Quebec man caught drug-resistant swine flu

[wotan]

This one almost seems to be under the radar....

http://www.cbc.ca/canada/montreal/story/2009/07/21/montreal-quebec-man-swine-flu-drug-resistant.html

Quebec man caught drug-resistant swine flu

Last Updated: Tuesday, July 21, 2009 | 4:22 PM ET Comments0Recommend1

CBC News


A 60-year-old Quebec man is one of a handful of people around the world to catch a strain of swine flu that is resistant to drugs.
Health officials said the man likely contracted the virus from his son and did not require hospital treatment.
Canada's lead researchers are trying to find out more about what this means for the effectiveness of millions of doses of stockpiled antiviral drugs.
Dr. Guy Boivin, Canada Research Chair on emerging viruses and antiviral resistance in Quebec City, said Tuesday the new strains of drug-resistant swine flu raise a red flag but should not scare anyone.
?We know the exact, specific mutation, and this is a mutation that has been reported before in human viruses that were resistant to Tamiflu, so it's not totally unexpected,? said Boivin.
Boivin said he suspects the Quebec father was already infected when he was given a low preventive dose of the antiviral drug Tamiflu. Boivin suspected the father?s virus adapted to the drug at that point, becoming resistant.
Never in hospital

Boivin said the good news is that the father recovered well and was never taken to hospital. He said the next step is to find out how quickly the drug-resistant strain reproduces, and whether it's more potent and dangerous.
?We are using a lot of Tamiflu since [the] beginning of the pandemic, so using more antivirals probably means there is more chance of developing resistances,? Boivin said.
He said he'd also like to see a greater variety of antiviral drugs on the market, in case more people develop or contract a drug-resistant swine flu.
There are only two antiviral drugs currently available, and Tamiflu makes up 80 per cent of the 50 million doses reserved for Canadians.

[Rwilmer]

Re: Quebec man caught drug-resistant swine flu

We suspected that it would be under the rader. Especially since the case in Hong Kong where the girl came from San Francisco. It is not a suprise that they found this case, I expect that we will find many more.

[AlaskaDenise]

Re: Quebec man caught drug-resistant swine flu

...suspects the Quebec father was already infected when he was given a low preventive dose of the antiviral drug Tamiflu. Boivin suspected the father’s virus adapted to the drug at that point, becoming resistant.

If confirmed, this is an important point. Supposedly, he did not acquire the resistance from a circulating resistant strain.

My next question would be - who were his contacts after the resistance mutation? Did it spread? Time for contact testing!

We need to know when there is a circulating resistant stain.

This case appears different from the HK girl who acquired a circulating resistant strain.

.

[Rwilmer]

Re: Quebec man caught drug-resistant swine flu

Excellent points AlaskaDenise

[AlaskaDenise]

Re: Quebec man caught drug-resistant swine flu

This story brings up something I never thought about, i.e., people are taking tamiflu and may not practice good hygiene & social distancing, assuming they're not contagious.

However, if their virus becomes tamiflu resistant, they might be contagious with a resistant version. Huummm.....something to think about.

.

[HenryN]

Re: Quebec man caught drug-resistant swine flu

This story brings up something I never thought about, i.e., people are taking tamiflu and may not practice good hygiene & social distancing, assuming they're not contagious.

However, if their virus becomes tamiflu resistant, they might be contagious with a resistant version. Huummm.....something to think about.

.

H274Y is on MILD H1N1. This is the second patient who was infected, but did not require hospitalization (although the Hong Kong patient was hospitalized because she was H1N1 positive).

[AlaskaDenise]

Re: Quebec man caught drug-resistant swine flu

H274Y is on MILD H1N1. This is the second patient who was infected, but did not require hospitalization (although the Hong Kong patient was hospitalized because she was H1N1 positive).

So are these mild 274Y tamiflu-taking patients unknowingly contagious?

.

[HenryN]

Re: Quebec man caught drug-resistant swine flu

So are these mild 274Y tamiflu-taking patients unknowingly contagious?

.

Mild cases are more likely to spread H1N1 because they don't know or don't think they are infected. Many cases of H1N1 don't produce a fever. Other H1N1 infections only produce a low grade fever. The recent recruits in CT (10% of freshman class) had fevers of about 100 F, and although the infection spread throughout the class, most cases were MILD.

[HenryN]

Re: Quebec man caught drug-resistant swine flu

>>?We know the exact, specific mutation, and this is a mutation that has been reported before in human viruses that were resistant to Tamiflu, so it's not totally unexpected,? said Boivin.<<
Sounds like H274Y again.

[AlaskaDenise]

Re: Quebec man caught drug-resistant swine flu

>>?We know the exact, specific mutation, and this is a mutation that has been reported before in human viruses that were resistant to Tamiflu, so it's not totally unexpected,? said Boivin.<<
Sounds like H274Y again.

Is he saying only that they know what to look for, or that they have actually found it?

My interpretation was that they are trying to downplay the mutation by saying it's nothing new - they know exactly what to look for.

.

[HenryN]

Re: Quebec man caught drug-resistant swine flu

Is he saying only that they know what to look for, or that they have actually found it?

My interpretation was that they are trying to downplay the mutation by saying it's nothing new - they know exactly what to look for.

.

They know it is H274Y, but don't specifically say it (just describe it indirectly). They are trying to downplay the significance.

[wotan]

Re: Quebec man caught drug-resistant swine flu

The headline is probably in error, but I will post it here for tracking:

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090721/tamiflu_h1n1_090721/20090721?hub=Health&s_name=

Quebec man dies of Tamiflu-resistant H1N1 flu virus

Updated Tue. Jul. 21 2009 9:04 PM ET
The Canadian Press
<!-- dateline -->TORONTO<!-- /dateline --> -- Canada has recorded a case of Tamiflu-resistant H1N1 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 University.
But she said given the amount of Tamiflu being used in the world right now, such cases are bound to arise.
"It's the problem with influenza, right? Either we're going to see small numbers of these and they're just going to kind of appear periodically and we're all going to worry or it's going to go big," McGeer said.
"There's probably not going to be much in between."
This is the fourth case reported so far of Tamiflu resistance in H1N1 cases; earlier cases were reported from Denmark, Japan and Hong Kong. Three of the four cases arose in people who had been taking the drug.
The other was in a girl from San Francisco who travelled to Hong Kong and was discovered to be ill there. She hadn't taken the drug, suggesting the virus that caused her infection was already resistant. U.S. officials have intensified surveillance for resistant viruses in the San Francisco area but say they have not found other cases.
The Public Health Agency says the man recovered from his bout of swine flu without complications and never needed hospitalization.
Vlk said the agency recommends using Tamiflu for treatment only, adding prudent use of the drug could stave off the development of resistance.

Note that the article is inconsistent with the headline.

[HenryN]

Re: Quebec man caught drug-resistant swine flu

>>This is the fourth case reported so far of Tamiflu resistance in H1N1 cases; earlier cases were reported from Denmark, Japan and Hong Kong. <<

Actually, the Quebec case is the fifth example of H274Y because the Yamaguchi case (second example from Japan) was reported July 17

http://www.flutrackers.com/forum/showpost.php?p=269852&postcount=16

[HenryN]

Re: Quebec man caught drug-resistant swine flu

Quebec finds case of Tamiflu-resistant swine flu, fourth recorded globally
By Helen Branswell Medical Reporter (CP) ? 30 minutes ago
TORONTO ? 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 University.
But she said given the amount of Tamiflu being used in the world right now, such cases are bound to arise.
"It's the problem with influenza, right? Either we're going to see small numbers of these and they're just going to kind of appear periodically and we're all going to worry or it's going to go big," McGeer said.
"There's probably not going to be much in between."
This is the fourth case reported so far of Tamiflu resistance in swine flu cases; earlier cases were reported from Denmark, Japan and Hong Kong. Three of the four cases arose in people who had been taking the drug.
The other was in a girl from San Francisco who travelled to Hong Kong and was discovered to be ill there. She hadn't taken the drug, suggesting the virus that caused her infection was already resistant. U.S. officials have intensified surveillance for resistant viruses in the San Francisco area but say they have not found other cases.
The Public Health Agency says the man recovered from his bout of swine flu without complications and never needed hospitalization.
Vlk said the agency recommends using Tamiflu for treatment only, adding prudent use of the drug could stave off the development of resistance.
-Follow Canadian Press Medical Writer Helen Branswell's flu updates on Twitter at CP-Branswell

http://www.google.com/hostednews/canadianpress/article/ALeqM5gaNQxQtkte8cDFnwA_JRXyesKjAQ

[HenryN]

Re: Quebec man caught drug-resistant swine flu

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