Influenza B Viruses with Mutation in the Neuraminidase Active Site, North Carolina, USA, 2010–11

DOI: http://dx.doi.org/10.3201/eid1711.110787 Suggested citation for this article: Sleeman K, Sheu TG, Moore Z, Kilpatrick S, Garg S, Fry AM, et al. Influenza B viruses with mutation in the neuraminidase active site, North Carolina, USA, 2010−11. Emerg Infect Dis [serial on the Internet]. 2011 Nov [date cited]; Epub ahead of print. Influenza B Viruses with Mutation in the Neuraminidase Active Site, North Carolina, USA, 2010–11 Katrina Sleeman, Tiffany G. Sheu, Zack Moore, Susan Kilpatrick, Shikha Garg, Alicia M. Fry, and Larisa V. Gubareva

Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (K. Sleeman, T.G. Sheu, S. Garg, A.M. Fry, L.V. Gubareva); Battelle, Atlanta (T.G. Sheu); and North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA (Z. Moore, S. Kilpatrick) Oseltamivir is 1 of 2 antiviral medications available for the treatment of influenza B virus infections. We describe and characterize a cluster of influenza B viruses circulating in North Carolina with a mutation in the neuraminidase active site that may reduce susceptibility to oseltamivir and the investigational drug peramivir but not to zanamivir.

Influenza B viruses are responsible for sporadic seasonal influenza illness and can be associated with severe illness and death. In the United States, there are 2 classes of antiviral drugs licensed by the Food and Drug Administration for treatment of influenza infections. The adamantanes are ineffective against influenza B viruses, which limits the available antiviral options to 2 neuraminidase inhibitors (NAIs), inhaled zanamivir and oral oseltamivir. Influenza B viruses seem to have reduced susceptibility to NAIs compared with influenza A viruses on the basis of neuraminidase inhibition (NAI) assays (Furthermore, in clinical studies, changes conferring either resistance or reduced susceptibility to NAIs have been identified in the neuraminidase (NA) of influenza B viruses isolated from patients after treatment (3–6). Although the use of an antiviral agent can lead to the development of drug resistance, influenza B viruses ...
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