title: Antiviral oseltamivir is not removed or degraded in normal sewage water treatment: implications for development of resistance by influenza A virus.
abstract: Oseltamivir is the main antiviral for treatment and prevention of pandemic influenza. The increase in oseltamivir resistance reported recently has therefore sparked a debate on how to use oseltamivir in non pandemic influenza and the risks associated with wide spread use during a pandemic. Several questions have been asked about the fate of oseltamivir in the sewage treatment plants and in the environment. We have assessed the fate of oseltamivir and discuss the implications of environmental residues of oseltamivir regarding the occurrence of resistance. A series of batch experiments that simulated normal sewage treatment with oseltamivir present was conducted and the UV-spectra of oseltamivir were recorded.
  
  
  RESULTS
  Our experiments show that the active moiety of oseltamivir is not removed in normal sewage water treatments and is not degraded substantially by UV light radiation, and that the active substance is released in waste water leaving the plant. Our conclusion is that a ubiquitous use of oseltamivir may result in selection pressures in the environment that favor development of drug-resistance.
authors.affiliation: Department of Chemistry, Umeå University, Umeå, Sweden. jerker.fick@chem.umu.se
authors.forename: Jerker
authors.initials: J
authors.lastname: Fick
authors.forename: Rickard H
authors.initials: RH
authors.lastname: Lindberg
authors.forename: Mats
authors.initials: M
authors.lastname: Tysklind
authors.forename: Paul D
authors.initials: PD
authors.lastname: Haemig
authors.forename: Jonas
authors.initials: J
authors.lastname: Waldenström
authors.forename: Anders
authors.initials: A
authors.lastname: Wallensten
authors.forename: Björn
authors.initials: B
authors.lastname: Olsen
mesh_terms: D000998:Antiviral Agents / Q000494:pharmacology*; D002853:Chromatography, Liquid / Q000379:methods; D024882:Drug Resistance, Viral; D009980:Influenza A virus / Q000378:metabolism*; D013058:Mass Spectrometry / Q000379:methods; D008956:Models, Chemical; D053139:Oseltamivir / Q000494:pharmacology*; D012722:Sewage; D014466:Ultraviolet Rays; D014867:Water / Q000737:chemistry; D014874:Water Pollutants, Chemical / Q000032:analysis*; D018508:Water Purification
chemical_list: D000998:Antiviral Agents; D012722:Sewage; D014874:Water Pollutants, Chemical; D014867:Water; D053139:Oseltamivir