Drug resistant swine flu found in N.C. hospital

Drug resistant swine flu found in N.C. hospital

Posted 29m ago
By Steve Sternberg, USA TODAY
Epidemic experts have launched an investigation of four Tamiflu-resistant swine flu cases at Duke University Medical Center to see whether the resistant virus has begun spreading person-to-person at the Durham, N.C. hospital and beyond.


If so, the cluster appears to be the first instance in which Tamiflu-resistant virus has been transmitted from person to person.



"The four patients involved in this situation had the same resistance pattern," says Daniel Sexton, the hospital epidemiologist leading the investigation, adding that the Centers for Disease Control and Prevention are now testing virus samples to see whether they're identical.



"The resistance pattern suggests that might be the case," he says.
All of the patients were located in a ward for people with cancer or severe blood disorders. All were severely ill and were highly susceptible to infections, Sexton says.


The patients became ill with flu in October. When they didn't respond to Tamiflu, the hospital sent specimens of their virus to see whether the virus might be resistant to antiviral treatment. The results didn't come back until two weeks ago, prompting Duke to launch an investigation.

Sexton says three epidemiologists from the CDC as well as experts from the state health department are now at Duke assisting in the investigation. The investigation has now been extended outside Duke to determine whether Tamiflu-resistant flu is circulating elsewhere in North Carolina.
CDC spokesman Dave Daige says the agency did confirm the cases and has sent three Epidemic Intelligence Service "disease detectives" to assist in the investigation.


Three of the four Duke patients have died; the fourth is extremely ill but is being treated with another antiviral called Relenza and appears to be recovering. In addition, the Reuters wire service has reported a cluster of nine Tamiflu resistant cases of swine flu, also called H1N1 flu, in Wales.


Ann Schuchat, director of CDC's national center for immunization and respiratory diseases, said Friday that she had not heard of the Wales cluster, but acknowledged that CDC has been tracking other instances of Tamiflu resistance. "We've seen a dozen or so at this point, but the cluster issue will be an important thing to track and understand because that would be a sign of transmission," she says.



If resistant strains start spreading in the midst of a pandemic, Sexton says, they could represent a global threat and potentially increase the number of flu deaths.