# 4093
If you follow the various flu forums, blogs, and websites you are probably aware that there has been a fair amount of discussion in recent days revolving around the `Norwegian’ and `Ukrainian’ mutations, and increased reports of Tamiflu resistant H1N1 viruses.
Don McNeil Jr. of the New York Times has an article about the WHO (World Health Organization’s) attempts to dampen fears over these reports, in a piece called Experts Say Swine Flu Mutations Do Not Warrant New Alarm.
The tone of the message from the World Health Organization is one of reassurance, although they admit there are things they do not yet understand about these mutations.
I’ll grant that the first inclination of most governments or health agencies - when faced with disturbing news - is to ratchet down public concerns.
It is almost an autonomic reflex, and not always a bad thing. Particularly when there is a good deal of ambiguity about the threat.
My take is simply that mutations happen, and that we shouldn’t be terribly surprised to see them when they do. As virologists like to say, `Shift Happens’ (more accurately `drift’ in this case).
But I’m not quick to jump on any viral bandwagon.
Which is why I tend not to become too alarmed over these reports. At least not until we can get some credible data and analysis.
Only time will tell if any of these mutations is `fit’ enough to compete with the existing virus strains and become a `contender’. Most mutations fail to thrive, and are destined to die out.
The isolation of a single mutation, or even a handful of them around the world, doesn’t automatically make for a public health threat, regardless of what the tabloid papers are saying.
But of course, every once in awhile . . . well, let’s face it. Every viral change started out small somewhere.
Are the `Norwegian Mutations’ (which actually have been seen in many places around the world) a big deal? Or the Tamiflu resistant strains?
We don’t know yet. Maybe. Stay tuned.
Good science takes time. You have to collect the data and then analyze it. And sometimes, the data can be confusing or misleading.
Hopefully we’ll have a better handle on all of this a week or two from now. But definitive answers could be months away.
Influenza is constantly fooling us, and the `rules‘ are rarely writ in stone. If any of these mutations end up being less benign than currently advertised, I figure that will become apparent over time.
For now, I regard these viral changes as worthy of our attention, but not our alarm.
This from the New York Times.
Experts Say Swine Flu Mutations Do Not Warrant New Alarm
Published: November 27, 2009
The World Health Organization tried this week to dampen fears about mutations seen in the swine flu virus in several countries, noting that both mutations had been found in very few people.
A change that created Tamiflu resistance has been found in about 75 people around the world, said Dr. Keiji Fukuda, chief flu adviser to the W.H.O.’s director general. Two clusters, in cancer units at Duke University Medical Center in North Carolina and a hospital in Wales, were both among patients whose immune systems had been severely suppressed by cancer treatment; some had had their bone marrow, which produces infection-fighting white blood cells, wiped out so that replacement blood stem cells could be injected.
Such patients are more likely to develop resistant viruses when on Tamiflu because they can not clear a virus on their own. But the mutant strain appears not to spread easily in people with normal immunity, like hospital workers.
“We don’t know the full answer, but it is more likely that we are not seeing a major shift,” Dr. Fukuda said.
Widespread Tamiflu resistance is a serious problem in the seasonal H1N1 virus, but it has not crossed over into the swine H1N1.
