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INFLUENZA A (H1N1) - WORLDWIDE (78): TAMIFLU RESISTANCE, DENMARK
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A ProMED-mail post
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International Society for Infectious Diseases
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Date: Mon 29 Jun 2009
Source: BBC News [edited]
<http://news.bbc.co.uk/1/hi/health/8124987.stm>
Experts have reported the 1st case of swine flu that is resistant to
Tamiflu [oseltamivir], the main drug being used to fight the pandemic.
Roche Holding AG confirmed a patient with H1N1 influenza in Denmark showed
resistance to the antiviral drug. David Reddy, company executive, said it
was not unexpected given that common seasonal flu could do the same.
The news comes as a 9 year old girl has become the 3rd to die in the UK
with swine flu. It is understood from her doctors at Birmingham Children's
Hospital that she had underlying health conditions. It is not yet known
whether swine flu contributed to her death.
Meanwhile, the Department of Health has announced a big jump in the number
of patients in England confirmed with swine flu, up 1604 since Friday [26
Jun 2009], taking the UK total so far to 5937. A Health Protection Agency
spokeswoman stated that: "Routine sampling in the UK has shown that there
is currently no resistance to oseltamivir or zanamivir." Experts have been
using Tamiflu, also known as oseltamivir, in a bid to stop the H1N1
spreading in communities. If taken early, it ensures that symptoms are mild
and reduces the chance of a victim giving the illness to someone else.
This 1st reported case of resistance developed in a swine flu patient
taking Tamiflu. Mr Reddy stressed that there were no signs of a
Tamiflu-resistant strain of H1N1 circulating in the community. This is in
contrast to seasonal H1N1 flu, where a Tamiflu resistant strain emerged
last year [2009] and is now widely circulating. Experts fear if this were
to happen, it could render Tamiflu ineffective [in treatment of the swine
flu H1N1 virus infection].
Another antiviral drug, called zanamivir or Relenza, made by
GlaxoSmithKline, is also effective against swine flu. The UK government has
been stockpiling these antiviral drugs and currently has enough to treat
half of the population, with a contract to bring that up to 80 per cent as
soon as possible. Supplies of flu vaccine have also been ordered, and the
1st doses could be administered in the autumn [2009].
A spokeswoman for the Health Protection Agency said: "The Health Protection
Agency continues to watch for antiviral resistance and will be carrying out
regular sample testing throughout this outbreak. We have been monitoring
antiviral drug resistance since the beginning of this outbreak. Routine
sampling in the UK has shown that there is currently no resistance to
oseltamivir or zanamivir." Virologist Professor John Oxford said: "I'm not
surprised about this finding. The question is whether it is going to
spread. We will soon know the answer."
--
communicated by:
ProMED-mail <promed@promedmail.org>
[According to the European Influenza Surveillance Scheme Weekly Electronic
Bulletin of 26 Jun 2009 (<http://www.euroflu.org/>), all but one pandemic A(H1N1) viruses tested have been sensitive to oseltamivir and zanamivir but resistant to M2 inhibitors, although widespread (98 per cent) Tamiflu
resistance has been observed in seasonal A(H1N1) viruses. [see posting Influenza A (H1N1) - worldwide (83): antiviral resistance 20090705.2417] The emergence of Tamiflu-resistant 209 swine-origin A H1N1 influenza virus is not unexpected in view of the widespread and somewhat indiscriminate use of the drug in the treatment of what is still a relatively mild disease. It remains to be seen whether the Tamiflu-resistant virus will spread in Europe and beyond and appear
independently elsewhere. It is presumed that the Tamiflu-resistant virus
isolated in Denmark remains sensitive to the alternate neuraminidase
inhibiter Relenza. - Mod.CP]
[see also:
Influenza A (H1N1) - worldwide (77): case count 20090627.2338
Influenza A (H1N1) - worldwide (76): comments on 1918 virus (03) 20090625.2309
Influenza A (H1N1) - worldwide (74): susp. origin 20090624.2303
Influenza A (H1N1) - worldwide (73): case count, epidemiology 20090622.2288
Influenza A (H1N1) - worldwide (72): case count, epidemiology 20090619.2261
Influenza A (H1N1) - worldwide (70): risk factors 20090619.2260
Influenza A (H1N1) - worldwide (69): other viral infections 20090618.2254
Influenza A (H1N1) - worldwide (68): southern hemisphere 20090618.2253
Influenza A (H1N1) - worldwide (65): antivirals in pregnancy 20090616.2224
Influenza A (H1N1) - worldwide (64): case count, pandemic 20090616.2221
Influenza A (H1N1) - worldwide (62): Egypt, Lebanon 20090611.2150
Influenza A (H1N1) - worldwide (62): Egypt, Lebanon 20090611.2150
Influenza A (H1N1) - worldwide (60): Egypt (Cairo) 20090608.2117
Influenza A (H1N1) - worldwide (59): Worldwide 20060608.2117
Influenza A (H1N1) - worldwide (58): USA, Africa 20090607.2109
Influenza A (H1N1) - worldwide (57): Brazil, USA 20090605.2090
Influenza A (H1N1) - worldwide (55) 20090603.2056
Influenza A (H1N1) - worldwide (47): China, epidemiology 20090526.1962
Influenza A (H1N1) - worldwide (45) 20090525.1951
Influenza A (H1N1) - worldwide (42) 20090523.1929
Influenza A (H1N1) - worldwide (39) 20090521.1903
Influenza A (H1N1) - worldwide (37) 20090520.1893
Influenza A (H1N1) - worldwide (34) 20090518.1863
Influenza A (H1N1) - worldwide (31) 20090516.1835
Influenza A (H1N1) - worldwide (29) 20090515.1824
Influenza A (H1N1) - worldwide (26) 20090514.1798
Influenza A (H1N1) - worldwide (23) 20090511.1764
Influenza A (H1N1) - worldwide (21) 20090510.1749
Influenza A (H1N1) - worldwide (19) 20090509.1733
Influenza A (H1N1) - worldwide (17) 20090508.1722
Influenza (H1N1) - worldwide (15) 20090507.1709
Influenza A (H1N1) - worldwide (13) 20090506.1695
Influenza A (H1N1) - worldwide (11): coincident H3N2 variation 20090505.1679
Influenza A (H1N1) - worldwide (09) 20090504.1673
Influenza A (H1N1) - worldwide (07) 20090503.1658
Influenza A (H1N1) - worldwide (05) 20090503.1657
Influenza A (H1N1) - worldwide (03) 20090501.1646
Influenza A (H1N1) - worldwide (02): case counts 20090430.1638
Influenza A (H1N1) - worldwide 20090430.1636
Influenza A (H1N1) "swine flu": worldwide (07), update, pandemic 5
20090429.1622
Influenza A (H1N1) "swine flu": worldwide (06) 20090429.1614
Influenza A (H1N1) "swine flu": worldwide (05) 20090428.1609
Influenza A (H1N1) "swine flu": worldwide (04) 20090428.1601
Influenza A (H1N1) "swine flu": worldwide (03) 20090428.1600
Influenza A (H1N1) "swine flu": Worldwide (02) 20090427.1586
Influenza A (H1N1) "swine flu": Worldwide 20090427.1583
Influenza A (H1N1) virus, human: worldwide 20090426.1577
Influenza A (H1N1) virus, human - New Zealand, susp 20090426.1574
Influenza A (H1N1) virus, human - N America (04) 20090426.1569
Influenza A (H1N1) virus, human - N America (03) 20090426.1566
Influenza A (H1N1) virus, human - N America (02) 20090425.1557
Influenza A (H1N1) virus, human - N America 20090425.1552
Acute respiratory disease - Mexico, swine virus susp 20090424.1546
Influenza A (H1N1) virus, swine, human - USA (02): (CA, TX) 20090424.1541
Influenza A (H1N1) virus, swine, human - USA: (CA) 20090422.1516
Influenza A (H1N1) virus, swine, human - Spain 20090220.0715]
...................cp/msp/sh
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