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Resistant Cluster in Pennsylvania
The above comments describe another Tamiflu resistant cluster in the US. It is not clear how closely linked these cases are, but the report follows a cluster in the Maryland/Virginia area, as well as human to human transmission at Duke, where three of the four cancer patients died.
These clusters of cases likely represent a very small percentage of the resistance transmitting in the US and worldwide. Recently WHO noted an increase fro 57 to 96 of reported cases in the past 2 weeks and CDC weekly reports show an increase in frequency of almost 10 fold (12/464 tested samples in the past 3 weeks vs 3/1076 in the prior weeks of the current 2009/2010 season).
In addition, the CDC has released sequences with H274Y from Tennessee, Georgia, and Tanzania, providing additional evidence on the spread of the polymorphisms.
These repeated reports of H274Y in geographic clusters, as well as transmission clusters, suggest that H274Y has passed a tipping point, and reports of H274Y will increase in the upcoming weeks.