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H1N1 Tamiflu Resistance in England Exceeds 92%
Recombinomics Commentary 18:05
November 20, 2008

13 influenza A (H1) isolates have been received and tested, of which twelve are resistant to oseltamivir but sensitive to zanamivir and amantadine. All of these 12 are from South West England and are being followed up in more detail.

The above quote from today’s UK report indicate the three most recent H1N1 isolates are oseltamivir resistant, so the frequency of H274Y in H1N1 in the UK now exceeds 92%.  These high levels are not a surprise.  Last season the have majority of H1N1 isolates with H274Y were due to a Brisbane/59 dominant sub-clade.  That sub-clade emerged in South Africa over the summer and the H274Y frequency was 100% (215/215).  Other countries in the southern hemisphere had similar high frequencies, which was firmly tied to the acquisition of D354G, which was present in all public clade 2A and clade 2C sequences from the past few years.

Thus, the all isolates in the dominant sub-clade had D354G in addition to H274Y which led to the dramatic spread of oseltamivir resistance last season in the northern hemisphere, which is likely to increase to levels close to 100% this year as evidenced by the detection of H274Y in 13/14 tested H1N1 isolates in Europe this season.

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