India: Possible case of “resistant” A (H1N1) virus

Ramya Kannan

Positive tests, even after treatment, suggest a mutation

Blood sample to be sent to National Institute of Virology

CHENNAI: The Indian Council of Medical Research will investigate what seems to be a case of “resistant” A (H1N1) virus in Chennai, its Director-General V. M. Katoch said. This is the first such case reported in the country.

The State health authorities have been asked to send a blood sample of the infected person to the National Institute of Virology (NIV), Pune.

The patient, a man who had flown in from the U.S. in the third week of June, had tested positive along with his wife.

They were quarantined at the Communicable Diseases Hospital (CDH) here and started on a course of Tamiflu. “This was through the Directly Observed Treatment Short-course method, which means we know he took every tablet and did not miss out on even a single dose. Missing on doses can lead to resistance, but that is not the case with this patient,” Director of Public Health S. Elango said.

While his wife recovered and tested negative for A (H1N1) after about 10 days, the husband continued to test positive even after the treatment was completed.

Though he showed no symptoms, his tests kept coming back positive, Dr. Elango said.

“This is a case to be studied, definitely. The virus should not remain in his blood after the treatment. It is possible that it is a mutation of the virus. I have instructed the officials at the NIV to sequence the strain [from the samples] as soon as possible. Once we have that, we can have the alternative drugs to treat the patient,” Dr. Katoch explained.

He said the patient at the CDH could be treated on recommended doses of the drug ‘Relenza’ available in India.

When told that the patient was anxious to go home, Dr. Katoch categorically said that he could not be discharged as long as he continued to test positive, even if he was not symptomatic.

“He is certainly a carrier and can spread the virus to members of his family, and thereby take it into the community. That should not be allowed to happen. Indigenous transmission of the virus from this person will lead to a huge public health problem,” Dr. Katoch said.

The issue would be sorted out as soon as the sequence was drawn up. “That way we will also be ready for any future occurrences.”

hat-tip Dutchy