Tamiflu-Resistant H1N1 Cluster Reported

Cases of 4 N.C. Patients Show Swine Flu Virus May be Mutating

(AP)  Updated at 7:51 p.m. EST

Four North Carolina patients at a single hospital tested positive for a type of swine flu that is resistant to Tamiflu, health officials said Friday.

The cases reported at Duke University Medical Center over six weeks make up the biggest cluster seen so far in the U.S.

Tamiflu - made by Switzerland's Roche Group - is one of two flu medicines that help against swine flu, and health officials have been closely watching for signs that the virus is mutating, making the drugs ineffective.

More than 50 resistant cases have been reported in the world since April, including 21 in the U.S. Almost all in the U.S. were isolated, said officials with the U.S. Centers for Disease Control and Prevention.

Special Report: H1N1 Virus

The BBC reported another cluster of five Tamiflu-resistant cases this week in Wales, in the United Kingdom.

The CDC has sent three disease investigators to North Carolina to help in the investigation there, said Dave Daigle, a CDC spokesman. CDC testing confirmed the Tamiflu-resistant cases.

All four cases at the hospital were very ill patients in an isolated cancer unit on the hospital's ninth floor, and it is believed they all caught the flu while at the hospital, said Dr. Daniel Sexton, professor of medicine and director of the Duke Infection Control Outreach Network.

Three of the four patients died and one is recovering, he said. Flu seems to have been a factor in each death, but they were very sick so it was hard to say that it was the primary cause, he added.

North Carolina health officials did not disclose details about the four patients, other than that three of them - including the survivor - were women and their flu illnesses occurred last month and this month.

The first patient had been given Tamiflu before becoming ill with the virus, as a preventive measure. The three others were given Tamiflu after developing flu symptoms, Sexton said.

The case is under investigation, but hospital officials said they have no evidence the cases represent a hospital-wide concern.

The North Carolina cluster is unusual, but "at this time we don't have any information that should raise concerns for the general population," said Dr. Alicia Frye, epidemiologist in the CDC's flu division, in a prepared statement.

The only other reported U.S. instance of Tamiflu-resistant swine flu spreading from one person to another occurred about four months ago at a summer camp in western North Carolina, where two teenage girls - cabin mates - were diagnosed with the same drug-resistant strain. Health officials said at the time that the virus may have spread from one girl to the other, or it's possible that the girls got it from another camper.

Why did both Tamiflu-resistant clusters occur in North Carolina? It could be coincidence, or perhaps North Carolina's disease surveillance is unusually good, said Megan Davies, the state's epidemiologist.

Overall, CDC officials said Friday that swine flu cases appear to be declining throughout most of the U.S., with reports of swine flu illnesses widespread in 43 states last week, down from 46 the week before.

CDC officials also said reports have been increasing in a few states, including Maine and Hawaii. They said it's hard to know whether the epidemic has peaked or not.

Thanksgiving and the holidays may not help matters, said Dr. Anne Schuchat, who heads the CDC's National Center for Immunization and Respiratory Diseases.

"All the kids get together with their grandparents and there's a lot of exchange of warmth and love, but a little exchange of viruses, too," she said.

Swine flu has sickened an estimated 22 million Americans, hospitalized about 98,000 and killed 4,000 since it was first identified last April. It has proved to be similar to seasonal flu but a much bigger threat to children and young adults.

Also on Friday, CDC officials said they are aware of a new report from Norway of a distinct form of swine flu seen in three patients that seems to have an unusual ability to settle deep into the lungs and therefore could potentially be more dangerous.

The Norway report isn't the first time that particular mutation has been seen: About 15 others have been reported around the world, including four in the United States. Some cases proved fatal, but others caused only mild illnesses, CDC officials said.

The swine flu vaccine and antiviral drugs like Tamiflu and Relenza all seem to work well against it, CDC officials also said.

[bucketoftea]

The same thing has just occurred at the University Hospital of Wales in Cardiff, but the good news is that the Tamiflu-resistant strain doesn't seem to be any worse.<br /><br />http://www.dailymail.co.uk/news/article-1229703/British-hospital-hit-swine-flu-strain-resists-Tamiflu.html

[searingtruth]

I warned of the consequences of not implementing social distancing immediately after this virus was detected. But all of the warnings of epidemiologists, and myself, were not heeded.<br />ST<br /><br /><br />"It's as if a dam has broken, and instead of fleeing the water we keep building our cities higher in hope of escape.<br /><br />Even as we are washed away."<br />SearingTruth<br /><br />A Future of the Brave

[Newster1]

If this is confirmed, this is what public health authorities have long feared. If true, it means that ..."<br /><br />It means like dumb sheep the public is being fleeced again with scare tactics to get a barely tested, suspicious vaccine for a disease that hasn't even done what regular flu does every year, REGULAR flu kills 34,000 a year.

[bradkt1]

If this is confirmed, this is what public health authorities have long feared. If true, it means that H1N1 is mutating...and that's scary. It's not about Tamiflu or any other treatment (if any) for H1N1. I do not recall that Tamiflu was 100% effective against H1N1 in the first place. <br /> <br />Let's all hope and pray that this is not a deadlier strain of flu virus.

[bucketoftea]

Viruses mutate all the time.....

[skepticalJM]

Why weren't these patients given the flu vaccine, especially since they were such high risk patients? Hospital neglect?

[robinspp]

Tamiflu is another placebo. Most of the drugs in the market have only placebo effect, except few antibiotics and sedatives. The pharmaceutical industries and the doctors are exploiting the patients by saying it is good for the sickness, whereas it is not. Nobody proved that Tamiflu cures influenza. People pay too much for nothing.

[wyodutch]

Cool man..... You dance naked, whacking yourself with a dead chicken and I'll take Tamiflu.

[saberhmmr]

Be sure you keep the tin foil hat on and watch out for black helicopters!

[robinspp]

Tamiflu is another placebo. Most of the drugs in the market have only placebo effect, except few antibiotics and sedatives. The pharmaceutical industries and the doctors are exploiting the patients by saying it is good for the sickness, whereas it is not. Nobody proved that Tamiflu cures influenza. People pay too much for nothing.

[wyodutch]

But on a positive note... America is still spending $12,000,000,000 a month on our glorious wars of occupation against the poorly clothed, ill-equipped and under-gunned forces of Eurasia. <br />. <br />Long Live Big Brother and his bizarre priorities. <br />.

Tamiflu is a joke, it can not cure anything, I would not take this synthetic poison. Posted by Baileyccc

[I_am_me1953]

So much for all those folks who went out early and bought their Tamiflu and got their shots. <br /> <br />Should have waited.