Home | Founder | What's New | In The News | Contact Us | |||||||
Paradigm Shift Intervention Monitoring | Commentary Tamiflu Selection of RBD Changes in Egypt? Recombinomics Commentary 15:54 December 26, 2007 has also decided to maintain the provision of real estate Altamflo [Tamiflu] all hospitals diets and processing places of confinement following the appearance of the first positive case among birds in the maintaining this winter. The above translation of comments was published two days ago. Although the report notes the first positive case in birds in Gharbiya, today’s announcement of the first H5N1 human case in Egypt this season suggest that the first human case in Beni Suef may have contributed to the implementation of a Tamiflu blanket in the region. The extensive use of osletamivir in Egypt could lead to the selection of Tamiflu resistant strains circulating in the area. One year ago Egypt reported the largest H5N1 cluster. The H5N1 sequences from the cluster were cause for concern. In addition to two receptor binding domain changes, which could lead to more efficient transmission, the NA sequence also had N294S, which is linked to resistance to Tamiflu. Since N294S was present prior to Tamiflu treatment, it was circulating in the source of the infections of the cluster. H5N1 was isolated from two collections from two of the patients. N294S was in both collections (prior to treatment and 48 hours after treatment) from both patients. A similar sequence was found in a chicken from Gharbiya, but that isolate did not have N294S. Another chicken isolate from Beni-Suef also had the Gharbiya HA sequence. The NA sequence from Beni Suef has not been released. However, the presence of the Gharbiya sequence in birds in Gharbiya and Beni Suef collected earlier this year suggests the Tamiflu resistance sequences are still in circulation, as are the two receptor binding domain sequences, V223I and M230I. These sequences are in competition with wild type H5N1 circulating in Egypt, and application of a Tamiflu blanket to the region may lead to a greater prevalence of the Tamiflu resistance marker, which is evolutionarily fit. Similarly, the association of receptor binding domain markers would also lead to an increased prevalence of such markers. The large cluster in Pakistan also raises the possibility of additional receptor binding domain changes, which could recombine with sequences circulation in Egypt last season. Sequence data from the cases in Pakistan and Egypt would be useful. Media Links Recombinomics Presentations Recombinomics Publications Recombinomics Paper at Nature Precedings |
||||||||||
|
Webmaster:
webmaster@recombinomics.com
© 2007
Recombinomics. All
rights
reserved.