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Commentary
H1N1pdm09 Louisiana Tamiflu Resistance Cluster
Grows
Recombinomics Commentary
20:30
December 3, 2013
The CDC release sequences for all eight gene segments, which showed that the two isolates were virtually identical. The Louisiana Department of Health indicated the CDC requested additional samples, which led to the identification of a third case (the first 2 cases were cited in week 44 FluView and the third case was in week 45) and all three cases were unlinked.
The CDC recently released sequences for all eight gene segments of the third case 25F, A/Louisiana/10/2013 from a sample collected on October 21. That set of sequences matched the first two, extending the clonal expansion. The CDC also released two sets of sequences (A/Louisiana/11/2013 and A/Louisiana/12/2013) which were oseltamivir sensitive, but these sequences were also closely related to the three resistant sequences.
This similarity raises concerns that the sensitive cases are mixtures, with H274Y present in lower concentration. The possibility of a mixture in the Louisiana sequences is support by newly released sequences from a resistant case (14F) in Utah, A/Utah/10/2013, which has almost equal levels of H274Y and wild type, but is also closely related to the Louisiana sequences.
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