By Sharmina Manandhar
WASHINGTON – Immunization against the new swine flu virus became even more important this week after the discovery of antiviral-drug-resistant infections in Maryland, experts said.
The Maryland Department of Health and Mental Hygiene reported the first two Tamiflu-resistant H1N1 infections in individuals with suppressed immune systems Tuesday.
Resistance to Tamiflu, the most frequently prescribed medicine for people age 1 or older, impedes physicians’ ability to treat flu patients, according to a statement issued by the department.
“The greatest worry is that the resistant strain would become widespread,” said DHMH Secretary John M. Colmers. “But that is not the case right now.”
Drug-resistant infections represent “the small minority of all flu cases out there” and were “not surprising,” according to Dr. Wilbur H. Chen, assistant professor at the University of Maryland School of Medicine, Baltimore.
“We have seen this type of resistance before in some seasonal flu virus strains,” Chen said.
However, if the resistance continues to spread then, “our ability to depend on Tamiflu to treat the flu becomes less and less,” Chen said.
In such a scenario, constant surveillance, vaccination and aggressive treatment of the early-detected infections become very important as “we are still early on the flu season,” Chen said.
“The bottom line is we need more vaccinations,” Chen said. “That’s what we have been encouraging all along.”
“Vaccination remains the best protection against the flu,” said Colmers in a statement Tuesday. “While we continue to see flu activity on a downward slope in Maryland for now, more H1N1 vaccine arrives each day and we urge everyone, especially members of the five target populations, to contact their doctors, health care providers or local health departments to get vaccinated.”
The proportion of visits to emergency departments for influenza-like illness declined for a fourth consecutive week, despite “widespread” flu activity in Maryland, according to the latest Maryland Influenza Surveillance Report available in the DHMH Web site.
Also, about 1.3 million doses of H1N1 vaccines have been ordered in Maryland so far.
Many local health departments that canceled or postponed their flu clinics earlier due to the lack of vaccines are now rescheduling them. The shortage had also caused vaccine seekers to line up hours before the clinics were scheduled to open.
Vaccinations are underway in Montgomery County with three clinics for priority groups scheduled next week. The priority groups are pregnant women; people living with or caring for children younger than 6 months old; health care and emergency medical services workers; young people age 6-months to 24; and 25-to-64-year-olds with chronic health disorders or compromised immune systems. Each clinic will immunize 300 people by appointment only.
A mass walk-in clinic providing 5,000 doses of vaccine is scheduled on Dec. 20, according to Mary Anderson, the county health department spokeswoman.
“We have got a good amount of vaccines,” Anderson said.
So far, the department has immunized about 17,000 people, according to Anderson.
Anderson also said that she has heard “anecdotally” that the vaccines are increasingly available in private physicians’ offices.
In St. Mary’s County, too, the vaccine situation is “catching up,” according to Karen Everett, county health department spokeswoman.
By Thanksgiving, the department immunized all public and private school children in grades K through 12 whose parents returned a permission slip, against both seasonal and H1N1 flu, Everett said. Beginning next week, the department will provide booster doses to all children under 10.
“We have not held a massive vaccination clinic yet,” Everett said. “But we hope to schedule one for priority groups before Christmas.”