LOS ANGELES, July 8 (Xinhua) -- Amid reports of
Tamiflu-resistant H1N1 cases, health officials are concerned about how quickly a
new strain of the virus resistant to the drug Tamiflu will spread, or how
dangerous it might become.
Although, isolated cases of the A/H1N1 virus, seem
mild for now, but future remains uncertain, the Health Day News reported on
Wednesday
So far, three people have been stricken in recent
weeks by a resistant strain of the new H1N1 flu virus -- one in the United
States, one in Denmark and one in Japan, according to earlier press reports.
In all three cases, the illnesses were mild and all
of the patients recovered.
More widespread resistance could come from one of two
scenarios, John J. Treanor, professor of medicine and of microbiology and
immunology at the University of Rochester Medical Center in New York, said in
remarks published by Health Day News.
The first would be if the virus develops mutations in
people who are being treated with Tamiflu and then spreads to others, Treanor
said.
The second would involve a random genetic
reassortment, in which the new swine flu and the seasonal flu exchange genes, he
said.
"The current seasonal viruses are resistant to
Tamiflu," Treanor noted. "We could see a get-together resulting in a hybrid
which ... potentially could be able to infect people more easily."
"This is not unexpected, but it's very unpredictable
whether this will end up spreading," said Treanor.
"There is certainly a potential for the novel H1N1
viruses to develop resistance to oseltamivir (Tamiflu) and for those resistant
viruses to become widespread," he added.
"Everyone recognizes that. That is the Achilles' heel
of antiviral therapy and it's completely possible that we will see this with the
novel H1N1."
"This is expected to a certain extent," agreed
Manjusha Gaglani, associate professor of pediatrics at Texas A&M Health
Science Center College of Medicine and a pediatric infectious diseases
specialist at Scott & White Hospital.
Strains of the "regular" seasonal flu often become resistant to antiviral drugs but, generally speaking, antiviral resistance is less common with Tamiflu and a related antiviral drug, Relenza, than it is with two other drugs, amantadine and rimantadine, which the U.S. Centers for Disease Control and Prevention has recommended against using for seasonal flu.
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A man leaves a school, attended by children from the five new confirmed cases of influenza A (H1N1), after collecting a box of Tamiflu in south London May 4, 2009. (Xinhua/Reuters File Photo) Photo Gallery>>> |
Tamiflu is preferred over Relenza in general because
it is easier to administer, Gaglani said.
Since there is no vaccine for the H1N1 virus, Tamiflu
is the main weapon available in the effort to prevent and treat H1N1 infections.
There has been speculation that overuse of the drug
has contributed to the new drug resistance but, at this point, that is another
unknown, and people who fall ill do need to be treated, said the report.
"I don't know how much that's being driven by use of
the drug," Treanor said. "I think the drug should be used where indicated. If
resistance happens, it's going to happen, but we have to use medicine to treat
sick people appropriately."