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CDC Advises Against Tamiflu Treatment of Seasonal Flu
Recombinomics Commentary 20:33
December 19, 2008

It advised doctors to use rival drug Relenza or rimantadine, an older drug.

Forty nine out of 50 samples tested resist the drug, although they can still be treated with other flu medications, the CDC said in a special advisory to doctors.

The above comments acknowledge the current level of Tamiflu resistance in the United States and notes the special advisory issued by the CDC which eliminates the recommendation mismatch that existed prior to the advisory.

The new data indicates that the only oseltamivir sensitive isolate reported by the CDC is the clade IIC isolate from California.  Thus, all clade IIB (Brisbane) is oseltamivir resistant.

The week 50 update for Europe had the same result.  There was only one oseltamivir sensitive H1N1 isolate reported and that isolate was also almost certainly clade IIC because there was one isolate that was adamantadine resistant, which is found in clade IIC isolates.  Thus, 100% of reported clade IIB in North America and Europe has H274Y.

Moreover, in the United States, the vast majority of influenza A is H1N1, which created the recommendation mismatch.  In Europe, most influenza A reported to date is H3N2, which is 100% oseltamivir sensitive, so the prior recommendations for Europe are appropriate.

However, clade IIB is dominating H1N1 in circulation, which has serious implications for pandemic concerns because H274Y can be acquired via recombination, and H5N1 with H274Y is fit.

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