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R292K Tamiflu Resistance In HPAI H7N9 In Guangdong and Taiwan

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The recently release H7N9 sequences from Guangdong and Taiwan cases with polybasic cleavage site, KRKRTAR also have R292K in the N9 sequences.  Media reports suggest that the two additional cases in Guangdong Province also have R292K.

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Cross-strait avian flu epidemic expansion, the mainland yesterday informed two H7N9 human infection cases, found that the virus mutation, more pathogenic to birds.Taiwan's Ministry of Health and Welfare Department of the afternoon of the emergency meeting of experts, said after the meeting, this month back to Taiwan confirmed H7N9 Taiwan businessmen, the specimen also found a similar situation, and resistance to the drug,


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H7N9 analyses hint at genetic mutations, drug resistance

In the latest H7N9 avian influenza developments, analysis of virus samples from China and Taiwan hint at mutations including resistance to the antiviral class of drugs known as neuraminidase inhibitors, and the World Health Organization (WHO) said today that the burgeoning number of cases this season now account for a third of all cases reported since the outbreak began in 2013.

Also, local officials reported three new cases in three Chinese provinces, signaling ongoing virus activity.

Scientists track pathogenicity, resistance mutations

Yesterday, Guangdong province's Center for Disease Control (Guangdong CDC) announced that two virus samples collected from humans show mutations that suggest H7N9 may be becoming more pathogenic in birds, according to an official statement translated and posted by Avian Flu Diary (AFD), an infectious disease news blog.

Authorities said an analysis of four samples from poultry in Guangdong province by agriculture colleagues had found similar changes in the virus and that the two groups would work together to monitor the virus.

H7N9 has been a low-pathogenic virus in poultry, which has made it difficult to track. Often, the virus isn't found in local poultry flocks until human illnesses in the area have been reported.

In a related development, Taiwan's CDC today, in an analysis of H7N9 from in imported case in January, found similar protein changes in the hemagglutinin (HA) protein that may make the virus more pathogenic in poultry, but it also said it found a mutation in the neuraminidase (NA) protein that may suggest resistance to antivirals such as oseltamivir (Tamiflu) and zanamivir (Relenza), which are neuraminidase inhibitors.

The statement from Taiwan CDC, also translated and posted by AFD, said the patient is a 69-year-old man from Guangdong province who is still hospitalized in critical condition. Officials said the mutation seen in an H7N9 sample from the man may have been a spontaneous mutation that occurred while he was undergoing treatment.

Hong Kong's Centre for Health Protection (CHP) in a statement today acknowledged the genetic findings announced by Guangdong CDC and said it will continue to monitor virus activity, but so far its analysis of viruses from its recent imported H7N9 cases from the mainland have not found any significant changes or any sign of resistance to oseltamivir.

A Feb 10 update from the WHO said an analysis of 83 H7N9 samples collected since Oct 1 from the current fifth wave of infections found no evidence of changes that would make the virus more virulent or more adapted to mammals. The group, however, noted three contained mutations in the NA protein that suggested reduced sensitivity to neuraminidase inhibitors.

The WHO added that testing is under way to assess in vitro susceptibility to the drugs.


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