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Oseltamivir-Resistant Influenza A(H1N1)pdm09 Viruses, United States, 2013–14 - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC

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Oseltamivir-Resistant Influenza A(H1N1)pdm09 Viruses, United States, 2013–14 - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC


Volume 21, Number 1—January 2015


Oseltamivir-Resistant Influenza A(H1N1)pdm09 Viruses, United States, 2013–14

Margaret Okomo-Adhiambo, Alicia M. Fry, Su Su, Ha T. Nguyen, Anwar Abd Elal, Elizabeth Negron, Julie Hand, Rebecca J. Garten, John Barnes, Xu Xiyan, Julie M. Villanueva, Larisa V. GubarevaComments to Author , and 2013–14 US Influenza Antiviral Working Group
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M. Okomo-Adhiambo, A.M. Fry, S. Su, H.T. Nguyen, A.A Elal, R.J. Garten, J. Barnes, X. Xiyan, J.M Villanueva, L.V. Gubareva)Atlanta Research and Education Foundation, Atlanta (S. Su)Battelle Memorial Institute, Atlanta (H.T. Nguyen, A.A. Elal);Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA (E. Negron)Louisiana Office of Public Health, New Orleans, Louisiana, USA (J. Hand)


We report characteristics of oseltamivir-resistant influenza A(H1N1)pdm09 viruses and patients infected with these viruses in the United States. During 2013–14, fifty-nine (1.2%) of 4,968 analyzed US influenza A(H1N1)pdm09 viruses had the H275Y oseltamivir resistance–conferring neuraminidase substitution. Our results emphasize the need for local surveillance for neuraminidase inhibitor susceptibility among circulating influenza viruses.
During the 2013–14 influenza season, influenza A(H1N1)pdm09 virus was the predominant circulating virus (≈80%) in the United States for the first time since the 2009 pandemic (1). We report and describe characteristics of oseltamivir-resistant influenza A(H1N1)pdm09 viruses and patients infected with these viruses in the United States.

The Study

We requested that all US state public health laboratories submit influenza-positive specimens for virologic surveillance, including antiviral susceptibility testing, as described (2). In brief, every 2 weeks each laboratory was asked to send ≤5 specimens for all virus types for virus isolation and neuraminidase (NA) inhibition assay for oseltamivir, zanamivir, and, in a subset, laninamivir and peramivir (3). All oseltamivir-resistant viruses were tested for the H275Y substitution in NA by pyrosequencing (4). Unpropagated influenza A(H1N1)pdm09 virus–positive clinical specimens were screened for the H275Y substitution by pyrosequencing (Technical Appendix[PDF - 326 KB - 4 pages]). If a cluster (>2 viruses) of oseltamivir-resistant A(H1N1)pdm09 viruses was detected, the state was asked to submit additional influenza A(H1N1)pdm09 virus specimens for testing.

Dr. Okomo-Adhiambo is a microbiologist in the Virology Surveillance and Diagnosis Branch of the Influenza Division at the Centers for Disease Control and Prevention, Atlanta, Georgia. Her primary research interest is the molecular epidemiology of influenza antiviral drug resistance.


We thank our collaborators in US public health laboratories for submitting specimens; colleagues from the Virus Reference Team, Influenza Sequence Activity Team and Molecular Epidemiology Team (Centers for Disease Control and Prevention, Atlanta, GA, USA) for providing valuable assistance; and the 2013–14 US Influenza Antiviral Working Group for providing valuable contributions to US national influenza virologic surveillance.


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Technical Appendix

Suggested citation for this article: Okomo-Adhiambo M, Fry AM, Su S, Nguyen HT, Elal AA, Negron E, et al. Oseltamivir-resistant influenza A(H1N1)pdm09 viruses, United States, 2013–14. Emerg Infect Dis [Internet]. 2015 Jan [date cited]. http://dx.doi.org/10.3201/eid2101.141006
DOI: 10.3201/eid2101.141006
1Members of the 2013–14 US Antiviral Working Group are listed at the end of this article.

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