Outbreak of Antiviral Drug–Resistant Influenza A | CDC EID

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Volume 15, Number 12–December 2009
Dispatch
Outbreak of Antiviral Drug–Resistant Influenza A in Long-Term Care Facility, Illinois, USA, 2008
Nila J. Dharan,1 Monica Patton,1 Alicia M. Siston,2 Julie Morita, Enrique Ramirez, Teresa R. Wallis, Varough Deyde, Larisa V. Gubareva, Alexander I. Klimov, Joseph S. Bresee, and Alicia M. Fry
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (N.J. Dharan, M. Patton, T.W. Wallis, V. Deyde, L.V. Gubareva, A.I. Klimov, J.S. Bresee, A.M. Fry); and Chicago Department of Public Health, Chicago, Illinois, USA (A.M. Siston, J. Morita, E. Ramirez)

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Abstract
An outbreak of oseltamivir-resistant influenza A (H1N1) occurred in a long-term care facility. Eight (47%) of 17 and 1 (6%) of 16 residents in 2 wards had oseltamivir-resistant influenza A virus (H1N1) infections. Initial outbreak response included treatment and prophylaxis with oseltamivir. The outbreak abated, likely because of infection control measures.

Outbreaks of influenza virus infection cause illness and death, especially among residents of long-term care facilities (LTCFs). In addition to annual vaccination and infection control measures, antiviral agents for treatment and prophylaxis are useful components for control of influenza outbreaks in LTCFs (1–4), especially in years with vaccine strain mismatches (4).

Two classes of antiviral agents are licensed for use in the United States: adamantanes (amantadine and rimantadine) and neuraminidase inhibitors (oseltamivir and zanamivir). Circulation of influenza A viruses resistant to both classes of antiviral agents, A (H3N2) to adamantanes and A (H1N1) to oseltamivir, was reported during the 2007–08 influenza season (5). We describe an outbreak of illness in an LTCF caused by 2 influenza viruses, an oseltamivir-resistant A virus (H1N1) and an adamantane-resistant A virus (H3N2), during January 2008.

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