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

Dispatch

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

On This Page

• The Study
• Conclusions
• Suggested Citation

Figures

• Figure 1
• Figure 2

Tables

• Table 1
• Table 2

Technical Appendicies

• Technical Appendix

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• PDF[569 KB - 6 pgs]
• RIS[TXT - 2 KB]

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. Gubareva , 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)

Suggested citation for this article

Abstract

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.

Acknowledgment

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.

References

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Figures

• Figure 1. Geographic distribution of oseltamivir-resistant influenza A(H1N1)pdm09 viruses, United States, 2013–14. Gray indicates the presence of an oseltamivir-resistant virus. Number of oseltamivir-resistant A(H1N1pdm)09 viruses divided by total number of viruses...
• Figure 2. Evolutionary relationships among influenza A (H1N1)pdm09 virus neuraminidase genes, United States, 2013–14. Phylogenetic tree was generated by using MEGA software v5.2 (http://www.megasoftware.net/) and the neighbor-joining method. Evolutionary distances were...

Tables

• Table 1. Neuraminidase inhibitor susceptibility for influenza A(H1N1)pdm09 viruses, United States, October 1, 2013–April 30, 2014
• Table 2. Characteristics of patients infected with oseltamivir-resistant and -susceptible A(H1N1)pdm09 viruses, United States, October 1, 2013–April 30, 2014

Technical Appendix

• Technical Appendix. Supplementary methods for analysis of oseltamivir-resistant influenza A(H1N1)pdm09 viruses, United States, 2013–14.  326 KB

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.