H1N1 virus turning Tamiflu-resistant

NEW DELHI
: An increasing number of countries, including some in Asia, are now reporting Tamiflu resistant H1N1 virus. The worrying development,
according to WHO, has seen 12 countries including China and Singapore. India has not reported the mutation in the virus so far.

The changes in the virus reported in samples are making these strains of swine flu resistant to oseltamivir or Tamiflu - the antiviral of choice globally. Such cases have also been found in Japan, US, Hong Kong, Denmark and Canada.

While India is monitoring these reports closely, it will begin exit screening of pilgrims bound for Saudi Arabia for Haj as the desert nation is refusing entry to anyone with even a common cold. Saudi authorities are insisting on certificates stating that Haj pilgrims are completely free of any influenza infection.

Changes in the virus are also being tracked closely as scientists are concerned that new strains may make the vaccines being developed at a feverish pace infructuous. As of now, WHO fears Tamiflu resistance may be more widespread than officially reported.
Going by available data, majority of the resistant cases were reported where oseltamivir was given as preventive medication to people exposed to the flu but who had not tested positive themselves. Some cases were a result of treatment of mild illness as well as "immuno-compromised" patients or persons whose immune systems were working imperfectly.

India has so far not reported such a mutation. ICMR director general Dr V M Katoch told TOI, "We have been constantly sequencing genes in H1N1 to mark any form of mutation. However, we have still not found a case of oseltamivir resistant H1N1 virus."

He added, "Fear of resistance is why we are so careful about Tamilfu's availability to the public and its use in management of H1N1 infected or suspected patients. Tamilfu is now only available in select hospitals so that we can keep a record of the treatment."

Meanwhile, the decision on exit screening was taken in a meeting between the director general of health services and the Haj Committee of India on Saturday.

Till now, India has only been carrying out screening of passengers arriving at the country's 22 international airports.

Saudi Arabia has announced that it will require a health certificate for all pilgrims to Mecca, showing they are not suffering from normal flu. In the meeting on Saturday, the health ministry said that in the next 10 days, it would provide the Haj committee and states with the prototype of India's flu free certificate that every pilgrim will have to get stamped after a check-up by designated doctors.

The certificate will state that the pilgrim isn't suffering from seasonal flu or has H1N1 symptoms.

Speaking to TOI from Mumbai, CEO of India's Haj committee Mohammad Owais said, "A high-level expert committee has been formed to see whether all Indian pilgrims can be given a 42-day regimen of Tamilfu as a form of protection. The committee will see what the drug's side effects will be if used for so long and whether it is a feasible proposition."