Swine Flu That Resists Tamiflu Is Harder to Spread, WHO Says
Sept. 15 (Bloomberg) -- Swine flu that can resist treatmentwith Roche Holding AG’s Tamiflu is also harder to spread toother people, according to World Health Organization officials.
Almost two dozen people have developed swine flu infectionsthat don’t respond to Tamiflu, a mainstay of therapy for theoutbreak that began in April. The genetic mutation that helpsthe virus evade the drug also thwarts its transmission, so theinfection isn’t passed on to other patients, said David Mercer,acting head of the communicable diseases unit of the WHO’sEuropean region.
“It’s a very specific genetic mutation that causesresistance and reduces the transmissibility of the virus, soit’s not infectious,” Mercer said in an interview in Copenhagen,where the WHO’s European governing body met this week.
The findings may reassure public health officials worriedthat overuse of Tamiflu would render impotent one of the keyweapons against the pandemic virus. Some countries, includingthe U.K., took an aggressive approach to controlling theoutbreak when it first arrived at the end of April, givingTamiflu to people who had come into contact with pandemic flupatients to slow the spread of the disease.
For patients with seasonal influenza that doesn’t respondto Tamiflu, the only treatment option is GlaxoSmithKline Plc’sinhaled drug Relenza. Reducing therapies for the pandemicoutbreak, caused by a novel combination of avian, swine andhuman influenza, could be disastrous if the virus, formallyknown as H1N1, turns more deadly, Mercer said. Flu patients whoare otherwise healthy and without serious complicationsshouldn’t get Tamiflu, he said.
Viruses Change
“Healthy patients with uncomplicated illness don’t needantivirals,” Mercer said. “Viruses do change and evolution isunpredictable. Seasonal influenza is almost entirely resistant.Overuse of Tamiflu could result in the same thing” for swineflu, he said.
The WHO has been too firm on its advice to not treatpatients with uncomplicated infections, said Liam Donaldson,England’s chief medical officer. About 40 percent of deathsoccur among previously healthy people, and treatment is mosteffective when given early, before it’s clear whether theinfection is complicated, he said.
“Some people will die” if left untreated, Donaldson said.“To regard them as inevitable statistical occurrences doesn’t godown well. We have these antivirals and we know they can have animpact.”
52,000 Cases
There have been more than 52,000 confirmed cases across 48countries in Europe, including at least 140 deaths, Mercer said.Almost 90 percent of the deaths occurred in the U.K., Spain andIsrael, he said.
There have been 23 cases of resistance developing toTamiflu, Mercer said. Twelve of them were healthy people who hadencountered swine flu patients, and were given Tamiflu in aneffort to prevent the infection from taking hold, he said. Fouror five others were healthy patients who had mild infections.
“The good news is that the resistant strains haven’t beentransmissible to others,” Mercer said. “It’s not infectinganyone else.”
To contact the reporter on this story:Michelle Fay Cortez in London at mcortez@bloomberg.net
Last Updated: September 15, 2009 11:00 EDTSource: Bloomberg
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