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PostPosted: Sat Mar 27, 2010 11:38 am 
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NIID has released 15 NA sequences (at GISAID) from Japan, including 5 from 2010. All 15 had H274Y. The number of 2010 NA sequences that have been released by NIID in Japan is now at 7, and 6 of the 7 have H274Y. 7 HA sequences have been released recently from additional 2010 isolates, but the H274Y status has not been revealed. The presence of H274Y in 6 of the 7 NA sequences from 2010 raises concerns that H274Y is rapidly becoming fixed in pH1N1 in Japan.

A/NIIGATA/19/2010*
A/NIIGATA/16/2010*
A/YAMAGATA/29/2010*
A/KITAKYUSYU/4/2010*
A/FUKUOKA/1/2010*
A/WAKAYAMA-C/1/2010*
A/HIROSHIMA-C/1/2010

Unknown
A/SHIZUOKA/1693/2010
A/KYOTO/2/2010
A/KYOTO/1/2010
A/NIIGATA/10/2010
A/Sendai-H/6/2010
A/Sendai-H/41/2010
A/Sendai-H/30/2010

* = H274Y

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PostPosted: Sat Mar 27, 2010 11:43 am 
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From memory, Japan is notorious for over prescription and use of Tamiflu.

So is this a worry for the rest of the world?


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PostPosted: Sat Mar 27, 2010 11:55 am 
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Dingo wrote:
From memory, Japan is notorious for over prescription and use of Tamiflu.

So is this a worry for the rest of the world?

Japan is well aware of the high levels of H274Y in pH1N1. Consequently, I believe most flu infections in Japan are treated with Relenza (H274Y was fixed in seasonal H1N1 flu in 2008/2009 season).

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PostPosted: Sat Mar 27, 2010 12:00 pm 
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niman wrote:
Dingo wrote:
From memory, Japan is notorious for over prescription and use of Tamiflu.

So is this a worry for the rest of the world?

Japan is well aware of the high levels of H274Y in pH1N1. Consequently, I believe most flu infections in Japan are treated with Relenza (H274Y was fixed in seasonal H1N1 flu in 2008/2009 season).

GlaxoSmithKline (GSK: 38.02 -0.40 -1.04%) shares are up today as well. The company makes Relenza, an inhaled anti-viral drug that is commonly administered prophylacticly in children. Relenza sales, much like Tamiflu, have been difficult to forecast given big swings in government orders.

For example, sales of Relenza in 2008 totaled only $103 million worldwide, down over 80% from $522 million in 2007. However, in the first quarter 2009, the UK and Japanese governments both placed significant stockpiling orders, and sales totaled $324 million. The CDC has a substantial stockpile of Relenza on hand as well for big orders in 2007.

In 2007, U.S. sales were $258 million, of which a large portion was stockpiling. Still, if fears continue to snowball over Swine flu, we would expect Relenza sales to skyrocket in the coming quarters as parents choose to vaccinate their children at greater rates.

http://www.dailymarkets.com/stocks/2009 ... tockpiles/

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PostPosted: Sat Mar 27, 2010 12:02 pm 
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I remember several articles about Tamiflu in detectable levels in Japan in rivers:

http://www.japanprobe.com/2009/10/04/ta ... ns-rivers/

Researchers in Japan have discovered troubling high levels of tamiflu in Kyoto’s rivers:

Concerns are now building that birds, which are natural influenza carriers, are being exposed to waterborne residues of Tamiflu’s active form and might develop and spread drug-resistant strains of seasonal and avian flu.

For their new study, Gopal Ghosh and his colleagues at Kyoto University sampled water discharged from three local sewage treatment plants and water at several points along two rivers into which the treated water flowed. Sampling started early in December 2008, as flu season got underway. The researchers sampled again at the height of the seasonal flu’s onslaught in early February and again as infection rates waned.


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PostPosted: Sat Mar 27, 2010 12:04 pm 
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niman wrote:
Dingo wrote:
From memory, Japan is notorious for over prescription and use of Tamiflu.

So is this a worry for the rest of the world?

Japan is well aware of the high levels of H274Y in pH1N1. Consequently, I believe most flu infections in Japan are treated with Relenza (H274Y was fixed in seasonal H1N1 flu in 2008/2009 season).

Stockpiling
A number of national governments have commenced or indicated their intention to commence the stockpiling of Relenza™, in preparation for a possible influenza pandemic. The U.S., U.K., France, Germany, Japan, Hong Kong, Holland and Australia have all ordered Relenza™ as part of their pandemic planning strategy. GlaxoSmithKline (GSK) has indicated that its 2009 production capacity is running at 50-60 million treatment packs per year.

http://www.biota.com.au/?page=1021002&subpage=1021104

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PostPosted: Sat Mar 27, 2010 12:08 pm 
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So how long will Relenza be effective before we start seeing the virus thwart that drug? If it's already in heavy use in Japan, should we expect to see the first Relenza-resistant strains in Japan?


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PostPosted: Sat Mar 27, 2010 12:18 pm 
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Pandora wrote:
So how long will Relenza be effective before we start seeing the virus thwart that drug? If it's already in heavy use in Japan, should we expect to see the first Relenza-resistant strains in Japan?

Use of one antiviral at a time is the formula for disaster.
Resistance in seasonal H1N1 was seen in US in 2008

http://www.recombinomics.com/News/08150 ... 4Y_NJ.html

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PostPosted: Sat Mar 27, 2010 12:38 pm 
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Quote:
in the first quarter 2009, the UKand Japanese governments both placed significant stockpiling orders, and sales totaled $324 million.


I knew we had stockpiles of Tamiflu but not Relenza, put my mind at rest, a little...

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PostPosted: Sat Mar 27, 2010 1:43 pm 
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Dingo wrote:
From memory, Japan is notorious for over prescription and use of Tamiflu.

So is this a worry for the rest of the world?

A/Texas/46172731/2009(H1N1) and A/New York/4777/2009(H1N1) are in the same sub-clade as Tochigi/471/2009*, Hiroshima/590/2009*, Shizuoka-C/270/2009*, Niigata/16/2010*.

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