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Thursday, March 26, 2009

Global Influenza on the Rise

A ProMED-mail post

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International Society for Infectious Diseases

Date: Sat 21 Mar 2009
Source: WHO Epidemic and Pandemic Alert and Response (EPR), Influenza [edited]
Click on title above to see report;

Influenza A(H1N1) virus resistance to oseltamivir -- 2008/2009
influenza season, northern hemisphere
During weeks 1-4 (28 Dec 2008-24 Jan 2009), the level of overall
influenza activity in the world increased. In Europe, most countries
reported regional or widespread activity with influenza A(H3) viruses
predominating. Widespread influenza A activity (H1 and H3) was
reported in Japan. In Canada, Hong Kong SAR, and the United States,
influenza activity increased but remained relatively low. Sporadic
influenza activity was observed in Brazil (A), Croatia (H1, H3, B),
Greece (H1, H3, B), Iran (H1, H3), Mongolia (A), Portugal (H1, H3,
B), Serbia (H1, H3, B), Singapore (H1, H3, B), Slovakia (H3), and
Turkey (H3, B).

During this period, a total of 30 countries from all WHO regions
reported oseltamivir resistance for 1291 of 1362 A(H1N1) viruses
analysed. The prevalence of oseltamivir resistance was very high in
the following countries/territory: Canada (52 of 52 tested), Hong
Kong SAR (72 of 80), Japan (420 of 422), the Republic of Korea (268
of 269), and the USA (237 of 241).

The resistance prevalence was relatively low in China (6 of 44
tested). In Europe, H1N1 circulation was low during this period while
the resistance prevalence was high: France (12 of 12 tested), Germany
(66 of 67), Ireland (9 of 10), Italy (16 of 16), Sweden (11 of 12)
and the United Kingdom (61 of 62).

WHO is collecting global data about this phenomenon from multiple
laboratories participating in Global Influenza Surveillance Network
[]. Data
from European countries participating in EISS [European Influenza
Surveillance Scheme, ] were provided by the
EISS and VirGil [vigilance against viral resistance] project
[]. This summary table will
be updated regularly (every 4 weeks).

Oseltamivir resistance results were based on phenotypic and/or
genotypic analyses.

A comprehensive table of influenza A(H1N1) virus resistance to
oseltamivir (4th quarter 2008-31 Jan 2009) can be found [at the URL

Communicated by:

[It should be noted that in Europe as of week 11 [9-15 Mar] 2009 all
influenza A(H3N2) viruses tested (the predominant epidemic virus)
were resistant to M2 inhibitors but sensitive to oseltamivir and
zanamivir ().
Consequently the appearance of oseltamivir resistance is dependent on
virus genotype and may not be a direct response to the use of
anti-neuraminidase antivirals. - Mod.CP]

[see also:
Influenza A(H1N1) virus, oseltamivir resistance: Korea 20090113.0136
Influenza A (H1N1) virus, oseltamivir resistance (10): CDC 20081224.4054
Influenza A (H1N1) virus, oseltamivir resistance (09): USA 20081220.4013
Influenza A (H1N1) virus, oseltamivir resistance (08): Europe 20081025.3375
Influenza A (H1N1) virus, oseltamivir resistance (07): Europe 20080906.2783
Influenza A (H1N1) virus, oseltamivir resistance (06): S. Hemisphere
Influenza virus, oseltamivir resistance (06): Japan 20080228.0812
Influenza A (H1N1) virus, oseltamivir resistance (05): China (HK)
Influenza A (H1N1) virus, oseltamivir resistance (04): CA, USA 20080202.0428
Influenza A (H1N1) virus, oseltamivir resistance (03): corr. 20080203.0430
Influenza A (H1N1) virus, oseltamivir resistance (03): Europe 20080201.0399
Influenza A (H1N1) virus, oseltamivir resistance (02): Europe 20080129.0371
Influenza A (H1N1) virus, oseltamivir resistance - Norway 20080128.0361
Avian influenza, human (162): oseltamivir resistance 20061010.2907]
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