Evidence of Person-to-Person Transmission of Oseltamivir-Resistant Pandemic Influenza A(H1N1) 2009 Virus in a Hematology Unit

• Published in: The Journal of infectious diseases Vol. 203; no. 1; pp. 18 - 24
• Main Authors: Moore, Catherine, Galiano, Monica, Lackenby, Angie, Abdelrahman, Tamer, Barnes, Rosemary, Evans, Meirion R., Fegan, Christopher, Froude, Susannah, Hastings, Mark, Knapper, Steven, Litt, Emma, Price, Nicola, Salmon, Roland, Temple, Mark, Davies, Eleri
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-01-2011
• Series: Editor's Choice
• Subjects: Adult; Aged; Amino Acid Substitution - genetics; Antiviral Agents - pharmacology; Biological and medical sciences; Cross Infection - transmission; Cross Infection - virology; Disease transmission; Drug Resistance, Viral; Fundamental and applied biological sciences. Psychology; Genetic mutation; H1N1 subtype influenza A virus; Hemagglutinins, Viral - genetics; Hematology; Hospitals; Humans; Infections; Infectious diseases; Influenza A Virus, H1N1 Subtype - drug effects; Influenza A Virus, H1N1 Subtype - isolation & purification; Influenza, Human - transmission; Influenza, Human - virology; Lymphopenia - complications; Major and Brief Reports; Medical sciences; Microbiology; Middle Aged; Mutation, Missense; Neuraminidase - genetics; Orthomyxoviridae; Oseltamivir - pharmacology; Pandemics; Public health; RNA, Viral - genetics; Sequence Analysis, DNA; Sequencing; United Kingdom; Viral Proteins - genetics; Viruses; Human; Neuraminidase inhibitor; Enzyme; Transmission; Enzyme inhibitor; Glycosylases; Infection; Resistance; Oseltamivir; Exo-α-sialidase; Glycosidases; Hydrolases; Antiviral; Influenzavirus A(H1N1)
• ISSN: 0022-1899; 1537-6613; 1537-6613; 0022-1899
• DOI: 10.1093/infdis/jiq007

We describe the first confirmed person-to-person transmission of oseltamivir-resistant pandemic influenza A(H1N1) 2009 virus that occurred in a hematology unit in the United Kingdom. Eleven cases of (H1N1) 2009 virus infection were identified, of which, ten were related as shown by sequence analysis of the hemagglutinin and neuraminidase genes. H275Y analysis demonstrated that 8 of 10 case patients had oseltamivir-resistant virus, with 4 of 8 case patients infected by direct transmission of resistant virus. Zanamivir should be considered as first-line therapy for influenza in patients with lymphopenic hematological conditions and uptake of influenza vaccination encouraged to further reduce the number of susceptible individuals.