Oseltamivir-resistant flu detected at border detention facility
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Researchers said four cases of oseltamivir-resistant influenza A(H1N1) were detected at a border detention center in Texas with hemagglutinin that belong to a subclade that may enable viral escape from pre-existing immunity.
The cases underscore the need to monitor drug resistance and the antigenic drift of circulating influenza viruses, according to Teena Mohan, PhD, a scientist in the CDC’s Influenza Division, and colleagues.
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“Resistance to antiviral drugs for influenza is an ongoing public health concern,” they wrote in Emerging Infectious Diseases. “The neuraminidase (NA) inhibitor oseltamivir is the most prescribed antiviral drug for controlling influenza. However, during 2007 to 2009, oseltamivir-resistant influenza A(H1N1) viruses rapidly spread worldwide.”
Since then, however, the old circulating H1N1 virus was replaced by the H1N1 virus that caused the 2009 pandemic, which has been sensitive to oseltamivir, the researchers noted.
For their study, Mohan and colleagues examined 951 H1N1 isolates collected between October 2019 and September 2020. Among them, four had the NA-H275Y mutation known to cause oseltamivir resistance. Further analysis revealed that all four isolates were collected from a border detention center in Webb County, Texas, on the same day, the researchers said.
Supplemental analysis of 282 viruses collected from 18 states between November and March of 2020 identified another six NA-H275Y viruses, for a total of 10 nationwide. All patients with the NA-H275Y virus presented with similar symptoms, including fever, cough, body aches and sore throat.
“Although no evidence of oseltamivir-resistant virus transmission outside the detention center was found, the properties of the cluster viruses are concerning,” the authors wrote. “They belong to an HA 122 antigenically drifted group, and escape from pre-existing immunity may contribute to the spread of oseltamivir-resistant viruses in coming seasons.”
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