Now ! - Mother of all H1N1 flu emerges !

[GoFlyKiteNow]

Concerns grows over drug-resistant flu

WASHINGTON (AFP) - - Health officials raised the alarm about a strain of swine flu that is resistant to the Tamiflu treatment as the virus claimed more lives on Tuesday, with Vietnam reporting its first fatal case.

Maria Teresa Cerqueira, head of the Pan-American Health Organization office in La Jolla, California, said a Tamiflu-resistant mutation of A(H1N1) had been found around the US-Mexico border in El Paso and close to McAllen, Texas.

Experts had gathered in La Jolla, California, on Monday to discuss responses to the outbreak, and warned that resistant strains were likely emerging because of overuse of antivirals like Tamiflu.

"In the United States Tamiflu is sold with a prescription, but in Mexico and Canada it is sold freely and taken at the first sneeze. Then, when it is really needed, it doesn't work," said Cerqueira late Monday.

Cases of A(H1N1) that were resistant to the anti-viral medicine have now been found in the United States, Canada, Denmark, Hong Kong and Japan.

In Vietnam, officials reported the country's first swine flu fatality after a 29-year-old woman died from the disease in the southern coastal province of Khanh Hoa.

 

[singveld]

"In the United States Tamiflu is sold with a prescription, but in Mexico and Canada it is sold freely and taken at the first sneeze. Then, when it is really needed, it doesn't work," said Cerqueira late Monday.


not the mexcian again
now they are creating tamiflu resistant h1n1 flu,

 

[ScarFace]

First Tamiflu Resistant Pandemic H1N1 - Singapore ex-Hawaii
Recombinomics Commentary 20:09
August 9, 2009

The third confirmed case is a 28-year-old American female who is working in Singapore. She returned to Singapore from Honolulu via Tokyo on Tuesday, 26 May at 2353 hrs, on United Airlines, UA 803. She was seated at 33C. She became unwell on 26 May.

She returned to Singapore on flight United Airlines 803 from Honolulu via Tokyo on 26 May 2353 hrs. She became unwell while on board and passed through the thermal scanner at the airport as she did not have a fever then. She was referred by her company doctor to TTSH for assessment on 27 May afternoon via a 993 ambulance. Laboratory results confirmed her infection at 1610 hours on 28 May.

For the above cases, they have been discharged from CDC today as they have been cleared of H1N1 virus. They are now on medical leave.

The above descriptions match the patient linked to the recently released NA sequence, A/Singapore/57/2009, by the CDC at GISAID. Although the sequence represents the earliest reported case of H274Y in pandemic H1N1, it was released without fanfare on Thursday. Media reports (see Singapore map) contained the information in the first paragraph above. This information, and the additional information described in Singapore MOH press releases, indicate the case was mild and made no mention of Tamiflu treatment, consistent with the short course and discharge on May 31.

The characterization sheet indicates isolation was on May 30 from a 28 year old female, which is consistent with the above information. The first confirmed case in Singapore was on May 26, and above patient was the third confirmed case. It is the only patient matching age and gender, indicating she is the source of A/Singapore/57/2009. Since she developed symptoms while in flight, the infection was likely from a contact in Honolulu, which is similar to the history of the American traveler from San Francisco. She also had a mild case and refused Tamiflu, but recovered quickly. Although media reports indicated she had a fever when she landed, Hong Kong reports suggested she was asymptomatic at landing, but tested positive shortly thereafter. Thus, infections in both passengers were confirmed in countries in Asia, but infections were in the United States, where there have been no reported cases of Tamiflu resistance.

The export of Tamiflu resistance in the absence of detection in the United States sends a strong signal of a flawed surveillance system. Since both of these cases were mild, yet involved a fit H1N1 with H274Y, the failure to detect similar cases in California or Hawaii may be due to an emphasis on testing more severe cases. The decision to ignore and not report mild cases creates an environment for silent spread of the H1N1 as well as the associated Tamiflu resistance.

Moreover, the release of the sequence in August from a patient infected in May, raises concerns of more such examples in samples collected, but not sequenced, analyzed, or reported. These concerns have been heightened by the frequent detection of H274Y in patients receiving prophylactic Tamiflu, which would be among those most easily identified, as well as additional reports of resistance in China and Thailand, which lack information on the Tamiflu treatment status of the patients or in the case of Thailand, the sample collection date. The sample in China was collected on June 13, again signaling a long delay between sample collection and release of the associated sequences, suggesting that these patients were also not taking Tamiflu, and sequencing of these milder cases has a low priority or a large backlog.

The resistance in patients in Singapore, China, and Thailand released this week adds to concerns associated with the prior Tamiflu resistance cases in Denmark, Japan, Canada and Hong Kong (ex San Francisco), which support silent spread of Tamiflu resistance worldwide.

 

[ScarFace]

Additional Spread of Tamiflu Resistant Pandemic H1N1
Recombinomics Commentary 20:07
August 12, 2009

Charles Penn, a scientist with the Geneva-based agency, says the WHO has also been alerted informally to the discovery of a small number of other Tamiflu-resistant viruses but he won't say where they were found.

The above comments describe additional cases of Tamiflu resistance (H274Y) but provide no detail on the circumstances or locations. Who has acknowledged the resistance that was evident in the sequences released from Singapore and Hunan, China, as well as the examples previously described in Denmark, Canada, Hong Kong, and Japan (3 times). However, the number and location of additional cases and circumstances remains unclear.

Media reports have described H274Y in Thailand, but it remains unclear how many cases were found. In addition, there were reports of resistance along the Texas / Mexican border, but those reports were denied. However, the denial only addressed the cited locations. There was no statement that the rumored cases were false. The media report was quite detailed about the cases (at least two), which raised concerns that the resistance was widespread, because multiple cases were reported in the same general area.

To date there are no reports of resistance developing during treatment. Several cases were discovered in patients receive prophylactic Tamiflu, but the development of symptoms on the fifth day or prophylactic treatment suggested the H274Y discovered was already present as a minor component and the preventive treatment led to the discovery of the H274Y.

All reported cases have H274Y, which matches the change in seasonal H1N1 and each pandemic sequence represents a different genetic background, raising concerns that the H274Y is spreading via recombination in mild cases which are not tested and in cases were the virus is a mixture dominated by wild type. Consequently, new isolates are being discovered, although reports are clearly being delayed.

The Singapore sequence, deposited at GISAID last week was from the third patient confirmed in Singapore, an American (28F) who became ill in flight from Honolulu to Singapore. Her cases was mild and she was discharged on May 31, three days after confirmation. Similarly, the sequence from Hunan was also released last week, from a patient (63F) which was confirmed June 13. These long delays, and the WHO refusal to give detail on the additional cases, increase concerns that the H274Y is widespread and it presence is either not being detected, or not being reported.

Details on the number and locations of the other isolates, as well as the circumstance surrounding the detection, would be useful. The patient from Hong Kong was not linked to Tamiflu, and circumstances surrounding cases in Singapore, China, and Thailand suggest that the H274Y was discovered during routine surveillance and therefore collected in the absence of or prior to oseltamivir treatment, raising additional concerns of spread of evolutionarily fit pandemic H1N1 with H274Y.

 

[Watchman]

<object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/K_rI7kfdO1A&color1=0xb1b1b1&color2=0xcfcfcf&hl=en&feature=player_embedded&fs=1"></param><param name="allowFullScreen" value="true"></param><param name="allowScriptAccess" value="always"></param><embed src="http://www.youtube.com/v/K_rI7kfdO1A&color1=0xb1b1b1&color2=0xcfcfcf&hl=en&feature=player_embedded&fs=1" type="application/x-shockwave-flash" allowfullscreen="true" allowScriptAccess="always" width="425" height="344"></embed></object>

 

[TeeKee]

wake up people!

the endtimes are near!! LOL!