Global transmission of oseltamivir-resistant influenza.

  title={Global transmission of oseltamivir-resistant influenza.},
  author={Anne Moscona},
  journal={The New England journal of medicine},
  volume={360 10},
  • A. Moscona
  • Published 3 December 2009
  • Biology, Medicine
  • The New England journal of medicine
This winter, the circulating strain of seasonal influenza A virus (H1N1) is resistant to the neuraminidase inhibitor oseltamivir. Dr. Anne Moscona writes that the surprise element of the circulating resistant virus is its apparently spontaneous emergence since 2007. 
Emergence of Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus within 48 Hours
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The recovery and identification of an influenza B virus with the H273Y neuraminidase point mutation directly from a human patient with high-level resistance to oseltamivir in isolates of human A(H1N1) influenza is reported.
Tamiflu in the Water : Resistance Dynamics of Influenza A Virus in Mallards Exposed to Oseltamivir
The natural reservoir of influenza A virus (IAV) is wild waterfowl, and all human IAVs have their genetic origins from avian viruses. Neuraminidase inhibitors (NAIs) are currently the best drugs fo
A community cluster of oseltamivir-resistant cases of 2009 H1N1 influenza.
Oseltamivir-resistant infection with the 2009 pandemic influenza A (H1N1) virus has so far been described only rarely and is conferred by the H275Y substitution in the neuraminidase enzyme, which was unrelated to selective drug pressure, and the H 275Y substitution did not.
Emerging antiviral resistance
Identification of transmissible BXM-resistant strains in Japan may hit pause on widespread adoption of this therapy and could lead to revision of surveillance practices for emerging viruses.
Detection of a Transient R292K Mutation in Influenza A/H3N2 Viruses Shed for Several Weeks by an Immunocompromised Patient
The case of an immunocompromised patient, positive for influenza A virus (H3N2), in whom the neuraminidase R292K mutation was transiently detected during oseltamivir treatment is described.
Prescription – Pollution – Poo – Pandemics - Priorities : Neuraminidase Inhibitors from an Environmental Resistance Development Perspective
The natural Influenza A virus (IAV) host is waterfowl. Human IAV is treated with neuraminidase inhibitors (NAIs), which are stockpiled worldwide in case of an IAV pandemic. As the drugs escape regu
Pandemic 2009 H1N1 Influenza A Virus Carrying a Q136K Mutation in the Neuraminidase Gene Is Resistant to Zanamivir but Exhibits Reduced Fitness in the Guinea Pig Transmission Model
It is shown that a Q136K mutation in the NA of the 2009 pandemic H1N1 virus confers a high degree of resistance to zanamivir, and strongly impairs viral fitness in the guinea pig transmission model.
Hedging against Antiviral Resistance during the Next Influenza Pandemic Using Small Stockpiles of an Alternative Chemotherapy
Using a secondary antiviral drug early in local epidemics would reduce global emergence of resistance to the primary stockpiled drug, according tohematically simulating an influenza pandemic.
Oseltamivir‐resistant pandemic (H1N1) 2009 influenza in a severely ill patient: the first Australian case
This is the first case of oseltamivir-resistant pandemic (H1N1) 2009 in Australia and the first report of resistance in a solid organ transplant recipient.


Oseltamivir-Resistant Influenza Viruses A (H1N1), Norway, 2007–08
Resistance was not associated with oseltamivir use or more severe disease and the number of patients treated with the drug was not higher than expected.
Crystal structures of oseltamivir-resistant influenza virus neuraminidase mutants
The enzymatic properties and crystal structures of neuraminidase mutants from H5N1-infected patients are reported that explain the molecular basis of resistance and indicate that it would be prudent for pandemic stockpiles of oseltamivir to be augmented by additional antiviral drugs, including zanamivIR.
Medical management of influenza infection.
  • A. Moscona
  • Biology, Medicine
    Annual review of medicine
  • 2008
Resistance to the NA inhibitors is now emerging, although at a level less significant than adamantane resistance, and this is a cause for concern if indeed some mutant strains of avian influenza are transmissible and pathogenic.
Drug design against a shifting target: a structural basis for resistance to inhibitors in a variant of influenza virus neuraminidase.
Results provide evidence that a general strategy for drug design when the target has a high mutation frequency is to design the inhibitor to be as closely related as possible to the natural ligands of the target.