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Shikha Garg, Zack Moore, Nicole Lee, John McKenna, Amber Bishop, Aaron Fleischauer, Chasisity B. Springs, Ha T. Nguyen, Tiffany G. Sheu, Katrina Sleeman, Lyn Finelli, Larisa Gubareva, Alicia M. Fry, A Cluster of Patients Infected With I221V Influenza B Virus Variants With Reduced Oseltamivir Susceptibility—North Carolina and South Carolina, 2010–2011, The Journal of Infectious Diseases, Volume 207, Issue 6, 15 March 2013, Pages 966–973, https://doi.org/10.1093/infdis/jis776
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Abstract
Background. During 2010–2011, influenza B viruses with a novel neuraminidase substitution, denoted I221V (B/I221V), associated with reduced in vitro oseltamivir susceptibility were detected in North Carolina.
Methods. We determined the prevalence of I221V among B viruses submitted to the Centers for Disease Control and Prevention for antiviral resistance surveillance, including all B viruses submitted to North Carolina and South Carolina state laboratories, during October 2010–September 2011.We conducted chart reviews and telephone interviews to characterize North Carolina and South Carolina patients with B/I221V vs wild-type B virus infection (B/WT).
Results. We detected I221V in 45 (22%) of 209 B viruses from North Carolina and 8 (10%) of 82 B viruses from South Carolina. We detected I221V in 3 (0.3%) of 881 B viruses tested from 45 other states. B/I221V infection was not associated with differences in underlying conditions or illness severity, compared with B/WT infection. No patients with B/I221V infection received oseltamivir prior to specimen collection. Among patients who completed oseltamivir, those with B/I221V infection reported a longer duration until illness resolution (5 vs 3 days; P = .02).
Conclusions. B/I221V cocirculated with B/WT in North Carolina and South Carolina during 2010–2011. I221V did not alter illness severity but may have reduced oseltamivir effectiveness. Thus, global surveillance for I221V is important.
