Community-acquired Oseltamivir-Resistant Pandemic (H1N1) 2009 in Child, Israel

To the Editor: During the spring of 2009, a pandemic influenza A (H1N1) virus emerged and spread globally. Initial testing of the virus found it susceptible to neuraminidase inhibitors and resistant to adamantanes (1,2). As of March 5, 2010, only 264 cases of oseltamivir-resistant pandemic (H1N1) 2009 infection had been reported to the World Health Organization, but the number of cases has been steadily increasing (2). These viruses were carrying the H275Y mutation, which conferred resistance to oseltamivir (2). Most of the reported cases were in immunocompromised patients who had prolonged viral shedding or in patients who had received oseltamivir prophylaxis or treatment (1–4). We describe an otherwise healthy 2-year-old boy with oseltamivir-resistant pandemic (H1N1) 2009 infection and a traumatic lung contusion, complicated by acute respiratory distress syndrome (ARDS). He had not received prior chemoprophylaxis or treatment with oseltamivir.