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H1N1 H274Y Tamiflu Resistance Spreads to California and Illinois
Recombinomics Commentary 18:15
May 18, 2012

The CDC has released another series of H1N1pdm09 sequences at GISAID.  The newly released sequences confirm and extend the clonal expansion of oseltamivir (Tamiflu) resistance due to H274Y.  Earlier sequences had H274Y in the five most recent sequences from Texas, as well as the four most recent sequences from Mexico, including cases from Mexico City.  The newly released sequences include four Texas isolates collected in March (A/Texas/31/2012, A/Texas/33/2012, A/Texas/34/2012, A/Texas/35/2012) and all four had H274Y and were closely related to each, other as well as the earlier cases in Texas and Mexico.

In addition, two recent isolates from California (A/California/21/2012) and Illinois (A/Illinois/1/2012) also had H274Y and were also closely related to the sequences from Texas and Mexico, signaling a broader clonal expansion.

The CDC’s week 19 Fluview notes that most of these isolates from cases not receiving anti0viral treatment, as well as two cases where family members were receiving treatment.  These observations support transmission of H274Y.

Moreover, two of the recently released sequences (A/Texas/34/2012 and A/California/21/2012) also had D225G raising concerns of increases in severe Tamiflu resistant cases.

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