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Fatal Tamiflu Resistant Cases Spike in the Netherlands
Recombinomics Commentary 14:53
December 11, 2009

Until this week were 11 patients diagnosed in the Netherlands, including 5 this week, with a New Influenza A (H1N1) virus that is resistant to the antiviral agent Tamiflu (oseltamivir) that such patients are treated. Four of these patients are deceased.

The above translation highlights the dramatic jump in H274Y in the Netherlands, which is associated with a high case fatality rate. The number of cases with H274Y has almost doubled in the past week (see map) and the case fatality rate for the 11 cases is above 36%.  This high rate raises concerns that isolates with H274Y also have receptor binding domain changes, leading to a high CFR.  In France, two fatalities with D225G were identified, and one of the two had H274Y.  These associations are creating increased concerns.

Release of the sequences with H274Y would help determine if a new sub-clade is emerging with lethal markers like the D225N and D225G identified in Ukraine.

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