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H1N1 Tamiflu Resistance Spreading In Mississippi
Recombinomics Commentary 16:00
January 17, 2014

The CDC has released another series of H1N1 sequences which included two more sequences (A/Mississippi/28/2013 and A/Mississippi/29/2013) from Mississippi with H274Y, signaling clonal expansion of Tamiflu resistance in Mississippi.  The gap in collections dates (December 7 and November 18, respectively) coupled with the November 4 collection date for A/Mississippi/11/2013, strongly suggests that H274Y is transmitting in Mississippi, as well as Louisiana, and is more common than indicated in CDC weekly updates in FluView.

The recent  acknowledgement of H274Y in Texas suggests it is widespread in southern states and is widely transmitting (also California?).  This transmission of H274Y is also supported by the sequences in Sapporo, Japan, which was supported by the recent Eurosurveillance paper, as well as recent sequences from China, which suggests H274Y has been transmitting in China since September.

These clusters and examples of transmission via clonal expansion, raise serious surveillance and reporting of resistance by the CDC.

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