At least two cases of the new "dual mutant" strains of H1N1 flu in humans have been found in the U.S. This could make the primary flu medicine less effective.
(Photo: Getty Images/ Jessica McGowan)
Emergence of Dual Mutant Strains
The Centers for Disease Control and Prevention (CDC) said they found the "dual mutant" strains. These strains have two worrying changes: I223V and S247N.
These gene changes could make oseltamivir, known as Tamiflu, less effective. Hong Kong scientists were the ones who first noticed the changes in the lab. This means that the drug might make H1N1 less likely to be killed.
In lab tests, the new H1N1 strains were up to 16 times less likely to be killed by oseltamivir. But it's still not clear what effect this has on the drug's usefulness in real life. Even with these changes, the viruses were still sensitive to other antiviral drugs like baloxavir and marboxil, which means there are different treatment methods.
The CDC stressed that no instant changes need to be made to clinical care because flu shots still protect against these changed viruses. The dual mutant strains have been reported in various countries. 101 sequences from Africa, Asia, Europe, North America, and Oceania have been submitted to the global virus database GISAID. At the time, these regions comprised less than 1% of all flu virus sequences.
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Monitoring and Implications for Treatment
The CDC is still monitoring these changed viruses. The University of Michigan and the Connecticut Department of Health have discovered two instances in the United States. People will closely monitor how these viruses spread and change to see how they affect the following flu season.
A study released last year states that oseltamivir is still the most widespread flu medicine. It makes up 99.8% of all flu antivirals given to children. The CDC tells doctors to immediately give flu antivirals to all patients admitted or at high risk of getting a severe illness. Oseltamivir has also been used to treat diseases in humans caused by the H5N1 bird flu outbreak that is still going on in dairy farms this year.
This is not the first time that potential concerns about the efficacy of flu treatments have been raised. In 2007 and 2008, a novel H1N1 strain resistant to oseltamivir was developed. The H275Y gene mutation caused it. In lab studies, this strain was up to 1,000 times less responsive to oseltamivir than the strain that caused the 2009 swine flu pandemic.
The influenza A viruses that affect people and animals are different. These go by A(H1N1) and A(H3N2) in humans and A(H1N1), A(H1N2), and A(H3N2) in pigs. These viruses can spread between species, occasionally combining genes to produce new strains. If individuals easily spread the new flu viruses produced by this procedure and most lack immunity, they may spark a pandemic.
2009 saw the outbreak of the new A(H1N1) virus worldwide. New strains of the influenza virus that may be dangerous can develop through evolution. Finding and adequately addressing these dangers needs extensive and continuous observation and study.
Considering everything, the finding of these two H1N1 strains highlights the significance of keeping a careful eye on new flu viruses and moving fast when they emerge. It does not follow that one should not employ great caution to lower the risks associated with these new diseases just because the current immunizations and therapies are successful.
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