Oseltamivir-Resistant Pandemic (H1N1) 2009 | CDC EID

EID Journal Home > Volume 17, Number 2–February 2011

Volume 17, Number 2–February 2011
Dispatch
Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus, Mexico
José Ernesto Ramirez-Gonzalez, Elizabeth Gonzalez-Duran, Patricia Alcantara-Perez, Claudia Wong-Arambula, Hiram Olivera-Diaz, Iliana Cortez-Ortiz, Gisela Barrera-Badillo, Ha Nguyen, Larisa Gubareva, Irma Lopez-Martinez, Jose Alberto Díaz-Quiñonez, Miguel Angel Lezana-Fernández, Hugo Lopez Gatell-Ramírez, Jose Angel Cordova Villalobos, Mauricio Hernández-Avila, and Celia Alpuche-Aranda

Author affiliations: Instituto de Diagnóstico y Referencia Epidemiológicos, Mexico City, Mexico (J.E. Ramirez-Gonzalez, E. Gonzalez-Duran, P. Alcantara-Perez, C. Wong-Arambula, H. Olivera-Diaz, I. Cortez-Ortiz, G. Barrera-Badillo, I. Lopez-Martinez, J.A. Díaz-Quiñonez, M.A. Lezana-Fernández, H.L. Gatell-Ramírez, J.A. Cordova Villalobos, M. Hernández-Avila, C. Alpuche-Aranda); Secretaría de Salud, Mexico City (J.E. Ramirez-Gonzalez, E. Gonzalez-Duran, P. Alcantara-Perez, C. Wong-Arambula, H. Olivera-Diaz, I. Cortez-Ortiz, G. Barrera-Badillo, I. Lopez-Martinez, J.A. Díaz-Quiñonez, M.A. Lezana-Fernández, H.L. Gatell-Ramírez, J.A. Cordova Villalobos, M. Hernández-Avila, C. Alpuche-Aranda); and Centers for Disease Control and Prevention, Atlanta, Georgia, USA (H. Nguyen, L. Gubareva)

Suggested citation for this article

Abstract
During May 2009–April 2010, we analyzed 692 samples of pandemic (H1N1) 2009 virus from patients in Mexico. We detected the H275Y substitution of the neuraminidase gene in a specimen from an infant with pandemic (H1N1) 2009 who was treated with oseltamivir. This virus was susceptible to zanamivir and resistant to adamantanes and oseltamivir.

In March and early April 2009, a new strain of influenza A virus that contained genes from the Eurasian–North American triple reassortant and classical swine lineage viruses emerged in North America (1,2). By May 21, 2010, a total of 214 countries and overseas territories or communities had reported laboratory-confirmed pandemic (H1N1) 2009, which resulted in at least 18,097 deaths in patients with PCR-confirmed illness (3). In Mexico 72,533 cases (1,228 deaths) were PCR confirmed by the second week of May 2010 (4).

To control influenza A virus infections, the US Food and Drug Administration has approved the use of matrix 2 (M2) blockers, amantadine and rimantadine, and the neuraminidase (NA) inhibitors (NAIs), oseltamivir and zanamivir (5). However, for pandemic (H1N1) 2009, therapeutic options are limited to the NAIs because this virus has a swine virus–origin M2 gene, which contains a mutation associated with resistance to adamantanes (6). NAI resistance in pandemic (H1N1) 2009 viruses has been rare; nevertheless, 285 oseltamivir-resistant cases were reported worldwide as of April 14, 2010 (7). All oseltamivir-resistant viruses have the H275Y substitution that confers resistance to oseltamivir but not to zanamivir. Spread of oseltamivir-resistant seasonal influenza A virus (H1N1) was first detected in 2007, and this virus has now become the predominant lineage of influenza A virus (H1N1) in humans (8,9). This finding raises strong concerns that the H275Y mutation could become dominant in pandemic (H1N1) 2009 as well. We report oseltamivir-resistant pandemic (H1N1) 2009 detected through virologic surveillance in Mexico.

full-text:
Oseltamivir-Resistant Pandemic (H1N1) 2009 | CDC EID



Suggested Citation for this Article
Ramirez-Gonzalez JE, Gonzalez-Duran E, Alcantara-Perez P, Wong-Arambula C, Olivera-Diaz H, Cortez-Ortiz I, et al. Oseltamivir-resistant pandemic (H1N1) 2009 virus, Mexico. Emerg Infect Dis [serial on the Internet]. 2011 Feb [date cited]. http://www.cdc.gov/EID/content/17/2/283.htm


DOI: 10.3201/eid1702.100897


Comments to the Authors
Please use the form below to submit correspondence to the authors or contact them at the following address:

Celia Alpuche-Aranda, InDRE-SSA, Carpio 470, Colonia Santo Tomás, CP 11340, Mexico; email: celia.alpuche@salud.gob.mx