PAHO rejects report of resistant H1N1 cases on US-Mexico border

Lisa Schnirring Staff Writer

Aug 4, 2009 (CIDRAP News) – A Pan American Health Organization (PAHO) official today rejected a media report that quoted her as saying that antiviral-resistant cases of novel H1N1 influenza had been found along the US-Mexican border.

Details in the original article, published by Agence France-Presse (AFP), were sketchy and at times confusing. The report, which quoted Maria Teresa Cerqueira, PhD, chief of PAHO's US-Mexico border office in El Paso, Tex., said a few oseltamivir (Tamiflu)-resistant cases had been detected in El Paso and near McAllen, Tex.

The story quoted her as saying one patient diagnosed with a resistant strain had been treated with zanamivir (Relenza) and that "another was given no alternative treatment." The article didn't say if either of the patients was initially treated with Tamiflu.

But in an e-mail message today, Cerqueira said she was misquoted. She sent the message to PAHO, which shared it with CIDRAP News.

Cerqueria wrote that she mentioned McAllen and El Paso as being among the border towns where novel flu virus has been detected. She said that in response to a question about resistant cases, she told the writer she was concerned and that PAHO has recommended surveillance for such cases, especially since people go back and forth across the border for medical care and to buy medicine.

Cerqueira said she repeated several times that she had no information on any antiviral-resistant cases in the border area. "It is an unfortunate misinterpretation that needs to be clarified," she wrote.

She wrote that she has heard about two antiviral-resistant cases from a physician in Colombia, but that the source did not say they were near the US-Mexico border.

So far, isolated oseltamivir-resistant novel flu cases have been confirmed in Denmark, Hong Kong, Japan, and Canada. All of the patients had a history of oseltamivir prophylaxis or treatment, except for the patient in Hong Kong, a girl who was visiting from the United States, where health officials believe she was exposed to the virus.

A spokesman for the US Centers for Disease Control and Prevention (CDC) today referred questions about the alleged border antiviral-resistant cases to PAHO, and a World Health Organization spokesman said its experts were following up on the claims in the report. A PAHO spokeswoman said the group was working on a statement to clarify the comments attributed to Cerqueira.