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Commentary
Japan
H1N1Tamiflu
Resistance Levels Raise Concerns
Recombinomics
Commentary 12:19
December 20, 2009
The above translation refers to 26 cases of H274Y in Japan, including 4 cases in Aichi. These high numbers may have contributed to the recent totals posted by WHO, which were approaching 100. Although the WHO report indicated that this spike in cases was in the past few weeks, the locations were not given. However, the CDC weekly reports have cited 30 cases in the past 5 weeks and the Netherlands has increased its total to 13. However, Vietnam reported a cluster of 7 cases in the New England Journal of Medicine, which were from infections in July, but were not confirmed until September and were first made public in the NEJM paper. Some reports from Vietnam suggest 6% of H1N1 cases had treatment failures consistent with H274Y, but the number of lab confirmed cases remains unclear.
Similarly, NIID in Japan deposited 68 full sequences which included eight with H274Y, but it was unclear how representative the numbers or frequencies were. Other sequences from Nagasaki Prefecture were of the same sub-clade that had 3 isolates with H274Y, suggesting the Nagasaki sequences had H274Y, but only HA sequences had been released.
Thus, the above translation confirms that the number of cases in Japan is high, and phylogenetic analysis of the recently released sequences suggests significant silent spread, increasing concerns that H274Y will soon be fixed in pandemic H1N1.
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