Govt plans survey on Tamiflu-resistant flu (Japan)

[HenryN]

Govt plans survey on Tamiflu-resistant flu

The Yomiuri Shimbun
The Health, Labor and Welfare Ministry plans to conduct a nationwide survey of patients infected with a strain of influenza virus resistant to the major oral drug Tamiflu this winter, it was learned Tuesday.
While an increasing number of cases of the drug-resistant virus have been reported in the United States and Europe, the spread of such a virus in the country likely will disrupt medical institutions because Japan is one of the world's largest users of the drug.
The ministry plans to set up a research group for the survey.
According to the National Institute of Infectious Diseases (NIID), the drug-resistant virus accounted for about 2.8 percent of flu cases in Japan last winter. In the United States, however, the drug-resistant strain accounted for 11 percent of all cases last winter, while the ratio sharply increased to 98 percent in a preliminary survey conducted on 50 test samples in autumn last year.
The result prompted the U.S. Centers for Disease Control and Prevention to decide that the drug-resistant virus will be this winter's mainstream influenza, and to announce emergency treatment guidelines that recommend medical institutions to use antiflu drugs other than Tamiflu, such as Relenza.
In Europe, 20 percent of influenza viruses surveyed last winter were resistant to Tamiflu. In Norway, 67 percent of flu viruses were resistant to the drug. As countries where the use of Tamiflu is less prevalent also saw the drug-resistant virus, it is believed that the resistant virus has been spontaneously generated and spread across Europe.
Meanwhile, among foreign patients, including those from Southeast Asia, infected with H5N1 bird flu virus, which some experts fear could mutate into new strains of influenza that can be passed on to humans, those who did not take Tamiflu at an early stage all died. Considering the situation, the government and other organizations have stockpiled Tamiflu for 28 million people, including a supply being distributed as part of efforts to head off an outbreak of new strains of influenza.
However, if the Tamiflu-resistant virus spreads across the country while a new strain of influenza against which human beings have no immunity occurs at the same time, people likely will be infected with both viruses, leading the new strain of influenza to become resistant to Tamiflu. And it will result in an expansion of infection with the new strain as the stockpiled Tamiflu will not work on the patients.
The planned survey will be conducted by a research group comprising members mainly from the International Medical Center of Japan and other institutions.
The group will study epidemic situations in six or seven locations from Hokkaido to Kyushu, including Tottori Prefecture, where more than 30 percent of cases of influenza A virus subtype H1N1 were found to be resistant to Tamiflu.
The survey also will study causal associations between the occurrence of the resistant virus and the use of Tamiflu, and collect information on patients such as group infections in schools and households.
The group also will survey how antiflu drugs other than Tamiflu are used, and then will compile new treatment guidelines for the resistant virus.
According to the NIID, the drug-resistant virus this winter have been found in primary school-age patients in Miyagi and Shiga prefectures.
"We hope to find an appropriate way to use antiflu drugs as early as possible in preparation for further spread of the drug-resistant virus," a ministry official said.
(Jan. 14, 2009)

http://www.yomiuri.co.jp/dy/national...14TDY02309.htm

[AlaskaDenise]

Originally Posted by niman

Govt plans survey on Tamiflu-resistant flu

The Yomiuri Shimbun
................... it is believed that the resistant virus has been spontaneously generated.....

...... which some experts fear could mutate into new strains of influenza that can be passed on to humans, those who did not take Tamiflu at an early stage all died.


......However, if the Tamiflu-resistant virus spreads across the country while a new strain of influenza against which human beings have no immunity occurs at the same time, people likely will be infected with both viruses, leading the new strain of influenza to become resistant to Tamiflu. And it will result in an expansion of infection with the new strain as the stockpiled Tamiflu will not work on the patients.

.....The group also will survey how antiflu drugs other than Tamiflu are used, and then will compile new treatment guidelines for the resistant virus......
(Jan. 14, 2009)

http://www.yomiuri.co.jp/dy/national...14TDY02309.htm

How can they ignore the evidence of earlier resistance in tamilfu-blanketed areas, unless someone doesn't want to admit that the blanketing protocol has a downside?

They got the message about no-tamiflu in H5N1 means death!

.

[HenryN]

Commentary

http://www.recombinomics.com/News/01...n_Concern.html

[AlaskaDenise]

Originally Posted by niman

Commentary

http://www.recombinomics.com/News/01...n_Concern.html

Commentary H1N1 Tamflu Resistance Causes Concern in Japan Recombinomics Commentary 22:02 January 13, 2009 However, if the Tamiflu-resistant virus spreads across the country while a new strain of influenza against which human beings have no immunity occurs at the same time, people likely will be infected with both viruses, leading the new strain of influenza to become resistant to Tamiflu. And it will result in an expansion of infection with the new strain as the stockpiled Tamiflu will not work on the patients. The group will study epidemic situations in six or seven locations from Hokkaido to Kyushu, including Tottori Prefecture, where more than 30 percent of cases of influenza A virus subtype H1N1 were found to be resistant to Tamiflu. The survey also will study causal associations between the occurrence of the resistant virus and the use of Tamiflu, and collect information on patients such as group infections in schools and households. The group also will survey how antiflu drugs other than Tamiflu are used, and then will compile new treatment guidelines for the resistant virus. According to the NIID, the drug-resistant virus this winter have been found in primary school-age patients in Miyagi and Shiga prefectures. "We hope to find an appropriate way to use antiflu drugs as early as possible in preparation for further spread of the drug-resistant virus," a ministry official said. The above comments describe a study of H1N1 Tamiflu resistance in Japan. As noted, there is a concern that use of Tamiflu to treat pandemic influenza, such as H5N1, might drive the H274Y in H1N1 seasonal flu onto the N1 in H5N1 pandemic flu. Both Japan and Korea have H1N1 Tamiflu resistance levels near 100% and both have had recent H5N1 outbreaks. The report notes the earlier outbreaks in Sendai in the Mayagi prefecture and the subsequent outbreak in the Shiga prefecture. Both outbreaks involved Tamiflu resistant H1N1 and the sequences from the Sendai outbreaks match the sequences in the United States this season (in HI, TX, PA). However, sequence analysis indicates that the H274Y outbreak had already started in 2006, as evidenced by H274Y in H1N1 in hosts not taking Tamiflu. These hosts were initially found in China, in patients infected with clade 2C (Hong Kong), which was followed by patients in the US and UK infected with clade 1 (New Caledonia) in 2007. Last season the initial cases were in Hawaii in patients infected with clade 2B (Brisbane), but the H274Y was subsequently acquired by another Brisbane sub-clade that spread H274Y at high frequencies in Norway, Russia, and France, and somewhat lower frequencies in other countries in Europe and North America. H274Y levels rose to 100% in South Africa and were driven by A193T, which is in all isolates reported for this season in the United States and Japan. The fixing of H274Y was driven by recombination, which placed H274Y on multiple genetic backgrounds, which subsequently spread via hitch hiking with key changes on HA, which did not originate in Japan and were not linked to recent Tamiflu usage. The linkage to Tamiflu usage goes back to Tamiflu blankets applied in northern Vietnam in 2005. .

[HenryN]

SABERANSU of infection by the ministry, about 5,000 of the weekly number of patients who visit a medical point of the flu.
From the standards established under the patient occurred in the past, over the reference value for each health center is to inform you that the system exceeds the warning level and warning level (See " alarm and warning system, "please).
These are only indicators of the epidemic situation, will be appointed as a state "warning" is different.

[gsgs]

> As noted, there is a concern that use of Tamiflu to treat pandemic influenza, such as H5N1,
> might drive the H274Y in H1N1 seasonal flu onto the N1 in H5N1 pandemic flu

they obviously meant reassortment

[HenryN]

Originally Posted by gsgs

> As noted, there is a concern that use of Tamiflu to treat pandemic influenza, such as H5N1,
> might drive the H274Y in H1N1 seasonal flu onto the N1 in H5N1 pandemic flu

they obviously meant reassortment

Only obvious to some. CDC has acknowledge recombination (over short regions) as a driver of antigenic drift in influenza.

[HenryN]

□ INFURU of Tamiflu-resistant up to 23 prefectures doubled in a week [09/01/21]

治療薬タミフルに耐性を持つインフルエンザウイルスが新たに１２都県で確認された

A new flu virus resistant to the drug full TAMI was confirmed in 12都県

ことが２１日、国立感染症研究所などの調査で分かった。

To 21, according to the survey and the National Institute of Infectious Diseases.

厚生労働省が既に発表した

The ministry has already announced

調査と合わせると２３都道府県に上り、その数は１週間で倍増した。

Combined with the investigation up to 23 prefectures, the number has doubled in a week.

耐性ウイルスはいずれも、国内で流行している３種類のうち３６％を占めるＡソ連型（Ｈ１Ｎ１） 。

Both resistant virus is prevalent in three of 36% of the Soviet-type A (H1N1).

感染研は「耐性ウイルスが全国に広くまん延していると推測され、今冬大規模な流行が懸念

Call infection "is estimated that the virus spread widely in the national resistance, a major concern in fashion this winter

される」と注意を呼び掛けた。

Be "called to attention.

同省は１６日、耐性ウイルスの急増について初公表。

The ministry on July 16, released for the first surge of resistant virus.

８日までに１１都道府県で耐性ウイルスが

8 resistant to the virus in 11 prefectures

確認されたとした。

Has been confirmed.

うち東京都については神奈川県と取り違えたとして２１日に訂正した。

For one, Tokyo, Kanagawa and a 21取RI違ETA corrected.

感染研によると、１６日までに１８道府県から５２人分のＡソ連型の検体が提出され、

According to the call of infection, 16 to 18 people from 52 prefectures A-sample was submitted by the Soviets,

うち５１人分（９８％）で耐性を確認した。

Of 51 people (98%) confirmed the resistance.

このほか、地方衛生研究所や関連施設が独自に調査した

The investigation into their own facilities and the local Health Institute

結果、感染研で確認されなかった青森や東京、和歌山、福岡、宮崎の５都県で、Ａソ連型の検体

As a result, Tokyo and Aomori in the call were not infected, Wakayama, Fukuoka and Miyazaki in都県, A sample of the Soviet Union

すべてが耐性だったという。

All were resistant.

http://translate.google.com/translat...3Dd%26pwst%3D1

[HenryN]

The epidemic is beginning to be seen in the prefecture is cold and flu group.

Elementary and middle schools, and kindergartens in the prefecture of one more 20, 21, is scheduled to be closed and classes and the school closed.

The kindergarten affiliated with the University of Toyama, 19, 2007, with a class of older children and young child found in the cold group and 26 were absent from the flu.

In these classes帰SHI afternoon to house the children, 20, 21 and closed the school year.

Others in the prefecture, 20, 21 and closed the classroom and the school closed, the young children in a kindergarten class明星of Uozu.

Asahi箇庄five elementary schools in the city of two classes a year.

The two middle school students早月Namerikawa City 4 class.

Yao, a junior high school in Toyama, a class of students.

The prefecture has been increasing rapidly in the number of flu patients.

Japan is not expected until next month from the peak of the epidemic late this month, the night rain washing hands, and calling for measures such as wearing a mask and be careful to dry the interior.
http://www2.knb.ne.jp/news/20090119_18622.htm

[HenryN]

Closed classes, small and cold affiliated group said Hiroshi Hukui three schools in full
January 19 at 8:01

Health Promotion Department in contact with the 19 prefectures, prefectures 3 flu occurred in the elementary school population is expected flu, and 20 take classes from the date of closure. The prefecture is a group of flu this season, was generated from last season's 39 days later.

Fukui Hiroshi Hukui attached a small city out of 443 school children, 99 people have fever and headache, complaints of symptoms such as coughing, 19 to 36 people were absent. The student is absent 36 out of 13 people three years to a pair of three-day closure.

In addition, a small group Fengdong Sabae a year (11 in absentia) to three days, a small city east Takefu Echizen a pair of 3 years (at 12) a two-day close.

Japan has issued 15 warnings to the flu, hand washing is the night rain, which call for a thorough prevention and wearing masks.

http://www.fukuishimbun.co.jp/module...p?storyid=6113

[HenryN]

Tuesday, January 20, 2009

Daily Report from ML_flu_front_DB [2009-01-20] Daily Report from ML_flu_front_DB [2009-01-20]

■ MLインフルエンザ流行前線情報DB 2008-2009年 ■ ML DB 2008-2009 flu information from the front http://ml-flu.children.jp/ MLインフルエンザ流行前線情報データベースより「日報」をお届けします。 ML front flu information from the database, "Daily" to deliver. 当データベースに、昨日[2009-01-19]登録された症例は、合計1900件で、 The database, yesterday [2009-01-19] The case was registered, a total of 1900 cases そのうち陽性例が1893件（陽性率99.6%）、陰性例が7件でした。 The 1893 cases of them positive cases (positive rate 99.6%), seven cases were negative. 陽性例の報告があった地域は以下の通りです。 Reported the number of positive cases is the following. ◆北海道・東北地方北海道 7 件，青森県 14 件，岩手県 1 件，宮城県 14 件，秋田県 7 件，山形県 41 件，福島県 60 件， ◆ Hokkaido, Tohoku, Hokkaido 7, 14, Aomori, Iwate 1, 14, Miyagi, Akita 7, 41, Yamagata, Fukushima 60, ◆関東・信越地方茨城県 53 件，栃木県 50 件，群馬県 48 件，埼玉県 97 件，千葉県 52 件，東京都 126 件，神奈川県 52 件， ◆ 53 Kanto Shinetsu Regional Ibaraki, Tochigi, 50, 48, Gunma, Saitama 97 cases, 52 cases in Chiba Prefecture, 126 cases in Tokyo, Kanagawa 52, ◆北陸・東海地方新潟県 39 件，富山県 23 件，石川県 168 件，福井県 2 件，山梨県 6 件，長野県 8 件，岐阜県 40 件，静岡県 28 件，愛知県 25 件，三重県 53 件， ◆ Tokai Hokuriku region, Niigata 39, 23, Toyama, Ishikawa 168, Fukui 2, 6, Yamanashi, Nagano, Japan 8, 40, Gifu, Shizuoka, 28, 25, Aichi, MIE 53, ◆近畿地方滋賀県 194 件，京都府 36 件，大阪府 149 件，兵庫県 49 件，奈良県 10 件，和歌山県 21 件， ◆ Kinki region, 194 cases, Shiga, Kyoto 36, 149 cases, Osaka, Hyogo 49, 10, Nara, Wakayama 21, ◆中国・四国地方鳥取県 14 件，島根県 1 件，岡山県 77 件，広島県 45 件，山口県 42 件，香川県 18 件，愛媛県 49 件， ◆ 14, Tottori Prefecture, Chugoku and Shikoku regions, Shimane 1, 77, Okayama, Hiroshima Prefecture, 45, Yamaguchi 42, 18, Kagawa, Ehime 49, ◆九州・沖縄地方福岡県 14 件，佐賀県 22 件，長崎県 1 件，熊本県 34 件，大分県 2 件，宮崎県 78 件，鹿児島県 14 件，沖縄県 9 件， ◆ Kyushu-Okinawa, Fukuoka 14, 22, Saga, Nagasaki 1, 34, Kumamoto, Oita 2, 78 cases, Miyazaki, Kagoshima Prefecture, 14, Okinawa, Japan 9, そのTYPE別の内訳は以下の通りです。 TYPE the breakdown is as follows another. 陽性：1893件［Ａ型 1827件(96.2%)，Ｂ型 63件(3.3%)，陽性(判別不可) 3件(0.2%)］ Positive: 1893 cases [A-1827 cases (96.2%), B-63 (3.3%), positive (non-discrimination) 3 (0.2%)] 陰性：7件 Negative: 7 ================================================== ========= ================================================== ========= ■ インフルエンザに関するトピックス ■ News about the flu ● インフルエンザの流行情報感染研：＜速報＞ 2008/09インフルエンザシーズンにおけるインフルエンザ（A/H1N1）オセルタミビル耐性株（H275Y*）の国内発生状況　[第１報] ● call infectious pandemic flu information: in the 2008/09 influenza season, influenza (A/H1N1) shares oseltamivir resistance (H275Y *) occur in situations [first report] http://idsc.nih.go.jp/iasr/rapid/pr3483.html 栃木県：インフルエンザ猛威　県内９校14学級で学年・学級閉鎖へ Tochigi Prefecture: 9 influenza rage prefecture to close 14 schools in the classroom grade classroom http://www.shimotsuke.co.jp/news/toc...0090119/100226 神奈川県：集団風邪が相次ぐ/小中高校などで１２０４人欠席 Kanagawa Prefecture: a series of cold groups / schools in 1204 and who miss http://www.kanaloco.jp/localnews/ent...yivjan0901389/ 東京都：1月15日インフルエンザの流行注意報を発令 Tokyo: January 15, issued a warning of flu pandemic http://www.caremanagement.jp/index.a...ryid+3459.html http://www.caremanagement.jp/index.action_news_detail + true + storyid +3459. html 東京都：発症者６人増え１１２人に　町田の病院 Tokyo: The incidence increased by six people in 112 hospitals in Machida http://mainichi.jp/select/jiken/news...40072000c.html 富山県：インフルエンザで学年学級閉鎖 Toyama: closed grade classroom flu http://www2.knb.ne.jp/news/20090119_18622.htm 福井県：学級閉鎖、福井大附属小など３校　インフルとみられる集団風邪 Fukui: closed classes, such as small-affiliated group said Hiroshi Hukui cold full three schools in http://www.fukuishimbun.co.jp/module...p?storyid=6113 京都府：インフルエンザが猛威　去年の４倍　小中学校などで学級閉鎖 KYOTO: The influence of the flu last year, four times the school closed and classes http://www.kyoto-np.co.jp/article.ph...re=F1&area=K00 ● 鳥インフルエンザ中国：専門家「中国には大規模な鳥インフルの感染はない」 ● China bird flu: experts "INFURU birds infected in China is large." http://japanese.cri.cn/881/2009/01/19/1s134089.htm 中国：鳥インフルで27歳女性が死亡、今年に入って3人目＝山東省 China: 27 dead birds in full-year-old woman, the third this year = Shandong http://www.cnn.co.jp/science/CNN200901190012.html http://www.zaikei.co.jp/article/bizn...119/31303.html http://www.nhk.or.jp/news/k10013634281000.html 農水省：米国ニューヨーク州からの家きん肉等輸入を解禁 Ministry: to lift the ban on meat and poultry imports from the U.S. state of New York http://www.jacom.or.jp/news/news09/n...s09011910.html ● 医学・医療・医薬厚労省研究班：ワクチン接種後、８人入院＝追加調査も ● medical research group ministry Medicine: after vaccination, the survey respondents, additional hospital http://www.jiji.com/jc/c?g=soc&rel=j7&k=2009011900718 http://www.chunichi.co.jp/s/article/...901000895.html http://sankei.jp.msn.com/life/body/0...2021003-n1.htm 母親意識調査：手洗い、うがいは都市部が熱心　１位は大阪 Survey mother: restrooms, is eager to gargle a place in the city of Osaka http://mainichi.jp/select/science/ne...40099000c.html http://translate.google.com/translat...3Dd%26pwst%3D1

[HenryN]

SABERANSU of infection by the ministry, about 5,000 of the weekly number of patients who visit a medical point of the flu.
From the standards established under the patient occurred in the past, over the reference value for each health center is to inform you that the system exceeds the warning level and warning level (See " alarm and warning system, "please).
These are only indicators of the epidemic situation, will be appointed as a state "warning" is different.

https://hasseidoko.mhlw.go.jp/Hassei...flu/index.html

[HenryN]

Aomori Prefecture, 12, issued a warning that this winter's flu within the jurisdiction of the two health centers and 30 Goshogawara. In vitro on 20 January 30 - a week for 80 days, 42人TONARI increase of 100 from 63 people last week reported the number of patients from a medical point 9, the average per agency People over 10 standards issued 87 warnings in the 31 patients. The prefectural government said it found a virus resistant to Tamiflu resistance in the treatment of patients in vitro from the same prefecture.
Japan has increased the total number of patients who at 50 102 205 80. The average number of patients is 10 people Goshogawara intratubular 92. Hachinohe 46 intratubular three, seven intratubular Mutsu is 65.
The warning indicates the possibility of a major epidemic occurs within four weeks. The prefecture has been increasing throughout the patient, the hand-washing after residents ▽ home, wear a mask gargle ▽ ▽ early medical consultation - is calling for a thorough preventive measures.
County Environmental Health Center, who found the virus in 60 patients with jurisdiction over 30 were resistant to Tamiflu had 20 people all of the results. According to the prefecture, to impede the effective treatment for other drugs, he said. Resistant virus has been found in any country.
Flu over the middle of this month, it is a case of infection by a group of patients died at a hospital in Tokyo. The Ministry of Health 12 days notice to take action to prevent the infection state. In response to Japan 22 days, a written reminder, such as hospitals and welfare facilities in the prefecture.

http://www.daily-tohoku.co.jp/news/2...0901220802.htm

[HenryN]

Relenza = request to increase the supply of Tamiflu-resistant virus - ministry

治療薬タミフルに耐性を持つインフルエンザウイルス「Ａソ連型」が全国に拡大していることから、厚生労働省 は２８日までに、耐性ウイルスに有効とされる別の治療薬「リレンザ」の製造販売元「グラクソ・スミスクライ ン」に対し、今冬の供給量を増加できないか要請した。

Influenza viruses resistant to drugs TAMI full "A Soviet-type" that is expanding throughout the country, the ministry at 28, another drug that is effective and resistant to the virus "Relenza" manufacturing vendor "GlaxoSmithKline" to the request can not increase the amount of winter.

同省によると、今冬、インフルエンザ治療薬としての国内での供給予定量は、タミフルが約９００万人分なのに 対し、リレンザは約３００万人分。

According to the ministry, this winter, the amount expected in the treatment of influenza, Tamiflu is about 900 minutes to a million people, about 300 million Relenza.

「リレンザがすぐ足りなくなることはないが、万が一の事態に備えてお願いをした」（医政局経済 課）という。

"Relenza is to run out soon, but in case I was just in case" (Department of Medicine political economy).

同省ホームページ（ＨＰ）上の「インフルエンザＱ＆Ａ」についても、うがいや手洗いの徹底など、耐性ウイル スへの対処法を盛り込んだものに改定し、週内にも掲載する。

Home ministry (HP) on "Flu Q & A", for hand washing and thorough outfield arm, which includes a revised approach to virus resistance, and also within the week.

全都道府県には同日付で「Ｑ＆Ａ」の内容を通知した。

In all prefectures in the same day "Q & A" of the contents of the notice.

（2009/01/28-19:53）

(2009/01/28-19: 53)

http://66.102.1.102/translate_c?hl=e...fhL-04e8tjv4ug