Drug-Resistant Flu Strain Turns Up In Denmark but Doesn’t Last Long - page 3

by Lovely_RN

1,947 Views | 35 Comments

June 30, 2009 Global Update Drug-Resistant Flu Strain Turns Up In Denmark but Doesn’t Last Long By DONALD G. McNEIL Jr. The first case of swine flu resistant to the antiviral drug Tamiflu has been found in Denmark,... Read More


  1. 0
    My dear colleague:

    This is the first post in a two page thread, where only you and one post from the op exist. I see that you are very concerned about flu.

    My level of concern is significantly less. I believe (actually know), that the response must meet the threat. The current public, governmental and individual responses are more than adequate to the threat.

    An example of the consequences from over-reaction can be seen by what happened in y2k.

    If the dangers exist as you seem to believe, what response do you believe (or know) would be adequate to the current situation?

    Please describe how the government, cdc and individuals should be responding, in an ideal response.
  2. 0
    I have no idea what consequences of Y2K you are alluding to.

    I have already posted information on govt and individual response, and this is not the thread for it.

    This thread is on Tamiflu resistance. Did you have a question on this? If not, perhaps you would like to start your own thread about your own issues.
  3. 0
    Quote from Woodenpug
    My dear colleague:

    This is the first post in a two page thread, where only you and one post from the op exist. I see that you are very concerned about flu.

    My level of concern is significantly less. I believe (actually know), that the response must meet the threat. The current public, governmental and individual responses are more than adequate to the threat.

    An example of the consequences from over-reaction can be seen by what happened in y2k.

    If the dangers exist as you seem to believe, what response do you believe (or know) would be adequate to the current situation?

    Please describe how the government, cdc and individuals should be responding, in an ideal response.
    Here is a link to the Pandemic Flu Forum where you will find other threads that you might find interesting, Woodenpug.

    Some, you will find, believe there is overreaction (but, that is a topic for another thread, not this one).
  4. 0
    My opinion that concerns over tamiflu resistance is yet another over-reaction is not applicable to this thread?

    O.k.
  5. 0
    http://www.weekendpost.co.za/article.aspx?id=443952

    Resistant cases are turning up all over, but they are not being announced as such.

    Quote from www.weekendpost.co.za

    He watched helplessly as doctors and specialists in protective gear battled to control Kelly‘s fever after she proved resistant to anti-viral Tamiflu, a drug being used globally to fight swine flu.

    “On the fifth day she started responding to another drug
    and they eventually released us. We caught the first flight out, even though they tried to make us stay in a hotel for two more days. We just wanted to get home and are so relieved to be back,” he said.
  6. 0
    http://www.thestandard.com.hk/news_d...603&con_type=1

    Quote from www.thestandard.com.hk

    The 37-year-old Filipino woman arrived in Hong Kong on June 28 to work for a pregnant woman and her husband. She developed flu symptoms the following day but two tests for the H1N1 virus proved negative. However, a third tested turned up positive on Saturday as her condition deteriorated.

    She is in the intensive care unit of the Kwun Tong hospital and is on a respirator. She was earlier given the antiviral drug Tamiflu and yesterday got Relenza, another antiviral drug.
  7. 0
    Another case of Tamiflu resistance found in Japan

    http://www.flutrackers.com/forum/sho...77&postcount=1

    From a Japanese translation:

    Quote from www.flutrackers.com

    The Ministry of Health Labor and Welfare announced Friday that another oseltamivir-resistant virus was found in Yamaguchi prefecture from a patient of novel influenza after prophylaxis of oseltamivir.
    The patient has already recovered and no further infection from the patient has been confirmed.

    According to the National Institute of Infectious Diseases, a spot mutation at H275Y of Neuraminidase was confirmed in the virus. No reassortment with the seasonal influenza virus was found.

    Source: http://www.mhlw.go.jp/kinkyu/kenkou/...fuh0717-04.pdf
  8. 0
    Quebec

    http://www.google.com/hostednews/can...nwA_JRXyesKjAQ

    Much as I admire Helen Branswell's work, this is not the 4th case of resistance to Tamiflu. There have been other cases that were noticeable by the lack of fanfare, just little blurbs of info describing what happened to these patients, and btw, they were still testing positive for swine flu despite Tamiflu treatment. Yes, it was expected that this would happen, just not this soon...

    Quote from www.google.com

    Canada has recorded a case of Tamiflu-resistant swine flu virus, in a Quebec man who had been given the drug to prevent infection.

    The case is the fourth reported globally since the new H1N1 virus was discovered in April.
    The man, 60, was given the flu antiviral after his son fell ill with the pandemic virus. It's believed the resistance arose in the man and there is no evidence he transmitted resistant virus to anyone else.

    "It appears to be an isolated case," said Jirina Vlk, spokesperson for the Public Health Agency of Canada.
    "Although the strain does not appear to have spread beyond the reported individual case we continue to be vigilant on this front."
    Use of Tamiflu to prevent infection - a procedure called prophylaxis - has been seen on occasion to give rise to resistant viruses.
    "We know that it was going to happen and it's not good news that it's happening," said Dr. Allison McGeer, an influenza expert at Toronto's Mount Sinai Hospital.

    But she said given the amount of Tamiflu being used in the world right now, such cases are bound to arise.
    http://www.recombinomics.com/News/07...ada_Japan.html
    Last edit by indigo girl on Jul 21, '09
  9. 0
    More Tamiflu resistance in Japan

    http://www.flutrackers.com/forum/sho...76&postcount=1

    This patient was being treated prophylactically after being exposed to a positive case in the workplace. He got sick anyway on day 5 after the exposure despite treatment. His virus was sampled and sent off to be tested revealing that he had a Tamiflu resistant virus.

    Not so surprising as Japan has always used more Tamiflu than any other country, Dr. Niman over at Recombinomics believes that there will be many more cases out there because Tamiflu resistance has been flying under the radar in many countries and not just in Japan. Whether he is right or not remains to be seen so stay tuned...

    http://www.flutrackers.com/forum/sho...1&postcount=17

    H274Y is the polymorphism associated with Tamiflu resistance in influenza viruses.

    Quote from www.flutrackers.com

    This case is virtually IDENTICAL to the Osaka case, down to the FIFTH day. The patient is started on a 10 day course of Tamiflu. However, the patient gets infected because the H1N1 with H274Y is at a relatively high level, but just below detection by the sequencers (unless they look closley). The published sequences are just "consensus" sequences and represent the dominant strain. If the strain with H274Y is 20% or less, it won't won't show up in the sequence (if it is 20-50% the sequence will have mixed signals).

    The fact that the patient become symptomatic five days after the start of treatment, means the level of H274Y is relatively high (normally it takes 2-4 days to develop symptoms), because the delay in disease onset date is small.

    The H1N1 at day 5 is exclusively virus with H274Y, so the sequencers are stuck with H274Y and announce the "discovery".

    H274Y is WIDESPREAD and below the sequencer's radar becasue they are not looking very hard.

    Japan has a high level of H1N1 and frequently uses Tamiflu, so 3 of the 5 isolates from treated patients are in Japan.
  10. 0
    http://www.recombinomics.com/news/08..._tx_cases.html

    h274y is a genetic marker indicating that a strain of virus is resistant to treatment with tamiflu. according to this commentary, tamiflu resistant strains of swine flu may be circulating along the texas/mexico border.

    zanamivir is the only available alternative antiviral drug but it must be inhaled. not every patient will be able to use it, and it only hits the respiratory tract. tamiflu treats systemically which is more useful considering that swine h1n1 also affects other body systems such as the gi tract.

    Quote from www.recombinomics.com

    "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 hong kong in a traveler from san francisco. the precursor for this strain has been reported worldwide, 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.


Top