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The Power of III
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From Recombinomics
August 17, 2009



He revealed that the WHO has also been alerted informally to the discovery of a small number of other Tamiflu-resistant viruses. He would not say where they were found or how many there were in total.

"It's a small number. It certainly doesn't change the scale of what we're seeing," Penn said.

The above comments by WHO are curious. WHO is funded by member nations and has a mandate to protect citizens of member nations. The withholding of important information such as the number and location of Tamiflu resistant pandemic H1N1 virus is not consistent with that mission. Tamiflu is widely used and recommended by WHO, so the withholding of information on resistance leads to inappropriate used of the antiviral, and places patient care and health care systems at risk.

This type of risk was easily seen in the two immuno-suppressed patients detailed in the recent MMWR dispatch. WHO has maintained that resistance is rare and due to spontaneous mutations selected in Tamiflu treated patients. However, recent data, including that from the patients in Washington state suggested that the limited number of reports is related to limited and delayed testing, which is compounded by the withholding of information on identified isolated.

The MMWR describe patients who were H1N1 infected in June. The patients were treated with Tamiflu and detectable resistance developed quickly. However, treatment was increased and resistance was not confirmed until August, after one patient developed a Tamiflu resistant recurrence and the other patient continues to be hospitalized in spite of treatment with Tamiflu, Relenza, and ribavirin. The ability of Tamiflu resistant pandemic H1N1 to persistence in such aggressively treated patients increases concerns that the recent worldwide rise in patient deaths and hospitalizations is linked in part to such resistance.
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