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First confirmed person-to-person transmission of dual-resistant H1N1 in UK hospital
Moore C.J lnfect Dis. 2011;203:18-24.
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A recent nosocomial outbreak of oseltamivir-resistant pandemic influenza A infection has been identified in an adult hematology unit in the United Kingdom, according to findings published in the Journal of Infectious Diseases.
“Vaccination against influenza remains the best way of preventing infection in these patients, and therefore, vaccine uptake must be strongly encouraged to reduce the pool of susceptible individuals prior to the start of influenza season,” the researchers wrote.
Previous findings have established the spread of the 2009 pandemic influenza A (H1N1) strains with resistance to adamantanes. However, this is the first case to confirm person-to-person transmission of dual antiviral resistance to both adamantane and oseltamivir (Tamiflu, Roche).
Researchers collected upper respiratory tract samples from inpatients with influenza-like symptoms; positive H1N1 virus isolates were tested for the H275Y mutation.
Eleven cases were confirmed between Oct. 29 and Nov. 25, 2009. Ten were found to be associated as identified by hemagglutinin and neuraminidase genes; eight were resistant to oseltamivir; and four were from direct transmission of the resistant virus.
As a result of this outbreak, researchers suggest actively screening patients for oseltamivir-resistant H1N1 viruses, and altering treatment guidelines to include zanamivir (Relenza, GlaxoSmithKline) alone, rather than dual treatment with oseltamivir in H1N1 patients, since the H1N1 virus is still susceptible to zanamivir.
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