Tamiflu resistance of influenza H1N1 strainsby Vincent Racaniello on 9 January 2009

Yesterday the New York Times ran an article on the resistance to Tamiflu of current influenza H1N1 strains circulating in the US. I wrote a post about this issue on 22 December 2008, so I’m happy to see the Times following my lead. But there is an issue with the Times article that I’d like to address here. According to the article:

The single mutation that creates Tamiflu resistance appears to be spontaneous, and not a reaction to overuse of the drug.

Drug-resistant viruses are not ‘reactions’ to overuse of the drug. The drug selects, from the diverse viral population in an individual, those viruses that can multiply in its presence. Usually the drug-resistant mutants are already in the host, and outpace other drug-sensitive viruses. Is that what the writer means by ’spontaneous’? Not in this case. What apparently happened is that the mutation that causes drug-resistance, a change from histidine to tyrosine at position 274 of the viral NA protein, emerged in parts of the world were little Tamiflu is used. There was some other reason why this change was selected for in those populations. The article implies that the his->tyr change accompanied a second amino acid change at position 193 of the HA protein which improved the ability of the virus to infect people. This change did not affect resistance to Tamiflu, but apparently it only persisted when the change at 274 was also present. It so happened that the 274 change also conferred resistance to Tamiflu. Thus, when this virus arrived in parts of the world where Tamiflu is used, the resistance was noted. None of this is made particularly clear from the article.

Quoted:
This whole H1N1 thing reeks to high heaven.  So far, (and sorry I don't have the source, I did read it here somewhere) something like 36 children have died of complications due to the manbirdpig flu.  30 of the 36 had significant underlying health problems, and the remainder died of pneumonia as a secondary infection following a bout of flu.  Seasonal flu kills  about 20,000 to 30,000 per year in CONUS if I remember correctly.

Why is the .gov hyping this up so intensely?  Why the big rush on a vaccine?  I'm not so sure that ".gov" would be in a big hurry to adulterate the vaccine with some harmful substance.  I remember the debacle with the Ft Dix flu in 1978(?) where one person died of the flu and several dozen died of vaccine reactions and hundreds were left permanently disabled by Epstein-Barre syndrome.  This vaccine is rushed into production, .gov has granted the vaccine makers immunity from lawsuit, and is available from non health care sources like Walmart for shit's sake.

SBK and I had some sort of virus that mimic'ed manbirdpig flu to a T.  Our doc put the kid on Tamiflu, took a nasal swab from the kid, and it came back a week later negative.  Something about that stinks as well.  We are being herded into something.

Ops

Key Flu Indicators

October 30, 2009, 1:30 PM

Each week CDC analyzes information about influenza disease activity in the United States and publishes findings of key flu indicators in a report called FluView. During the week of October 18-24, 2009, a review of the key indictors found that influenza activity continued to increase in the United States from the previous week. Below is a summary of the most recent key indicators:

   * Visits to doctors for influenza-like illness (ILI) increased steeply since last week in the United States, and overall, are much higher than what is expected for this time of the year. ILI activity now is higher than what is seen during the peak of many regular flu seasons.
   * Total influenza hospitalization rates for laboratory-confirmed flu are climbing and are higher than expected for this time of year. Hospitalization rates continue to be highest is younger populations with the highest hospitalization rate reported in children 0-4 years old.
   * The proportion of deaths attributed to pneumonia and influenza (P&I) based on the 122 Cities Report has increased and has been higher than what is expected at this time of year for four weeks now. In addition, 22 flu-related pediatric deaths were reported this week; 19 of these deaths were confirmed 2009 H1N1, and three were influenza A viruses, but were not subtyped........

Quoted:
I'm watching the news right now and some Dr. was on talking about how H1N1 has mutated and they are detecting Tamiflu-resistant H1N1 that can still be transmitted if you are taking Tamiflu.  She was saying that if you have H1N1 (or in the case around here, if you show "flu-like" symptoms), you should stay home for 14 days.  If my math is right and if it staggers enough, a family of 3 where someone gets sick every 10 days would stay home up to 42 days.

I understand trying to keep things from spreading but how many of you have 30 days of sick leave?

Quoted:


Was it here that I read about the CDC not segregating out H1N1 stats from its reported flu cases?