During the last 2 years, the medical community has been tensely following the emergence of resistance to oseltamivir in strains of influenza A.1 The clinical relevance and transmissibility of these resistant variants has been unknown, and planning for epidemic and pandemic influenza thus far has ignored the issue due to lack of evidence that it will be of medical consequence. Neuraminidase inhibitors are presently the only reliable antiviral option for treatment of influenza infection: the usefulness of the adamantanes (amantadine and rimantidine) has been virtually eliminated by the development of resistance.2 Until now, little spontaneous resistance to neuraminidase inhibitors has been documented, and no spontaneously resistant influenza viruses were identified in the world prior to the introduction of the drugs. This may now be changing.
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