Global Transmission of Oseltamivir-Resistant Influenza

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Abstract
Seemingly from one influenza season to the next, we have lost the use of our leading antiviral influenza drug because of resistance. This winter, the circulating strain of seasonal influenza A virus (H1N1) is resistant to the neuraminidase inhibitor oseltamivir. Moreover, rather than emerging under selective pressure of drug use, as many antibiotic-resistant bacteria do and as has been the concern for influenza, this resistant strain seems to be a natural, spontaneously arising variant. Nevertheless, science has given us the tools with which to anticipate these events — and should allow us to develop new clinical solutions that build on our knowledge of the biology of RNA viruses.