An increasing number of countries, including some in Asia, are now reporting Tamiflu resistant H1N1 virus. The worrying development, according to WHO, has seen 12 countries including China and Singapore. India has not reported the mutation in the virus so far. The changes in the virus reported in samples are making these strains of swine flu resistant to oseltamivir or Tamiflu – the antiviral of choice globally. Such cases have also been found in Japan, US, Hong Kong, Denmark and Canada.
Going by available data, majority of the resistant cases were reported where oseltamivir was given as preventive medication to people exposed to the flu but who had not tested positive themselves. Some cases were a result of treatment of mild illness as well as “immuno-compromised” patients or persons whose immune systems were working imperfectly.

This was the main worry in the case of earlier diseases where antibiotics were given for any problem, including treating the common cold. In the current case, health authorities are trying to prevent such a case by not allowing Tamilflu to be sold over the counter, and the dispensation of which has been restricted to either patients, or to those who are in high risk situations such as medical personnel, screening personnel.
Barring any mutation that causes the virus to become more virulent, the expectation would be that swine flu will be like any other flu, which spreads like the common flu, and patients recover after treatment. Initially, the media also went overboard, but now it seems like that there is some sense of responsibility and carefulness being exhibited by media all over the world.

Health officials around the world worked to contain what appears to be a spreading swine flu outbreak early Monday, while one out of every five residents of Mexico’s most populous city wore masks to protect themselves against the virus. Mexico seems to be the epicenter of the outbreak, where as many as 103 deaths are thought to have been caused by swine flu, the country’s health minister said. An additional 1,614 reported cases have been reported in the country.
The WHO has called the outbreak a “public health emergency of international concern.” Researchers are trying to determine how easily it can jump from person to person. And Keiji Fukuda, WHO’s assistant director-general, said it was too early to predict whether there will be a mild or serious pandemic. The H1N1 strain of swine flu is usually associated with pigs. When the flu spreads person-to-person, instead of from animals to humans, it can continue to mutate, making it harder to treat or fight off. Symptoms of swine flu include fever, lethargy, lack of appetite, coughing, runny nose, sore throat, nausea, vomiting and diarrhea, the CDC said.

The problems with such a disease are manifold:
- Many of them start in areas where health services are not available at the desired levels, and growth in the disease can happen quickly before detection happens
- Countries tend to repress such diseases for fear of inflaming citizens or investors or tourists (such as China with-holding information about SARS and bird flu earlier)
- Drugs are not available, since the disease mutates fast and there has not been much research by drug companies in this area
- People are hesitant to take the measures that are required to bring such diseases under control (such as culling stock, and taking the extensive health measures and ceasing contact with other people)

The swine flu is not yet an epidemic (or a pandemic), but is bothering health authorities and Governments enough that they are taking the necessary precautions such as ordering closure of cinema halls in Mexico, quarantining people in other countries who have recently visited Mexico and who show signs of flu-like conditions, and so on. If the disease does turn out to be serious enough, Governments all over the world will have to get more active, and take the necessary steps to enhance their health facilities.