title: Evidence of person-to-person transmission of oseltamivir-resistant pandemic influenza A(H1N1) 2009 virus in a hematology unit.
abstract: We describe the first confirmed person-to-person transmission of oseltamivir-resistant pandemic influenza A(H1N1) 2009 virus that occurred in a hematology unit in the United Kingdom. Eleven cases of (H1N1) 2009 virus infection were identified, of which, ten were related as shown by sequence analysis of the hemagglutinin and neuraminidase genes. H275Y analysis demonstrated that 8 of 10 case patients had oseltamivir-resistant virus, with 4 of 8 case patients infected by direct transmission of resistant virus. Zanamivir should be considered as first-line therapy for influenza in patients with lymphopenic hematological conditions and uptake of influenza vaccination encouraged to further reduce the number of susceptible individuals.
authors.affiliation: Public Health Wales Microbiology, Public Health Wales NHS Trust, Cardiff, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Moore
authors.forename: Monica
authors.initials: M
authors.lastname: Galiano
authors.forename: Angie
authors.initials: A
authors.lastname: Lackenby
authors.forename: Tamer
authors.initials: T
authors.lastname: Abdelrahman
authors.forename: Rosemary
authors.initials: R
authors.lastname: Barnes
authors.forename: Meirion R
authors.initials: MR
authors.lastname: Evans
authors.forename: Christopher
authors.initials: C
authors.lastname: Fegan
authors.forename: Susannah
authors.initials: S
authors.lastname: Froude
authors.forename: Mark
authors.initials: M
authors.lastname: Hastings
authors.forename: Steven
authors.initials: S
authors.lastname: Knapper
authors.forename: Emma
authors.initials: E
authors.lastname: Litt
authors.forename: Nicola
authors.initials: N
authors.lastname: Price
authors.forename: Roland
authors.initials: R
authors.lastname: Salmon
authors.forename: Mark
authors.initials: M
authors.lastname: Temple
authors.forename: Eleri
authors.initials: E
authors.lastname: Davies
mesh_terms: D000328:Adult; D000368:Aged; D019943:Amino Acid Substitution / Q000235:genetics; D000998:Antiviral Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000635:transmission / Q000821:virology; D024882:Drug Resistance, Viral; D006389:Hemagglutinins, Viral / Q000235:genetics; D006761:Hospitals; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects* / Q000302:isolation & purification; D007251:Influenza, Human / Q000635:transmission* / Q000821:virology*; D008231:Lymphopenia / Q000150:complications; D008875:Middle Aged; D020125:Mutation, Missense; D009439:Neuraminidase / Q000235:genetics; D053139:Oseltamivir / Q000494:pharmacology*; D012367:RNA, Viral / Q000235:genetics; D017422:Sequence Analysis, DNA; D006113:United Kingdom; D014764:Viral Proteins / Q000235:genetics
chemical_list: D000998:Antiviral Agents; D006389:Hemagglutinins, Viral; D012367:RNA, Viral; D014764:Viral Proteins; C458881:hemagglutinin fusogenic peptide, influenza virus; D053139:Oseltamivir; C487630:NA protein, influenza A virus; D009439:Neuraminidase