l'Université Laval (CHUL) in Quebec, who had discovered this resistant strain. Cases of resistance to antiviral therapy were also recorded in Denmark, Japan and Hong Kong.
The World Health Organization (WHO) has estimated that these cases are "isolated" and that it maintains its recommendation for Tamiflu and Relenza.


"There is no worry for the moment"
The laboratory Roche, Tamiflu seller, said he expected at 0.5% of its antiviral resistance from the results of clinical trials.
"This is not a surprise," says the director of the pharmaceutical division of Roche, William Burns: "in the case of the flu season, about 0.4% of the organisms may be resistant. There not worried at the moment. " "We do not increase in these cases of resistance," adds the CEO of Roche Severin Schwan.
"It is not excluded that in a community where people are treated with Tamiflu, there are few cases of viruses that develop resistance and spread," explains Dr. Thierry Buclin, a medical assistant in the office clinical pharmacology and toxicology at the CHUV of Lausanne. "The real question is: who should take Tamiflu?" Dr. Buclin nuance. "What you win to deal with Tamiflu, if one can be cured with paracetamol?" Hits there.

http://tempsreel.nouvelobs.com/actu...stance_au_tamiflu_a_la_frontiere_america.html
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

(Google translation)

"We found cases of Tamiflu resistance to the border. We have seen some cases, few of which we are confident, El Paso and around McAllen, Texas," said Dr. Maria Teresa Cerqueira, responsible local office of PAHO, at a conference on influenza A. The persons concerned cross the border regularly and were autom?dicament?es, says the doctor.




http://tempsreel.nouvelobs.com/actu...stance_au_tamiflu_a_la_frontiere_america.html
This version of the AFP story suggest that resistance might have been linked to self-prescribed tamiflu. However, it doesn't state that it was, and also does state that the resistance was discovered because the patients received Tamiflu treatment from a doctor. Thus, the number of patients and details surrounding the "diagnosis" remain murky.
 
Re: Tamiflu-resistant swine flu found on US-Mexico border

Re: Tamiflu-resistant swine flu found on US-Mexico border

<a rel="nofollow" href="http://www.recombinomics.com/News/08040902/H274Y_TX_Spread.html">Commentary</a>
 
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