Abstract
Oseltamivir is 1 of 2 antiviral medications available for the treatment of influenza B virus infections. We describe and characterize a cluster of influenza B viruses circulating in North Carolina with a mutation in the neuraminidase active site that may reduce susceptibility to oseltamivir and the investigational drug peramivir but not to zanamivir.
Highlights
Influenza B viruses are responsible for sporadic seasonal influenza illness and can be associated with severe illness and death
Subsequent fluorescent neuraminidase inhibitors (NAIs) testing of isolates recovered during surveillance showed a cluster of 14 influenza B viruses from North Carolina with elevated oseltamivir IC values compared with reference wildtype influenza B, wild-type pandemic (H1N1) 2009, and wild-type A(H3N2) viruses; a similar trend was observed for peramivir IC50 values (Table 1)
Conclusions the NA change I221V has been seen among the N1 NA subtype of influenza A viruses [1,13], such a change has not been reported in influenza B viruses
Summary
Susceptible and resistant reference viruses used as controls in NAI assays. IC50 values for reference viruses represent the average taken from 5 replicates. Because some susceptibility-altering NA mutations have been shown to arise from virus propagation in tissue culture [15], pyrosequencing analysis at position 221 in available matching clinical specimens was performed to rule out cell culture selection. The I221V substitution was identified in the 9 available matching clinical specimens (Table 2). Most of the clinical specimens contained higher percentages of the V221 variant compared with the
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