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Fatal Tamiflu Resistant H1N1 Cases in The Netherlands
Recombinomics Commentary 12:58
May 23, 2008

Both in Utrecht and Rotterdam is a deceased patient with flu, by resistance to oseltamivir (Tamiflu). The victims were young patients with a weakened immune system strong.

The above translation describes two patients in the Netherlands who died from infection with Tamiflu resistant H1N1.  Their immune system was compromised, and the H1N1 was not susceptible to Tamiflu (oseltamivir) treatment. 

The report highlights the limitations of using Tamiflu to treat seasonal flu when the H274Y status is unknown.  H274Y is common in many European countries.  In Norway, more H1N1 infections are Tamiflu resistant than wild type.  High levels have also been reported in France and Russia, while many countries have frequencies between 10-20% of H1N1 cases.

Although these isolates are susceptible to Relenza, and some are still sensitive to amantadines, the reliance on Tamiflu can have deadly consequences.

Moreover, the widespread distribution of H274Y in H1N1 can impact H5N1 treatment if the polymorphism is acquired by recombination. 

Recent mild H5N1 cases raise concerns that the level of H5N1 in human populations is significantly higher than the confirmed cases reported by the WHO.

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