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The European Journal of Public Health Advance Access originally published online on February 12, 2009
The European Journal of Public Health 2009 19(3):238-239; doi:10.1093/eurpub/ckp012
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© The Author 2009. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Commentaries

Influenza virus resistance to oseltamivir: what are the implications?

Douglas M. Fleming1, Alex J. Elliot1, Adam Meijer2 and W. John Paget3

1 Birmingham Research Unit of the Royal College of General Practitioners, Birmingham, UK
2 National Institute for Public Health and the Environment, Bilthoven, the Netherlands
3 NIVEL – the Netherlands Institute for Health Services Research, Utrecht, the Netherlands

Correspondence: Douglas M. Fleming, Birmingham Research Unit of the Royal College of General Practitioners, Lordswood House, 54 Lordswood Road, Harborne, Birmingham, B17 9DB, UK, tel: +44 121 426 1125, fax: +44 121 428 2084, e-mail: dfleming@rcgpbhamresunit.nhs.uk

Received November 5, 2008, accepted January 16, 2009

The first 10% of the full text of this article appears below.

Influenza caused by an oseltamivir-resistant influenza A(H1N1) virus was widespread across Europe during the 2007–08 winter.1 About 25% of A(H1N1) viruses tested in the European Influenza Surveillance Scheme (EISS) were resistant with an H274Y mutation in the neuraminidase glycoprotein.1 Early indications during the 2008–09 season are that a large proportion of circulating A(H1N1) viruses have retained oseltamivir resistance, and that the resistant virus will likely become dominant in the United States but not in Europe.2,3 Further analyses have indicated that these oseltamivir-resistant A(H1N1) viruses retain sensitivity to zanamivir and the M2 ion channel inhibitors (M2Is).1


   Resistance to anti-influenza drugs
 
Two classes of drugs are used in the treatment and prevention of influenza: the M2Is (amantadine and rimantadine) targeting influenza A viruses, and the neuraminidase inhibitors (NIs; oseltamivir and zanamivir), . . . [Full Text of this Article]


   Implications for treatment
 

   Patient management issues
 

   Implications for global pandemic planning
 

   Monitoring infrastructure
 

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