Person-to-person spread of Tamiflu-resistant strain of swine flu
Health officials in Wales say a strain of Tamiflu-resistant H1N1 swine flu has passed from person to person in a Cardiff hospital. The first news of this story was broken on this blog just a couple of hours ago. The National Public Health Service for Wales says that five patients at the University Hospital of Wales in Cardiff were all diagnosed with swine flu resistant to Tamiflu. All have severe underlying health conditions. Three appear to have acquired the infection in hospital.
We know that sporadic resistance to Tamiflu has developed in individuals being treated for swine flu. But this appears to be the first definite case in the world of person-to-person transmission of a Tamiflu-resistant strain. in September had a number of other possible explanations.
In truth it's not easy to be absolutely certain that there has been person-to-person transmission in Wales. Chris Lines, director of communications for Public Health Wales, said "we can't find any other explanation for this, so our confirmation of person-to-person spread is based on the lack of evidence of any other means of transmission."
He gave some more detail about the patients: "Of the five, two have recovered and been discharged having recovered. Of the three in hospital, one is in critical care and two are on the wards but being isolated from other patients."
So how important is this? Hopefully this will be a viral dead-end and it won't go any further. I'm told all the patients were immunocompromised and so especially vulnerable to developing Tamiflu resistance.
Dr Roland Salmon, director of the NPHS Communicable Disease Surveillance Centre, said:
"The emergence of influenza A viruses that are resistant to Tamiflu is not unexpected in patients with serious underlying conditions and suppressed immune systems, who still test positive for the virus despite treatment."
Finally, just to stress, there's no evidence or suggestion that a "new" Tamiflu-resistant strain of H1N1 virus is now "out there" in the community. But public health officials in Wales will be very busy this weekend tracing contacts to ensure they have contained this among this small group of patients.
I'm 
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