title: Antiviral resistance during the 2009 influenza A H1N1 pandemic: public health, laboratory, and clinical perspectives.
abstract: Influenza A H1N1 2009 virus caused the first pandemic in an era when neuraminidase inhibitor antiviral drugs were available in many countries. The experiences of detecting and responding to resistance during the pandemic provided important lessons for public health, laboratory testing, and clinical management. We propose recommendations for antiviral susceptibility testing, reporting results, and management of patients infected with 2009 pandemic influenza A H1N1. Sustained global monitoring for antiviral resistance among circulating influenza viruses is crucial to inform public health and clinical recommendations for antiviral use, especially since community spread of oseltamivir-resistant A H1N1 2009 virus remains a concern. Further studies are needed to better understand influenza management in specific patient groups, such as severely immunocompromised hosts, including optimisation of antiviral treatment, rapid sample testing, and timely reporting of susceptibility results.
authors.affiliation: WHO Collaborating Centre for Reference and Research on Influenza, North Melbourne, VIC, Australia. aeron.hurt@infl uenzacentre.org
authors.forename: Aeron C
authors.initials: AC
authors.lastname: Hurt
authors.forename: Tawee
authors.initials: T
authors.lastname: Chotpitayasunondh
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Cox
authors.forename: Rod
authors.initials: R
authors.lastname: Daniels
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Fry
authors.forename: Larisa V
authors.initials: LV
authors.lastname: Gubareva
authors.forename: Frederick G
authors.initials: FG
authors.lastname: Hayden
authors.forename: David S
authors.initials: DS
authors.lastname: Hui
authors.forename: Olav
authors.initials: O
authors.lastname: Hungnes
authors.forename: Angie
authors.initials: A
authors.lastname: Lackenby
authors.forename: Wilina
authors.initials: W
authors.lastname: Lim
authors.forename: Adam
authors.initials: A
authors.lastname: Meijer
authors.forename: Charles
authors.initials: C
authors.lastname: Penn
authors.forename: Masato
authors.initials: M
authors.lastname: Tashiro
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Uyeki
authors.forename: Maria
authors.initials: M
authors.lastname: Zambon
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D024882:Drug Resistance, Viral; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics; D011634:Public Health; D013997:Time Factors
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir