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Cluster of Tamiflu Resistance Near Edinburgh Scotland
Recombinomics Commentary 13:42
November 16, 2009

One patient in the Lothians and another believed to be from Fife failed to respond to Tamiflu, one of the only treatments for the H1N1 virus.

Doctors around the world have seen a handful of cases where the virus has mutated to develop resistance to the drug.

NHS Lothian confirmed it has seen one patient with Tamiflu-resistant swine flu.

A spokesman for the Scottish Government said: "We are aware of Tamiflu resistance in two Scottish H1N1 patients.

"We have asked Health Protection Scotland to monitor the situation closely."

The above comments describe two patients in Scotland north of Edinburgh (see map) who were found to have Tamiflu resistant (H274Y) swine H1N1 after failing to respond to treatment.  Initial reports do not describe the patients as being immune-suppressed or on prophylactic Tamiflu.  Instead the cases appear to be independent but reported at the same time from the same area, raising concerns that swine H1N1 with H274Y is transmitting.

Prior reports of H274Y described cases that were not linked to Tamiflu usage, but were sporadic.  The patients in Scotland, however, appear to come from the same geographic region and are being reported at the same time.

Currently the number of severe H1N1 cases and deaths is rising throughout the northern hemisphere, including Scotland, raising concern that the rise is due in part to H274Y.

More information on these two cases, as well as the release of the resistant sequences, would be useful.

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