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http://www.wdel.com/story.php?id=34495

DPH confirms 4 more drug-resistant flu cases

The state Division of Public Health says it's confirmed four more cases of flu resistant to commonly-used treatment drugs.

DPH says one victim, a 45-year-old Sussex County woman, died in February, and the others, a 28-year-old New Castle County man and a 2-month-old boy and 7-month-old girl from Sussex County, were hospitalized briefly or didn't need hospitalization.

These cases bring the number of flu cases in Delaware resistant to Tamiflu and other widely-used drugs to 10.

DPH is working with the CDC to determine whether revised treatment guidelines will be needed for next year's flu season.

Recent US sequences with H274Y

EPI309995 A/Maryland/08/2011 (A/H1N1 swl) segment 6 (NA) 27.0 6.40970
EPI309989 A/Maryland/07/2011 (A/H1N1 swl) segment 6 (NA) 27.0 6.40970
EPI309983 A/Maryland/06/2011 (A/H1N1 swl) segment 6 (NA) 27.0 6.40970
EPI309969 A/Maryland/04/2011 (A/H1N1 swl) segment 6 (NA) 27.0 6.40970
EPI309953 A/Maine/04/2011 (A/H1N1 swl) segment 6 (NA) 27.0 6.40970
EPI309907 A/Indiana/04/2011 (A/H1N1 swl) segment 6 (NA) 27.0 6.40970
EPI309876 A/Delaware/08/2011 (A/H1N1 swl) segment 6 (NA) 27.0 6.40970
EPI309869 A/Delaware/07/2011 (A/H1N1 swl) segment 6 (NA) 27.0 6.40970
EPI309864 A/Delaware/06/2011 (A/H1N1 swl) segment 6 (NA) 27.0 6.40970
EPI309856 A/Delaware/04/2011 (A/H1N1 swl) segment 6 (NA) 27.0 6.40970
EPI309836 A/Colorado/11/2010 (A/H1N1 swl) segment 6 (NA) 27.0 6.40970

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MD/04 is the Chihuahua sub-clade. The rest have S188T and form multiple clusters, supporting transmission as well as recombination.

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Earlier commentary

http://www.recombinomics.com/News/03241 ... 4Y_DE.html

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http://dhss.delaware.gov/dhss/pressrele ... 41811.html

SIXTH ANTI-VIRAL RESISTANT FLU CASE IDENTIFIED


Delaware's Division of Public Health (DPH) laboratory results confirm a sixth Delaware case of antiviral-resistant influenza for the 2010 - 2011 flu season. A 55 year-old woman from Kent County was infected with an influenza strain found to be resistant to oseltamivir, the preferred treatment antiviral medication used to treat confirmed cases of influenza. There is no reason to change treatment approaches at this time. There are four influenza antiviral medications approved for use in the United States: oseltamivir (brand name Tamiflu), zanamivir (brand name Relenza), amantadine (Symmetrel, generic) and rimantadine (Flumadine, generic).

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FIFTH INFLUENZA DEATH IN DELAWARE

Delaware's Division of Public Health reports the fifth flu death statewide of the 2010-2011 flu season occurred March 13 of a 63 year-old woman from Kent County. The individual had underlying health conditions and had been hospitalized.

http://dhss.delaware.gov/dhss/pressrele ... 32211.html

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http://dhss.delaware.gov/dhss/pressrele ... 32311.html

THREE ADDITIONAL ANTI-VIRAL RESISTANT FLU CASES IDENTIFIED


Delaware's Division of Public Health (DPH) is following-up on three additional antiviral-resistant influenza cases. Lab results provided March 21 found that a 1 month-old girl and a 33 year-old woman from Kent County were infected with influenza strains found to be resistant to oseltamivir, an antiviral medication used to treat influenza. A 3 year-old Sussex County boy was also identified as having had antiviral resistant influenza. This brings Delaware's number of influenza cases resistant to oseltamivir (brand name Tamiflu) treatment to four for the 2010-2011 flu season.

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http://dhss.delaware.gov/dhss/pressrele ... 30911.html

ANTI-VIRAL RESISTANT FLU CASE IDENTIFIED


Delaware's Division of Public Health (DPH) is following up on an antiviral-resistant influenza case identified March 2 in a child from Kent County. The child was not hospitalized and has fully recovered. This is Delaware�s first known case of influenza resistant to oseltamivir (brand name Tamiflu) treatment for the 2010-2011 flu season.

The case under investigation tested positive for influenza A / H1N1 in mid-February. The specimen � part of a random sample submitted for routine anti-viral resistance testing � was reported as oseltamivir-resistant the first week of March. Oseltamivir is the preferred treatment for confirmed cases of influenza. Resistance to oseltamivir is very rare, occurring in just 0.5 percent of cases studied during the 2009-2010 flu season. There is no reason to change treatment approaches at this time.

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Week 15 report for DE

http://dhss.delaware.gov/dhss/dph/epi/f ... 11wk15.pdf

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Four people have been found with cases of anti-viral resistant influenza – three of them in Sussex County – a 2 month old boy who was briefly hospitalized, a 7 year old girl and a 45 year old woman who died in February. She was the state’s second death from the flu this year. Also a 28 year old New Castle County man was briefly hospitalized. This means that the usual methods of treating the flu are not effective for these people, however there are other methods of treatment.

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http://www.dhss.delaware.gov/dhss/press ... 92011.html
NEWS RELEASE: ADDITIONAL RESISTANT FLU CASES IDENTIFIED
Continued laboratory testing of flu cases at the request of the Centers for Disease Control and Prevention (CDC) confirms four additional Delaware cases of antiviral-resistant influenza for the 2010 – 2011 flu season. This brings the total number of resistant flu cases to 10.
- a 2-month-old boy from Sussex County, briefly hospitalized.
- a 7-year-old girl from Sussex County, did not require hospitalization.
- a 45-year-old woman from Sussex County, who died Feb. 24. This was the second flu death of the 2010-2011 flu season, and was announced Feb. 25
- a 28-year-old man from New Castle County, briefly hospitalized.

More test results are pending as DPH partners with a CDC disease investigation. The CDC requested that DPH increase its testing as an initial step in exploring the presence of anti-viral resistant strains in the U.S. Since this year’s flu activity is winding down, these findings will help CDC develop revised recommendations if needed, for next year.

http://www.wgmd.com/?p=24215

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