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Fixing H1N1 Tamiflu Resistance Worldwide
Recombinomics Commentary 23:31
September 29, 2008

The newly released WHO report on oseltamivir resistance in the southern Hemisphere leaves little doubt that H274Y is being fixed in Brisbane/59 clade 2B.  Although there are some pockets of H1N1 that are not Tamiflu resistant, many countries are reporting frequencies approaching 100% including South Africa (129/129), Cameroon (2/2), El Salvador (7/7), United States (2/3), Uruguay (6/7), United Kingdom (1/1), Australia (25/26), New Caledonia (3/3), New Zealand (1/1), Philippines (10/11).

These latest results strongly suggest that H274Y is quickly becoming fixed in Brisbane/59, and this version of H1N1 is widespread.  Although the numbers in countries in the northern hemisphere are low, these numbers should increase markedly as the influenza season starts  in the northern hemisphere.  It is likely that Tamiflu will have little utility for treating H1N1 in areas were Brisban/59 is dominant.  If  H1N1 becomes  common in these areas, there will be serious concerns over the utility for the use of Tamiflu to blunt an H5N1 pandemic, because of the homology between the N1 in H1N1 and H5N1.

The worldwide fixing of H274Y is an increasing cause for concern.

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