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Commentary
Fatal H1N1 Tamiflu
Resistance in New Brunswick Canada
Recombinomics
Commentary 00:20
December 30, 2009
A 27-year-old Quispamsis man died in hospital on Monday after nearly a month in intensive care, public health officials said. Doctors tried treating him with the anti-viral drug Tamiflu but those efforts failed.
According to Van Buynder, the H1N1 strain the man contracted was resistant to drugs such as Tamiflu that are used to fight the virus.
The above comments describe another fatal case linked to Tamiflu resistant H1N1. Although the explosion in Tamiflu resistance has been reported across the northern hemisphere, there has also been a spike in fatal cases linked to H274Y. The fixing of H274Y in seasonal flu was tied to hitchhiking of H274Y with receptor binding domain changes. A193T was in all isolates, and was associated with one of more additional changes at positions 187, 189, and 196.
In pandemic H1N1, H275Y has been found in association with receptor binding domain changes at position 225 (D225E and D225G). D225G has been closely linked to fatal and severe cases, so H274Y linked fatalities raise concerns that such outcomes signal H274Y on a sequence that not only is fit, but is also lethal.
Recent fatal cases of Tamiflu resistance include three patients at Duke Medical Center and addition deaths in Delaware, South Korea, the Netherlands, and France. The death in France also had D225G.
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