August 14, 11:59 AMMiami Health Care ExaminerDeborah Shlian

Tamiflu resistance to A/H1N1 swine flu has been formally reported by the World Health Organization (WHO) in Hunan, China and Singapore adding to the three cases in Japan, two in Hong Kong (the second just reported today) and one each in Denmark and Canada. There have also been media reports of some resistance in Thailand, but it is unclear how many cases were found and if they were even confirmed. Resistance first reported along the Texas / Mexican border was later denied.

The Japanese, Danish, Canadian and second Hong Kong patients all had been taking Tamiflu as a preventive measure after exposure to the disease and still developed symptoms of flu around the fifth day of their prophylactic treatment, suggesting development of resistant strains after taking the drug.
The first Hong Kong case involved a 16 year old American teen flying from San Francisco who had not taken Tamiflu before she became ill. The patient seen in Singapore was a 28 year old American woman flying from Hawaii. Although the details are not clear, it is possible that she too already had contracted a circulating resistant strain of the virus prior to treatment.

Lack of details from WHO has fostered concerns that Tamiflu resistance may be more widespread than officially reported. Speaking to the Canadian Press, Dr. Charles Penn, a scientist with WHO said that “reported cases to date have been isolated, with no connections among them and no sign that the infected people passed resistant viruses to their contacts.”

Tamiflu and Relenza are currently the only two antiviral drugs available to treat swine flu. Since its emergence in April, the now pandemic A/H1N1 swine flu virus has been resistant to two older antivirals, amantadine and rimantadine.

Dr. Penn stated that laboratories around the world are monitoring the virus, looking for changes in the strain that might suggest a similar problem of resistance.


•  Kasabian Released From Quarantine After Swine Flu Scare (Link)
•  Swine flu deaths in Australia pass 100 (Link)

•  Brazil Flu Deaths up to 277 (Link)
•  Brazil bans swine flu drug ads (Link)

•  Swine flu patient dies weeks after giving birth (Link)
•  Ontario to study how many residents have had swine flu (Link)

•  Hong Kong – 2nd Tamiflu Resistant Case (Link)

Costa Rica
•  Costa Rica’s Oscar Arias Sees A Lesson In His Swine Flu (Link)

•  Minister in Ecuador suspected with H1N1 (translated) (Link)

•  Five more swine flu deaths in Pune; countrywide toll 23 (Link)
•  In India Swine Flu Panic Spreads Faster Than Virus (Link)
•  Toll down: 3 Pune deaths not H1N1 (Link)

•  Two Japanese Students Are H1N1 Suspects (translated) (Link)

•  Swine flu cases at summer language course (Link)

•  Palace workers quarantined (Link)
•  Private doctors, staff also hit by H1N1 (Link)

•  Mexican state postpones school start because of flu fears (Link)

New Zealand
•  Swine Flu Numbers up to 3,034 (Link)

•  Nearly 150 new swine flu cases in Portugal: Govt (Link)
•  UK’s advise against Tamiflu for children “not applicable to Portugal” (Link)
•  Ambulance crews threaten action if Gov’t. does not review their status (Link)

•  Tamiflu Resistant Case Recovers (Link)

South Africa
•  Editorial: Sty door should’ve been shut before swine flu bolted (Link)

United States
•  FL: Lake Worth Woman In ICU (Link)
•  NC: Duke trying to keep infected isolated (Link)
•  Louisiana Confirms First Death from H1N1 Flu (Link)
•  CA: Two Valley Women Latest to Lose H1N1 Battle (Link)
•  IL: University asks students with flu to quarantine themselves for a week (Link)
•  Third swine flu case strikes fear in tiny Yolo County town (Link)
•  NC: Officials Now Say No Swine Flu At Middle School (Link)
•  King County, Washington – Two Tamiflu Resistant Cases (Link)
•  Officials lower expectations for size of first novel flu vaccine deliveries (Link)
•  Arkansas: Woman Who Died Of Swine Flu Identified (Link)
•  Tamiflu-Resistant flu cases in WA (Link)
•  CA: First El Dorado Cty swine flu death (Link)
•  IL: More H1N1 flu cases confirmed in Champaign County (Link)
•  NC: Potential flu cases disrupt football at Elon, Duke (Link)
•  CA: Swine Flu / West Nile Scares  (Link)
•  VT: South Hero camper diagnosed with swine flu (Link)

•  Second swine-flu death raises concern in community (Link)

•  Podcast Examines Link Between Arsenic Exposure And Flu Susceptibility (Link)
•  Osteoporosis drugs can kill flu viruses (Link)