Persistent oseltamivir-resistant pandemic influenza A/H1N1 infection in an adult with cystic fibrosis.
The authors report the case of a 25-year-old patient with cystic fibrosis (CF) who developed pandemic influenza A/H1N1 during a visit to the USA in August 2010. The patient has severe CF lung disease and takes maintenance oral corticosteroids. The influenza virus was positive for the H275Y oseltamivir-resistance mutation despite the patient never having received oseltamivir. The patient has remained sputum-positive for over 4 months despite inhaled zanamivir therapy. This is the first reported case of transmission of oseltamivir-resistant H1N1 influenza to a patient with CF. The frequency of prolonged sputum carriage of pandemic influenza and transmission of oseltamivir-resistant strains are unknown on a population level. However, if our observations are replicated in other CF patients, they are potentially of considerable importance to clinical and infection-control practices in this patient group.
Manchester Adult Cystic Fibrosis Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK. william.flight@uhsm.nhs.uk
William George
WG
Flight
Rowland
R
Bright-Thomas
Kenneth
K
Mutton
Kevin
K
Webb
Andrew
A
Jones
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001987:Bronchiectasis / Q000209:etiology; D003550:Cystic Fibrosis / Q000150:complications* / Q000821:virology; D024882:Drug Resistance, Viral; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000187:drug effects; D007251:Influenza, Human / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D053139:Oseltamivir / Q000627:therapeutic use*; D058873:Pandemics
D000998:Antiviral Agents; D053139:Oseltamivir