Early H1N1 Tamiflu Resistance in the United States
Recombinomics Commentary 15:43
March 4, 2008
The sudden appearance of Tamiflu (oseltamivir) resistance in H1N1 has “startled” influenza “experts”, as noted earlier. Analysis of H1N1 public sequences at Los Alamos indicated that H274Y began appearing in the United States in 2007. However, closure of the Los Alamos data to the public has lead to movement of many of the sequences from Los Alamos to Genbank. Out of almost 1500 H1N1 human sequences at Genbank, six had H274Y (two were from the same patient).
The recent movement of sequences from Los Alamos was accompanied by newly released sequences, so the number of H1N1 sequences with H274Y has grown to 14 (from 11 patients), and like the sequences at Los Alamos, represent both H1N1 strains in circulation, New Caledonia/20/1999 and Solomon Island/3/2006 (which has largely been replaced by Brisbance/59/2007). The new sequences move the first appearance back to 2006 in Georgia and raise the number of New Caledonia sequences with H274Y to seven (from five patients). The number of sequences with H274Y has grown to seven (from six patients), and expanded the number of states from one (Hawaii), to four (Arizona, Illinois, New Jersey).
The presence of the same change on two different genetic H1N1 backgrounds in addition to H5N1 genetic backgrounds decreases the likelihood that the acquisitions are linked to unrelated independent events, and moves the sudden appearance of Tamiflu resistance closer to the broader application of Tamiflu blankets to treat H5N1.
New Caledonia-like sequences
Georgia/20/2006
Kansas/UR06-0104/2007
Massachusetts/05/2007
Minnesota/23/2007
Texas/31/2007
Solomon Island (Brisbane/59)-like sequences
Arizona/03/2007
Illinois/10/2007
New Jersey/15/2007
New Jersey/16/2007
Hawaii/21/2007
Hawaii/28/2007
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