25-AUG-2011
A cluster of oseltamivir-resistant A(H1N1)2009 influenza cases with onset between May and August 2011 has been detected in the Hunter region of New South Wales (NSW), Australia. Viruses from 25 of 184 (14 percent) A(H1N1)2009 cases from the Hunter New England region exhibited highly reduced oseltamivir sensitivity due to the H275Y substitution in the neuraminidase. The H275Y mutation is a well-established substitution previously reported to confer oseltamivir resistance in N1 neuraminidases and was present in the widespread oseltamivir resistant pre-pandemic seasonal A(H1N1) virus. 15 of the 1st 16 cases lived within a 50-km radius of the regional centre of Newcastle. 16 of the 25 patients have been interviewed, and none had received oseltamivir prior to influenza specimen collection. Only 5 were hospitalised at the time of specimen collection. None of the 16 had a history of immune suppression; 3 cases were pregnant. No one was admitted to ICU or had a fatal outcome. Further interviews with cases and virological analyses are ongoing.
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