Canada:
Tamiflu-resistant H1N1 in Hamilton
October 16, 2009
Joanna Frketich
The Hamilton Spectator
(Oct 16, 2009)
A young Hamilton man was infected with Ontario's first case of Tamiflu-resistant H1N1.
Only a few dozen people worldwide have been reported to have pandemic influenza resistant to the antiviral treatment. They include a 60-year-old Quebec man and an Alberta woman. Both recovered without being hospitalized.
The Hamilton man is in his 20s. Public health officials don't believe he spread it because no one he had contact with has become sick.
"People should take this seriously, but not panic," said Dr. Chris Mackie, Hamilton's associate medical officer of health.
The emergence of Tamiflu-resistant H1N1 comes at the same time local doctors have reported to the public health department that at least one company tried to pay for its staff to get prescriptions for the antiviral to prevent the flu.
"It sent a letter with all of their employees out to doctors saying we'll pay you $60 to give a 60-day prescription to prophylactics," Mackie said.
"This is exactly the sort of thing that generates resistance."
Tamiflu is only to be used as a treatment for high-risk patients with symptoms and not for prevention.
The H1N1 flu shot is the best way to protect against the pandemic and Mackie says he's hoping to announce today when it will be available and where.
He refused to provide any details about the young man who caught the Tamiflu-resistant strain. He wouldn't even say whether the man is dead or alive.
Normally, public health provides details about whether the person is in hospital or at home and how ill.
"For reasons of confidentiality, I'm afraid we can't say anything more about this individual case and I really apologize about that," said Mackie.
The Ministry of Health is confident it's an isolated case.
"At the moment there is no evidence of widespread resistance to Tamiflu anywhere," said ministry spokesperson David Jensen.
There are other antiviral treatments available when H1N1 is resistant to Tamiflu. However, it can take weeks to determine the strain is resistant. Often, the patient's illness gets worse and that's what prompts doctors to try other antiviral treatments.
So far, it hasn't been a big concern because there have been so few cases.
"This virus has been remarkably stable," said Dr. Michael Gardam, director of infectious disease prevention and control at Ontario's Agency for Health Protection and Promotion. "It hasn't shown any propensity at this point to easily develop resistance and then for those resistant strains to spread."
hat-tip Treyfish
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