Mutated H1N1 kills three

A mutation in the H1N1 virus is making it harder for health officials to treat patients with the flu.

Three of the four patients infected with the mutated virus at Duke University Medical Center died Friday.

Doctors are worried because the mutated virus is resistant to Tamiflu, the main drug used to treat the flu.

Resistance to the drug is common in the seasonal flu, but rare in H1N1, said Dr. Cameron Wolfe, an infectious disease specialist at Duke.

The patients at Duke represented the largest cluster of Tamiflu-resistant swine flu victims in the nation, Wolfe said.

All four of the patients suffered from multiple ailments, which weakened the patients’ immune systems and their abilities to fight the virus. But it is still unclear what part the drug-resistant flu played in the deaths of three of the patients.

“If you look at the cases that have occurred so far, they have occurred in patients that have been immunosuppressed,” Wolfe said, referring to the patients’ weak immune systems.

The resistant flu strain is being tested by infectious disease clinicians at Duke but is not believed to have spread from patient-to-patient.

Early detection of the mutation enabled the fourth patient to make a full recovery, Wolfe said.

“Some viruses mutate, and people who have compromised immune systems end up getting the medication longer, so the flu virus becomes resistant,” said Carol Schriber, spokeswoman for the N.C. Department of Health and Human Services.

Because these mutations are common, the public should keep the situation in perspective, Schriber said.

“We take it very seriously, but there’s no need to panic about it,” Schriber said.

Officials were not concerned that Tamiflu-resistant H1N1 could be a big threat if there is another wave of the flu, which some have predicted could happen in January as students return to school.

Doctors can prescribe Relenza, an alternative drug that treats the flu, to patients that are resistant to Tamiflu, Wolfe said.

He said the key difference between the two drugs is the administration of the medications.

Tamiflu is provided in pill form, which is easier for the average patient to take, but Relenza is a nasal spray, which can be problematic for asthmatic patients and flu-infected children.

Mary Covington, executive director for Campus Health Services at UNC, said the University is not worried about the mutation because the majority of the cases can be treated with Tamiflu.

Covington reminded students that the key to preventing the virus is to avoid exposure all together. This includes receiving the flu vaccine and practicing good hand hygiene.



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