Researchers find Tamiflu-resistant H1N1 virus mutation

In a widely reported story this week, research presented by North Carolina
Division of Public Health at the annual conference of the Infectious Diseases
Society of America
, documented evidence of the passing of Tamiflu-resistant
H1N1 virus between two people
.

The North Carolina Division of Public Health had earlier reported warnings to
clinicians on this H1N1 mutation in a health alert issued dated 21 August.

Thus far, strains of H1N1 have responded to two antiviral medications oseltamivir (Tamiflu) and zanamivir (Relenza), both are widely used for treatment of H1N1.

In June and July of 2009, 65 campers and staff at a summer camp in North
Carolina were treated with Tamiflu after becoming ill with H1N1, while another
600 campers and staff took the antiviral to prevent the illness. Two females, who shared a cabin, developed mild symptoms after starting on Tamiflu, and were later found to have a H1N1 virus with two mutations that were resistant to the antiviral. Both fully recovered.

HealthDay news reports the principal recommendation from the study is that H1N1 vaccine, not antivirals should be used for prevention. CDC recommends priority use of antiviral medications for people hospitalized with influenza and those at increased risk of influenza-related complications.

Last week, in response to CDC requests, FDA authorized emergency use of the
investigational antiviral drug peramivir
for patients hospitalized with confirmed or suspected cases of H1N1. Peramivir is administered intraveneously and would provided to patients who are not reponsive to other therapies or in circumstances where IV treatments are more appropriate.

CDC: Updated Interim Recommendations for the Use of Antiviral Medications
in the Treatment and Prevention of Influenza for the 2009-2010 Season

FDA: FDA Authorizes Emergency Use of Intravenous Antiviral Peramivir for 2009 H1N1 Influenza for Certain Patients, Settings
HealthDay: Tamiflu-Resistant Swine Flu Passed Person-to-Person in U.S.
Infectious Diseases Society of America: 47th Annual Conference
NC Dept of Public Health: Oseltamivir-Resistant Novel H1N1 virus: Alert to North Carolina Clinicians, 8/21/09 – N.C. DPH

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