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Tamiflu-resistant H5N1 strain surfaces in Egypt

November 18, 2020 | lpjxbyhj | No Comments

first_imgJan 18, 2007 (CIDRAP News) – Two patients who recently died of H5N1 avian influenza in Egypt had a strain of the virus that was moderately resistant to oseltamivir (Tamiflu), the World Health Organization (WHO) announced today, but the finding has not prompted new health advisories.News of the drug-resistant strain came as Egypt’s health ministry announced a new human H5N1 case, involving a 27-year-old woman from the town of Beni Suef, about 62 miles south of Cairo. The report was carried today by IRIN, a United Nations news and information service.Oseltamivir is recommended by the WHO as the first-line drug for H5N1 patients. The patients who had resistant infections were a 16-year-old girl and her 26-year-old uncle, who lived in the same house in Egypt’s Gharbiyah province, in the Nile delta 50 miles northwest of Cairo. They got sick in December; the man was hospitalized on the 17th, followed by his niece 2 days later, the WHO said. Both received 2 tablets of oseltamivir on Dec 21 and were transferred to a referral hospital on Dec 23, the same day samples were taken.The girl died Dec 25 and her uncle died Dec 28. They were part of a possible family cluster; H5N1 avian influenza was also confirmed in a 30-year-old woman in the household, said to be the man’s sister, who died, though few details are available about her. The WHO said the patients reportedly had contact with sick ducks. The two cases boosted Egypt’s avian flu total to 18 cases and 10 fatalities, all of which occurred in 2006.Genetic sequencing was done at US Naval Medical Research Unit 3 in Cairo and at WHO collaborating centers in Atlanta and London, the WHO said. Tests suggested that the virus had “moderately reduced susceptibility” to osteltamivir. The same type of mutation was previously identified in a Vietnamese case in 2005, the WHO said.But in contrast to the Egyptian cases, the virus in the Vietnamese case appeared to be highly resistant to oseltamivir. The case, reported in December 2005 in the New England Journal of Medicine (NEJM), involved a 13-year-old girl who was started on oseltamivir the day she was hospitalized, receiving the recommended dose of 75 mg twice a day for 5 days.The girl was one of 8 patients whose cases were analyzed after they were treated for H5N1 infection in Ho Chi Minh City in 2004 and 2005. Researchers sequenced the H5N1 virus’s neuraminidase gene to look for resistance, signaled by the substitution of tyrosine for histidine at amino acid position 274. The mutation was found in the 13-year-old girl, who died of severe pneumonia on her seventh day in the hospital.The viral load in her throat was higher by the time of her death than it was earlier, which, with other laboratory evidence, suggested that drug resistance contributed to treatment failure and ultimately death, the NEJM report noted.The mutation was also found in an 18-year-old girl, but the researchers said the relationship between the viral resistance and her death was less clear.Fred Hayden, a WHO avian flu and antiviral expert, told the Associated Press (AP) today the drug-resistant strains in the Egyptian patients likely developed after they were treated with oseltamivir. He said a more worrying scenario would be if oseltamivir-resistant strains were circulating in birds.The mutations in Egypt are different from the ones in Vietnam, Hayden told the AP. The Vietnamese strains were definitely resistant to oseltamivir, but the Egyptian ones were only shown to be less susceptible to the drug.There is no evidence that oseltamivir-resistant strains are spreading in Egypt or elsewhere, the WHO said. The agency said it is not changing its antiviral treatment recommendations, because the clinical level of resistance of the mutations is not yet well established.Public health implications of the findings are limited because the mutation is not associated with any known changes in transmissibility of the virus between humans, the WHO said, adding that it would not be raising the pandemic alert level.Because of concerns about drug-resistant strains, avian flu experts have suggested that a higher dosage, longer treatment course, or combination therapy with other antiviral drugs may be needed to ensure the effectiveness of oseltamivir.Terence Hurley, a US spokesperson for Roche, the maker of Tamiflu, told CIDRAP News by e-mail that studies are being conducted to gauge the optimal oseltamivir regimens for use in H5N1 flu cases. “These activities are based upon laboratory data and from information from patients infected with H5N1 who have been treated with Tamiflu,” he said.Roche is collaborating with the US National Institutes of Health on clinical studies to determine the efficacy of oseltamivir in the treatment of severe influenza, including H5N1, Hurley reported. “The NIH study is comparing standard doses of Tamiflu versus double doses for the treatment of people infected with avian influenza and other severe influenza infections in the Far East,” he wrote. “Results of the study will be reported as soon as they are available.”The Egyptian woman reported today as a new H5N1 patient was admitted to a hospital Jan 11 after having given birth on Jan 2, IRIN reported. She initially denied contact with poultry, but WHO spokesman Hassan el-Bushra told IRIN that ducks and pigeons were found in her home and chickens had died nearby.If her case is confirmed by the WHO, it will be Egypt’s 19th.See also:Jan 18 WHO reportDec 27 WHO reportDec 22, 2005 CIDRAP News article “Tamiflu resistance in avian flu victims sparks concern”De Jong MD, Thanh TT, Khanh TH, et al. Oseltamivir resistance during treatment of influenza A (H5N1) infection. N Engl J Med 2005 Dec 22;353(25):2667-72 [Full text]last_img read more

Kay wins thriller, Freiburger repeats at Dubuque

September 23, 2020 | bqfdduvy | No Comments

first_imgBy Jerry MackeyDUBUQUE, Iowa (June 25) – The Out-Pace IMCA Late Model main event was a thriller on a fast-paced night of racing Sunday at Dubuque Speedway.Dan Shelliam quickly took the lead by using the extreme high line around the track and appeared to be planning on celebrating his anniversary in victory lane, but the late race heroics by Justin Kay changed those plans.Shelliam saw his huge lead erased by a lap 17 caution. Kay and Shelliam swapped the lead on every corner the last eight circuits by using very well executed slide jobs. When the final check­ered flew it was Kay holding off Shelliam to garner the win.While the leaders were battling it out, the race for third was hotly contested as well. Jeremiah Hurst was able to cross the line in third ahead of Joel Callahan and Luke Merfeld.The Merfeld Brothers IMCA Modified feature was another great race which saw brother-in-laws Jed Freiburger and Mark Schulte race for the win. Freiburger topped the very competitive event for his second consecutive Dubuque Speedway win. Schulte took second ahead of Tyler Madigan.Tyler Soppe again flexed his muscles in the GSI Collision Specialists IMCA Northern SportMod class. Soppe started eighth and worked his way to the front using multiple lines on the track. Soppe took the feature win by holding off a strong running Troy Bauer.The Bakey Seamless Gutters IMCA Stock Car feature win went to Dustin Wilwert. Driving Jerry Miles’ no. 4 car, Wilwert out raced Brian Meier to the 12-lap victory.The final checkered flag of the night waved at 8:59 p.m.last_img read more

first_imgAnother home game, another win for the University of Wisconsin-Madison men’s soccer team as they took down UW-Milwaukee at home Tuesday night, 3-0.The victory finishes off the season series against in-state opponents, completing the Badgers’ sweep with wins of 1-0 over Marquette University and 3-0 over UW-Green Bay earlier this year.The 3-0-0 record is a big improvement over last season when the Badgers went 1-1-1 against the same three opponents, which proved to hurt the squad come conference play.For most of the first half Tuesday’s game, the UW-Milwaukee Panthers (6-6-2, 3-2-1 Horizon) kept pressure on the defensive front of the Badgers (8-3-2, 3-2-1 Big Ten), pushing the ball forward and challenging the possession of the defenders. The home squad was able to take advantage of the aggressive play and struck for their first goal of the game early in the match.Senior midfielder Brian Hail found the back of the net after the keeper was put out of position by a cross from the end line. The ninth minute strike was the first goal on the season for Hail and came off of the third assist on the season from junior forward Mark Segbars.Coming out of the gate in the second half, the momentum switched as the Badgers played to the formula of the Panthers and kept pressure on Milwaukee’s backline with three shots and a corner kick in the first five minutes. Soon afterwards, UW-Madison won a penalty kick when UW-Milwaukee redshirt sophomore Jason Palitang Svensson was given a yellow card for his tackle of Badger junior midfielder Mike Catalano in the box. Junior Christopher Mueller was able to calmly take advantage of the penalty kick, guiding the ball smoothly into the bottom right corner of the goal. It was Mueller’s fifth goal of the season.The third and final goal of the game came from sophomore defender Sam Brotherton, the recent call-up for the New Zealand national team, in the 70th minute. The goal was the Auckland, New Zealand defender’s second in two games since his return from international play.Overall, the strike was his third on the season and moved him into fourth on the team with six points. Brotherton has been far more aggressive in his sophomore season and adds a depth to the Wisconsin offense to go along with a dominant defensive front.Men’s soccer: Badgers fall short in thrilling overtime against No. 1 TerrapinsIn what will be remembered as one of the best Big Ten games in recent memory, the battle of first Read…The next game for the Badgers is this Friday against Indiana University. The conference game will be the second match of a four game stretch at home to end regular season play for Wisconsin.last_img read more