Sequences from Tamiflu Resistant Immunocompromised Patients Released

[wotan]

Re: Sequences from Tamiflu Resistant Immunocompromised Patients Released

Comparing the date of the released sequence and the test dates, the obvious escaped me Maybe they found resistance in the earlier specimens and are withholding the sequences because someone is writing a paper or any of the other reasons they withhold sequences?

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When I did the summary, I realized just how much these poor people have been through with their original health problems and now the flu. The hospital confinements, home confinements, all the precautionary measures, the side effects from the meds, waiting for the many test results...

If their families ever find their way to this thread, I want them to know their loved ones aren't just some case numbers being discussed on a flu board.

Well, if you want people to hold onto the hopes of a safe, effective vaccine and use-able antivirals, wouldn't it be in your interest to with-hold evidense that at least one of those is no longer viable as long as you can? Remember, the US has done nothing to try to contain this (even though they would have failed anyway), so all they have to prevent "panic" when the SHTF is that you have a vaccine coming and even if you get it Tamiflu will save you.

 

[HenryN]

Re: Sequences from Tamiflu Resistant Immunocompromised Patients Released

Wouldn't the presence of only a single polymorphism that leads to Tamiflu resistance itself tend to discredit random mutations. From following your various discussions in different threads here and elsewhere I gather that there is at least one other known polymorphism that leads to Tamiflu resistance and that it is at least reasonably fit. In the case of purely random generation of Tamiflu resistance, shouldn't we see roughly equal amounts of both of those?

The spontaneous mutations are discredited MANY ways. In H5N1 N294S was fit. The infected patients died and the N294S was present PRIOR to treatment. However, there are NO reported cases of N294S in recent seasonal H1N1 or pandemic H1N1. Similarly, there are also Tamiflu resistant markers in N2 (as in H3N2) and there are ZERO recent reports of resistance in seasonal H3N2.
Spontaneous mutations are VERY rare, but are constantly cited WITHOUT supporting data.

 

[HenryN]

Re: Sequences from Tamiflu Resistant Immunocompromised Patients Released

Well, if you want people to hold onto the hopes of a safe, effective vaccine and use-able antivirals, wouldn't it be in your interest to with-hold evidense that at least one of those is no longer viable as long as you can? Remember, the US has done nothing to try to contain this (even though they would have failed anyway), so all they have to prevent "panic" when the SHTF is that you have a vaccine coming and even if you get it Tamiflu will save you.

From the report to President Obama:

Resistance to these agents, especially oseltamivir, as a result of viral mutation or genetic recombination, can be a major factor limiting antiviral effectiveness

 

[mixin]

Re: Sequences from Tamiflu Resistant Immunocompromised Patients Released

Niman:

I suspect the greater the differences between the two patients, the happier the CDC is, but they will have a problem with NC, becasue they will be virtually identical (so I suspect the CDC will hold those sequences as long as possible (but the cat really is out of the bag)

Isn't it possible that the difference in the treatments, health and ages of the 2 immunosuppressed patients would result in greater sequence differences than the 2 healthy kids at camp?

 

[HenryN]

Re: Sequences from Tamiflu Resistant Immunocompromised Patients Released

Niman:

Isn't it possible that the difference in the treatments, health and ages of the 2 immunosuppressed patients would result in greater sequence differences than the 2 healthy kids at camp?

All that I saw on the two campers is that they were from the same camp, prophylatically treated with Tamiflu, developed symtoms in July, and recovered. I STRONGLY suspect they were infected at about the same time by the same virus with the same minor component with H274Y. As a result, the viruses will be virtually identical (and claiming two spontaneous mutations at the same time and the same location will be a MAJOR stretch).
In Seattle, the marker appeared many months earlier, the infections were not epidemiologically linked, and were in different hospitals (locations in Seattle). Thus, the viruses were close (both had A1230G and H274Y), but that was awhile ago and there was some divergence.