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Three patients with drug-resistant H1N1 died

Posted November 20, 2009

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— North Carolina public health officials said Friday that three of four patients at Duke University Hospital with a drug-resistant form of the H1N1 flu virus have died.

The adult patients, treated in an isolated unit of the hospital over the last six weeks, tested positive for a mutation of the virus that was resistant to the drug Tamiflu, one of two medicines that help against H1N1.

Health officials said the cases were rare and the patients were very ill with underlying compromised immune systems and multiple other complex medical conditions. It is not clear whether their deaths were related to the flu infections.

The patients that died were identified as two men and a woman. The fourth patient is a woman. The patients were from different parts of the state. Doctors are investigating to see if there is any link between the cases.

Three patients with drug-resistant H1N1 died Drug-resistant H1N1 reported

Tamiflu is still the most effective treatment for the virus, and a vaccination is the best prevention for contracting the virus, they emphasized Friday. No resistance has been found to Relenza, also known as zanamivir, the other drug approved to treat H1N1, they said.

Health officials have been closely watching for signs to see if the virus is mutating and making the drugs ineffective.

Duke is looking into the cases, along with the U.S. Centers for Disease Control and Prevention, the state Division of Public Health and the Durham County Health Department.

"The mutation is not expected to have any effect on the vaccine at all," said Dr. Cameron Wolfe, an infectious disease specialist at Duke University Medical Center. "So, the vaccine will still be very effective in protecting patients against this form of H1N1. If anything, it re-encourages us to encourage everyone to get vaccinated."

Dr. Allen Mask Dr. Mask talks about drug-resistant H1N1

 The only other reported U.S. instance of Tamiflu-resistant swine flu spreading from one person to another occurred about four months ago at a summer camp in western North Carolina, where two teenage girls – cabin mates – were diagnosed with the same drug-resistant strain. Health officials said at the time that the virus may have spread from one girl to the other, or it's possible that the girls got it from another camper.

Why did both Tamiflu-resistant clusters occur in North Carolina? It could be coincidence, or perhaps North Carolina's disease surveillance is unusually good, said Megan Davies, the state's epidemiologist.

About 52 resistant cases have been reported in the world since April, including 15 in the U.S. Last summer, health officials said two people in western North Carolina also had a drug-resistant form of the virus.

CDC officials have said that almost all the U.S. cases have been isolated.

Since the H1N1 pandemic began, 58 people in North Carolina have died as a result of the virus, health officials said. That number is based on reports from local health departments to the state as of last Monday.


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  • blisstate Nov 20, 2009

    shame on you WRAL! WRAL published this story for the fear factor to grab headlines. There is absolutely no medical significance to this story related to H1N1. As any scientist knows, virus mutate many times in a given patient population, no big story here.

  • rofly Nov 20, 2009

    20 cups of tea has GOT to be bad for you. They don't exactly study this kind of strange consumption, you know. If there was some magical protective quality about drinking this much tea, it would have been discovered by now.

  • Wenchmaid Nov 20, 2009

    Prettylittleangeleyes, What is questionable about the ingredients in the h1n1 vaccine? Do you have any evidence to provide that the vaccine is dangerous? And last time I checked, tsunamis don't kill people based on how strong their immune system is. Your overall logic is puzzling.

  • colliedave Nov 20, 2009

    It is not clear whether their deaths were related to the flu infections

    Then why does the headline to the story make it appear to be so?

  • Nov 20, 2009

    I wonder if the people had the vaccine first. Remember Bush told us to purchase plastic and duct tape. Thats to wrap the dead bodies of your neighbors up in this Obama plot to reduce the population.

  • Orange RN Nov 20, 2009

    The reason it is considered news is that Tamiflu resistance is still rare among pandemic H1N1 samples. That could change.

    We watched as Tamiflu resistance spread worldwide from a few samples of seasonal H1N1 to almost 100% resistance in less than a year.

    We need to track resistance in the pandemic H1N1 virus to know how to treat sick patients. Right now, Tamiflu is saving lives.

  • prettylittleangeleyes Nov 20, 2009

    I don't care what anyone says. More people died last year from vending machines falling on them than from this " drug resistant" strain of h1n1. It sounds to me more like they had serious health problems as it was, and that they just couldn't handle the virus. Things like this happen every couple of hundred years or so. Take the bubonic plague, severe droughts in Africa , tsunamis etc. for example. It's just the worlds way of naturally ridding itself of weaker life forms. I just hope I'm not one of them when it comes to me. I will never get any vaccine though. I refuse to inject myself with the questionable ingredients!

  • GinkgoPhyta Nov 20, 2009

    "GinkgoPhyta, nice find! I had to look up the research there. Yea, EGCG is a Hemagglutinin inhibitor, meaning it stops the absorption of the virus into cells. However, I don't know how well it would work in vivo considering how rampant the flu is in Asia" -supernik87

    They did studies in rats a view years back. Unfortunately, EGCG has a short half-life in the body (6 hours I think?) and the amount of tea consumed has to be more than most people drink. I drink about 20 cups of regular and decaf tea a day spread throughout the day. Unfortunately, sporadic tea drinkers will see limited or no benefits.

  • ckblackm Nov 20, 2009

    Chicken Little... thy alias is q0..0

  • smcallah Nov 20, 2009

    "Is it time to panic now?"

    Yes, because 52 cases in the ENTIRE WORLD where people died have been drug resistant.