# 4110
The `big’ story over the past couple of weeks has been the announced discovery of the D225G mutation in Norway (which has been seen in many other places for months), and two hospital clusters of Tamiflu resistant H1N1 strains.
I put `big’ in quotes because, while many websites have promoted these as major and very serious mutations, their true impact is far from clear. (See Hyperbolic Headlines)
The Tamiflu resistant clusters both appeared in hospitals, one in Cardiff Wales, and the other at Duke University Hospital in North Carolina. Both apparently occurred among a small group of immunocompromised patients.
Oseltamivir (Tamiflu) Resistance is associated with the swapping of the amino acid histidine for tyrosine at position 275 (N1 numbering) in the neuraminidase glycoprotein (H275Y).
The good news today is that Duke University Hospital has done extensive testing for this antiviral resistant mutation, and has found no indication that it has spread beyond the initial 4 patients.
Further investigation into this matter will continue. This from the News Observer.
Duke finds no new cases of drug-resistant H1N1
Modified Wed, Dec 02, 2009 05:32 AM
BY SARAH AVERY - Staff Writer
No additional cases of Tamiflu-resistant H1N1 flu have been found at Duke University Medical Center, officials reported Tuesday.
Last month, four people in a cancer ward at the hospital were discovered to have contracted a resistant strain of the pandemic virus, and three died.
Hospital officials, along with the U.S. Centers for Disease Control and Prevention, began a testing program to see whether additional cases showed up. Duke reported Tuesday that patients on the ward, which is on the hospital's ninth floor, have been tested several times in the past 10 days.
"We're pleased with the results to date," Dr. Daniel Sexton, an infectious disease specialist, said in a prepared statement. "However, much work is still being done to better understand the nature of the four cases that were reported previously."
While legitimate concerns over the novel H1N1 virus eventually acquiring broader Tamiflu resistance persist, for now the vast majority of infections continue to respond to this antiviral.
The small number of resistant cases detected to date, do respond to Zanamivir (Relenza).
