Published Date: 2009-09-17 19:00:04
Subject: PRO/AH/EDR> Influenza pandemic (H1N1) 2009 (50): oseltamivir resistance
Archive Number: 20090917.3260
INFLUENZA PANDEMIC (H1N1) 2009 (50): OSELTAMIVIR RESISTANCE
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Date: Tue 15 Sep 2009
Source: The Tyee, Canadian Press report [edited]
<http://thetyee.ca/CanadianPress/2009/09/15/Flu-Drug-Resistant/>
Alberta Health Services is reporting Canada's 2nd drug-resistant case
of swine flu [pandemic (H1N1) 2009] virus infection, one of about 24
such cases around the world. Officials were busy Tuesday [15 Sep 2009]
trying to determine if anyone who came into contact with the Alberta
woman last month [August 2009] has been infected, but they were
optimistic that this was an isolated case. "The patient was not
hospitalized and has since recovered," said Dr. Gerry Predy, Alberta's
senior medical officer of health. "This is not unexpected. However, it
is important because oseltamivir is one of our main tools in dealing
with the pandemic. But we don't think this is going to change our
approach in any way because it is an isolated case as far as we know
at this time."
Health officials say any resistance to oseltamivir, also known as
Tamiflu, could possibly lead to further cases of resistant disease and
might affect how the disease spreads. Information about the Alberta
case has been forwarded to the federal government and the World Health
Organization. Predy said officials haven't determined if any people
who were in contact with the woman had taken antiviral medication.
Officials were not sure if she developed an infection with the
resistant strain from the outset or developed the resistance during
treatment.
About 24 cases of drug-resistant swine flu [influenza pandemic (H1N1)
2009 virus] have been reported around the world, including an earlier
case involving a 60-year-old man from Quebec who was given the drug
when he was exposed to swine flu because his son was ill. He recovered
and didn't appear to spread resistant virus to people around home.
Other resistant cases have been reported in the United States,
Denmark, Australia, China and Singapore [and Japan, see comment
below]. Most of the cases have been in people who have taken the drug,
either as treatment for swine flu or to prevent swine flu after they
were exposed to it.
People who are resistant to Tamiflu may also be treated with the
antiviral drug zanamivir. Predy said the drug-resistant case will not
affect Alberta's plan to roll out a swine flu vaccination program this
fall, probably in November 2009. "This is nothing that should cause
any kind of concern," Predy said. "It is something that means we will
just have to keep the monitoring process in place."
[Byline: John Cotter]
--
Communicated by:
ProMED-mail Rapporteur Mary Marshall
[An instance of isolation of both oseltamivir sensitive and resistant
pandemic (H1N1) 2009 virus from the same individual, reported in the
Chiba local edition of The Yomiuri Shimbun of 10 Sep 2009
(<http://www.yomiuri.co.jp/e-japan/chiba/news/20090910-OYT8T00068.htm>) has
been drawn to our attention by a Japanese correspondent who wished to
remain anonymous. The Disease Control Division, Health and Welfare
Department, Chiba prefectual Government has described the case of a
young woman hospitalised in June 2009 and treated with Tamiflu
(<http://www.pref.chiba.lg.jp/syozoku/c_kenfuku/kikikanri/press/090909.htm>).
Virus isolated from this patient prior to treatment was
Tamiflu-sensitive, whereas a subsequent sample was Tamiflu-resistant
and carried the Tamiflu-resistance marker H275Y. The patient recovered
and was virus-free on release from hospital. There has been no onward
transmission of Tamiflu-resistant virus in this or any other such case
as far as is known at present. - Mod.CP]
See Also
Influenza pandemic (H1N1) 2009 (49): FDA vaccine update 20090917.3254Influenza pandemic (H1N1) 2009 (48): contagious period 20090915.3243
Influenza pandemic (H1N1) 2009 (47): Spain, ICU patients 20090914.3234
Influenza pandemic (H1N1) 2009 (46): WHO update 65 20090911.3209
Influenza pandemic (H1N1) 2009 (45): antiviral resistance 20090911.3207
Influenza pandemic (H1N1) 2009 (44): receptor binding 20090910.3192
Influenza pandemic (H1N1) 2009 (43): pediatric questions 20090909.3185
Influenza pandemic (H1N1) 2009 (42): China, pork consumption 20090907.3146
Influenza pandemic (H1N1) 2009 (41): Iran 20090906.3140
Influenza pandemic (H1N1) 2009 (40): global update 20090906.3138
Influenza pandemic (H1N1) 2009 (39): pediatric deaths 20090904.3118
Influenza pandemic (H1N1) 2009 (38): 10 S.Amer. presidents exposed
20090831.3063
Influenza pandemic (H1N1) 2009 (37): 2nd wave plan, WHO 20090830.3042
Influenza pandemic (H1N1) 2009 (36): USA (IL), NZ 20090828.3032
Influenza pandemic (H1N1) 2009 (35): NZ surveillance 20090827.3022
Influenza pandemic (H1N1) 2009 (34): Tamiflu shelf-life 20090826.3006
Influenza pandemic (H1N1) 2009 (33): cases, fatalities 20090820.2955
Influenza pandemic (H1N1) 2009 (32): Tamiflu use policy 20090817.2914
Influenza pandemic (H1N1) 2009 (31): drug resistance 20090815.2900
Influenza pandemic (H1N1) 2009 (30): assumptions 20090813.2879
Influenza pandemic (H1N1) 2009 (20): Peru, 33 percent asymptomatic
20090730.2668
Influenza pandemic (H1N1) 2009 (10): vaccine 20090720.2577
Influenza pandemic (H1N1) 2009 - Viet Nam: patient data 20090708.2450
.....................................................cp/msp/jw
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