Child dies as swine flu turns drug-resistant

Published on Monday 16 November 2009 21:29

ANOTHER child has died after contracting swine flu, as it emerged yesterday that the first cases of swine flu becoming resistant to antiviral drugs have been reported in Scotland.

The youngster, from the NHS Ayrshire and Arran area, had an underlying health condition and is the fifth person under the age of 18 to die after catching the H1N1 virus.

The death brings the total number of H1N1-related deaths in Scotland to 38. Two patients in Scotland have shown resistance to Tamiflu – the main drug being used to reduce illness in those struck with the H1N1 virus.

Experts yesterday said concern would increase if resistant strains of swine flu started spreading. But there is no evidence that this has happened, and both patients who showed resistance have fully recovered.

Yesterday, health secretary Nicola Sturgeon said there was no cause for concern after the emergence of the drug-resistant cases.

But microbiologist Professor Hugh Pennington said the cases showed it was vital that Tamiflu was only given to patients at risk of complications to avoid further and widespread resistance.

He warned against Scotland following a similar policy as England in allowing patients to access Tamiflu through the swine flu helpline without having to see a doctor.

At the moment, another antiviral drug, Relenza, is available for patients who become resistant to Tamiflu. Ms Sturgeon said the cases of resistance were "a rare occurrence" but "not of huge concern".

She added: "We have stockpiles of another antiviral which can be used to treat patients."

Ms Sturgeon said there had been no evidence so far of the resistant strain spreading from person to person. She added: "Health Protection Scotland monitor these things carefully, but at this stage there's no cause for people to be concerned."

Dr Jim McMenamin, consultant epidemiologist at Health Protection Scotland, said it was likely that more cases of resistance would be seen.

"This is because we are looking for this mutation in samples submitted and expect to find this mutation in a small proportion of these samples," he said.

He said the best way to prevent resistance was for patients to make sure they finish their course of antivirals.

Prof Pennington said a key future development would be if cases of Tamiflu-resistant H1N1 started spreading from one patient to another.

"None of the cases so far have done that. It has been a bit of a dead end for them," he said.

Prof Pennington said if there was an outbreak caused by a resistant virus then there could be "serious difficulties".

But he said just because a virus had developed resistance to Tamiflu, it did not mean it had mutated in a serious way.