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Type: Journal article
Title: Characteristics of a widespread community cluster of H275Y oseltamivir-resistant a(H1N1)pdm09 influenza in Australia
Author: Hurt, A.
Hardie, K.
Wilson, N.
Deng, Y.
Osbourn, M.
Leang, S.
Lee, R.
Iannello, P.
Gehrig, N.
Shaw, R.
Wark, P.
Caldwell, N.
Givney, R.
Xue, L.
Maurer-Stroh, S.
Dwyer, D.
Wang, B.
Smith, D.
Levy, A.
Booy, R.
et al.
Citation: Journal of Infectious Diseases, 2012; 206(2):148-157
Publisher: University of Chicago Press
Issue Date: 2012
ISSN: 0022-1899
Statement of
A. C. Hurt, K. Hardie, N. J. Wilson, Y. M. Deng, M. Osbourn, S. K. Leang, R. T. C. Lee, P. Iannello, N. Gehrig, R. Shaw, P. Wark, N. Caldwell, R. C. Givney, L. Xue, S. Maurer-Stroh, D. E. Dwyer, B. Wang, D. W. Smith, A. Levy, R. Booy, R. Dixit, T. Merritt, A. Kelso, C. Dalton, D. Durrheim, and I. G. Barr
Abstract: Background: Oseltamivir resistance in A(H1N1)pdm09 influenza is rare, particularly in untreated community cases. Sustained community transmission has not previously been reported. Methods: Influenza specimens from the Asia-Pacific region were collected through sentinel surveillance, hospital, and general practitioner networks. Clinical and epidemiological information was collected on patients infected with oseltamivir-resistant viruses. Results: Twenty-nine (15%) of 191 A(H1N1)pdm09 viruses collected between May and September 2011 from Hunter New England (HNE), Australia, contained the H275Y neuraminidase substitution responsible for oseltamivir resistance. Only 1 patient had received oseltamivir before specimen collection. The resistant strains were genetically very closely related, suggesting the spread of a single variant. Ninety percent of cases lived within 50 kilometers. Three genetically similar oseltamivir-resistant variants were detected outside of HNE, including 1 strain from Perth, approximately 4000 kilometers away. Computational analysis predicted that neuraminidase substitutions V241I, N369K, and N386S in these viruses may offset the destabilizing effect of the H275Y substitution. Conclusions: This cluster represents the first widespread community transmission of H275Y oseltamivir-resistant A(H1N1)pdm09 influenza. These cases and data on potential permissive mutations suggest that currently circulating A(H1N1)pdm09 viruses retain viral fitness in the presence of the H275Y mutation and that widespread emergence of oseltamivir-resistant strains may now be more likely.
Keywords: Influenza, Human
Description: Electronically published 4 May 2012.
Rights: © The Author 2012. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
RMID: 0030050160
DOI: 10.1093/infdis/jis337
Appears in Collections:Public Health publications

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