# 4163
Even though the vast majority of novel H1N1 strains tested to date remain sensitive to Tamiflu, we’ve seen reports of more than 100 resistant samples from around the world.
An indication that – while still rare – growing Tamiflu resistance is a concern.
Undoubtedly there are far more resistant cases out there than we are aware of, given the very limited testing that is conducted. But random sampling indicates that as a percentage of total cases, that number remains very low. At least for now.
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 concern is that novel H1N1 could eventually become widely resistant to oseltamivir (Tamiflu), just as its seasonal H1N1 cousin did a couple of years ago. The resistant viruses tested so far still remain sensitive to Zanamivir (Relenza), GSK’s alternative antiviral.
Today, a sad but inevitable story of a 1 year-old who succumbed to a Tamiflu-resistant strain of the H1N1 virus. Despite the headline, this is not the first recorded Tamiflu-resistant flu fatality.
The Cluster at Duke University Hospital in North Carolina involved 3 deaths. (see Duke Hospital Reports No Further Spread Of Resistant Strain). These were among severely immunocompromised cancer patients, however.
This report from Xinhua News.
S Korea reports world's 1st Tamiflu-resistant death case
17:21, December 17, 2009A South Korean infant, whose body showed no response to anti-viral drug Tamiflu, died of pneumonia and respiratory failure on Thursday, the country's health authorities said, which local media say is the first such case in the world.
The one-year-old girl, who was suffering nervous-system disorders, was hospitalized for high fever and coughs last month, but her conditions continued to deteriorate despite taking Tamiflu, or double doses of it in her final days, according to Ministry of Health, Welfare and Family Affairs.
Health authorities last week confirmed the virus resistant to Tamiflu was found in the infant's body.
This is the first such fatality reported at home and abroad, with South Korea having reported two other similar cases of Tamiflu-resistant patients and the World Health Organization 102 cases worldwide, Seoul's media reports said.
The girl was too young to be given relenza, which is approved for treatment in children who are seven years and older, according to local media.
South Korea has posted 117 A/H1N1 flu fatalities as of Dec. 4, according to data collected by the health ministry.
Source: Xinhua
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