What implications does oseltamivir resistance in seasonal H1N1 viruses have for the avian influenza H5N1?
The implications are uncertain at this point. The neuraminidase protein in human H1N1 viruses is different from that in avian H5N1 viruses. Until we learn why the unexpected increase in oseltamivir resistance has occurred in H1N1 viruses, it is too early to know what, if any, potential there might be for a similar increase in resistance to occur in H5N1 viruses. Furthermore, H5N1 viruses have not shown the ability to spread efficiently from person-to-person. WHO has not changed any of its recommendations regarding H5N1 treatment and preparations. A resistant human H1N1 virus could theoretically give its neuraminidase gene to an oseltamivir susceptible avian H5N1 virus if both viruses were to infect the same host. This is one way in which a resistant H5N1 could develop. However, none of the H5N1 viruses recovered from people have shown any evidence of such gene swapping to date. H5N1 viruses made from combinations of human and avian virus genes do not transmit or transmit very poorly in
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