Maryland: Mutated swine flu in city raises concerns

By Kelly Brewington
December 3, 2009
A mutated strain resistant to the most commonly prescribed drug used to treat swine flu has surfaced in Baltimore, raising concern among experts that the virus could become harder to treat.

The cases of two cancer patients at Johns Hopkins Hospital who contracted the mutated strain are the first involving Tamiflu-resistant H1N1 in Maryland and are among 75 worldwide.

Health officials, noting that the Hopkins patients recovered, say there is no cause for alarm because the cases are isolated and have not spread. But the local cases, diagnosed in October and November, come on the heels of similar mutations found last week in four cancer patients at Duke University Medical Center in North Carolina - three of whom died - and in another cluster of patients at a hospital in Wales.

Dr. Trish Perl, a Hopkins epidemiologist, said hospitals need to be careful about hygiene and watch for new strains, that doctors should prescribe Tamiflu only when necessary, and that the public should get vaccinated against swine flu to avoid transmission.

"Probably, this mutation is out there, so what we want to do is to engage everyone in thinking about this more, particularly the medical community," Perl said. "This is a big wake up call for us. We are going to be more vigilant."

The Hopkins patients were two men who have since been discharged. One was admitted to the hospital after complaining of fever. Doctors tested him for influenza and the sample was sent to the state Department of Health and Mental Hygiene, which has been testing for virus mutations since summer. The other patient was being treated at the hospital and did not get better after taking Tamiflu. Samples sent to the state lab confirmed a mutated strain.

Officials at Hopkins and at the state health department would not disclose more information on the men's conditions, ages or hometowns. Officials said the patients were not likely to spread the virus. The men, who had weakened immune systems which made them more susceptible, were cared for in private rooms by medical staff wearing masks.

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