Originally Posted by theforeigner
OK let me ask you if I´v got this right? (I don´t have knowhow concerning the technical part of the virus )
The Tamiflu resistant patient "A" possibly/proably got/developed a virus where Swine flu virus and preexisting Tamiflu resistant sesonal flu virus H274Y had mixed into a new Tamiflu-resistant Swine flu variation ?
Is that close? or am I totaly off ?
You are close. You have described how the resistance formed, but it was probably not in patient A or B. It has been circulating undetected. The overseas traveler was infected, but recovered even though the Tamiflu played no role (many recover without Tamiflu treatment). He infected the Denmark contact and the Tamiflu also didn't help her, but she needed antiviral help, so when she developed symptoms while taking Tamiflu, the Drs knew there was a good chance that the H1N1 was resistant, so they isolated it. They also switched treatment to Relenza, which worked.
The bottom line is the resistant strain is circulating, but surveillence is poor and the only reason it was detected was because the contact develped symptoms while taking Tamiflu and she responded to Relenza.
However, now countries will look harder and find H274Y in patients not taking tamiflu and realize it has been silently spreading (as happened with seasonal flu in 2007/2008. It had been circulating for MONTHS prior to detection in Norway (and for YEARS at low levels prior to that - in patients that were NOT taking Tamiflu).