Picture: Thinstock Source: Supplied
THE swine flu virus that hit more than 37,000 Australians and killed 186 people in 2009 is now resistant to key flu medicine Tamiflu, raising fears a new outbreak may be difficult to fight.
Just weeks before the flu seasons starts, new Australian research reveals one in five cases of swine flu in one area in 2011 were resistant to the antiviral medicine.
Dr Aeron Hurt from the World Health Organisation collaborating centre for flu research in Melbourne, says the bug appears more prone than other types of flu to developing drug resistance.
And he warns access to anti-viral treatments may have to be restricted to limit further resistance developing.
While just 2 per cent of swine flu strains around the world are resistant to Tamiflu, the Australian research found mutations in all strains of the swine flu that suggest they might be prone to develop resistance.
Tamiflu resistance develops when an individual under treatment receives the drug to control their symptoms.
In most flu viruses, the changes that make the virus resistant to treatment also make it less likely to spread to others.
With swine flu, this has not happened and the virus remains fit enough to spread to others, Dr Hurt said.
Research on patients in Newcastle NSW in 2011 found just one person in the area had used Tamiflu but the resistant form of the virus spread to 20 per cent of all those who developed swine flu in that region.
"Widespread transmission of a fit resistant strain is of significant public health concern," Dr Hurt will tell a conference in Canberra on Tuesday.
"The development of resistance to these drugs reduces the options for treating seriously ill patients," he says.
The only way to combat the growth of drug resistant strain of the virus is to save medicines for the most needy cases, he says.
Dr Hurt says he is not qualified to say who should get access to the medicine.
Research on the 2009 swine flu outbreak found pregnant women children aged under 5, those aged over 65 and those with significant illnesses are most at risk from swine flu.
Around 13 per cent of influenza samples circulating in Australia that were tested by the WHO centre in Melbourne in 2012 were swine flu.
Early flu activity in Queensland this year has shown swine flu is the predominant strain, Dr Hurt said.
Swine flu has not yet developed resistance to Relenza, an inhaled form of anti-viral treatment.
However, Dr Hurt says most pharmacies do not stock Relenza and it is not widely used in hospitals.
The flu season in Australia runs from May to October.
The current flu vaccine will protect against strains of swine flu that are resistant to Tamiflu as well as influenza B and the H3 flu.
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