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Mutant strain scare prompts flu drug influx

Shiloh

Editor, Senior Moderator
Source: http://www.bangkokpost.com/news/local/21817/mutant-strain-scare-prompts-flu-drug-influx

Mutant strain scare prompts flu drug influx

Thai-UK import deal for nasal medication
Writer: APIRADEE TREERUTKUARKUL
Published: 11/08/2009 at 12:00 AM
Newspaper section: News

Thai authorities will import second-line type-A (H1N1) flu medicine following the case of an infected patient who did not respond to doses of oseltamivir.

Laboratory tests at Ramathibodi Hospital confirmed the discovery of a mutant flu strain that was resistant to the medicine.

Government Pharmaceutical Organisation (GPO) managing director Witit Artavatkun said the organisation would sign the agreement today to import zanamivir, the second-line anti-flu regimen, from Britain-based GlaxoSmithKline for use at state hospitals and for medicinal stockpiling to fight the flu pandemic.

"The British company has agreed to halve the price of the medicine," Dr Witit said.


Under the agreement, the price of zanamivir would be cut to 450 baht a dose.

The imported medicine will be distributed to state hospitals nationwide as a back-up for flu pandemic preparedness, he said.

Dr Witit said the GPO planned to import 30,000 doses as part of tomorrow's agreement.

As well as 50 million tablets of oseltamivir, Thailand has stockpiled 20,000 doses of zanamivir intranasal spray. The government has approved the Public Health Ministry's proposal to buy a further 20,000 more doses for stockpiling, bringing the total to 70,000. Dr Witit expressed concern over reports of the oseltamivir-resistant virus discovery because the drug resistance could affect the GPO's plan to produce the local first-line drug GPO-A-Flu.

Virologist Prasert Thongcharoen, chairman of the subcommittee responsible for academic and strategic planning against the flu pandemic, said the public should not panic about the reported drug resistance case.

"If we want to fight against invisible diseases, we should have sufficient weapons just like having both knives and guns," he said.

"Stockpiling the anti-flu drugs for 10% of the population is not even considered high."

Dr Prasert said the viral resistance case needed further tests to confirm whether the virus was resistant to oseltamivir.

The case was proved only by a sequencing test designed to monitor a residue of neuraminidase protein in H1N1 virus sample.

However, it is essential to test the virus resistance on the specific drug to confirm the resistance, he said.

In Thailand, only laboratories at Siriraj Hospital and the Department of Medical Sciences could conduct such a test.

Only Denmark, Hong Kong, Canada and Japan have reported oseltamivir-resistance cases, according to the World Health Organisation.

The members of the subcommittee from medical schools are drafting regulations and guidelines for using each anti-flu regimen for treatment to avoid the problem of drug resistance, Dr Prasert said.
 
Re: Mutant strain scare prompts flu drug influx

Source: http://www.bangkokpost.com/news/local/21817/mutant-strain-scare-prompts-flu-drug-influx

The case was proved only by a sequencing test designed to monitor a residue of neuraminidase protein in H1N1 virus sample.

However, it is essential to test the virus resistance on the specific drug to confirm the resistance, he said.

In Thailand, only laboratories at Siriraj Hospital and the Department of Medical Sciences could conduct such a test.

Only Denmark, Hong Kong, Canada and Japan have reported oseltamivir-resistance cases, according to the World Health Organisation.
The above confirms that the resistance is H274Y. It is NOT essential to do a biological test. When H274Y is present in H1N1, it takes 300-1000X as much Tamiflu to match wild type inhibition. H274Y is NOT a borderline resistance situation.

WHO reporting lags. The sequences with H274Y from Singapore (ex Honolulu) and Hunan, China are public (and the Hong Long sequence was from a patient infected in San Francisco).
 
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