On October 20, 2009, the Central Epidemic Command Center (CECC) announced the discovery of three Tamiflu-resistant pandemic influenza A (H1N1) virus strains in three hospitalized patients with pandemic influenza A (H1N1) infection in Taiwan who have all fully recovered.Two of the cases wh developed symptoms in October, 2009 are a 5-year-old girl and 2-year-old girl who reside in northern Taiwan. Both cases developed Tamiflu resistance after being treated with the drug.After an epidemiological investigation was conducted, the Taiwan Centers for Disease Control (Taiwan CDC) determined that the two cases of Tamiflu-reistant virus are sporadic and have not resulted in community transmission.On the other hand, the other case that developed symptoms in November, 2009 is a 12-year-old girl who resides in central Taiwan.After an initial investigation was conducted, it was determined the case has also not resulted in community transmission.

Since July 1, 2009, Taiwan CDC has conducted antiviral resistance testing on a total of 562 strains of pandemic influenza A (H1N1) virus isolated from cases that occurred in Taiwan and five of the 562 strains have shown Tamiflu resistance.According to the latest data released by the World Health Organization (WHO), 52 of the approximately 10,000 strains of pandemic influenza A (H1N1) virus isolated from cases that occurred around the world have shown Tamiflu resistance.As Tamiflu is commonly used in Taiwan to treat pandemic influenza A (H1N1) infection, Taiwan CDC will continue to conduct antiviral resistance testing on pandemic influenza A (H1N1) virus strains and will not exclude the possibility of future occurrence of Tamiflu-reisistant virus strains in Taiwan. In addition, Taiwan CDC will continue to monitor pandemic influenza A (H1N1) antiviral resistance.Taiwan CDC has stockpiled 0.96 million treatment courses of Relenza that have been distributed to local hospitals and clinics for use when necessary.

CECC urged the public to comply with the government policy and get the pandemic influenza A (H1N1) vaccine according to the vaccine priority list and schedule because vaccination is the single best way to prevent pandemic influenza A (H1N1).

CECC reported that the immunization campaign yesterday was proceeded smoothly.CECC indicated that some people may experience possible side effects of the vaccine such as localized pain, redness and swelling at injection site and very few people may have fever, headache, or nausea. These side effects may last for 1 to 2 days after the vaccination.As of now, the adverse effects of the pandemic influenza A (H1N1) vaccine in Taiwan are similar to those of the seasonal influenza vaccine in Taiwan and those of the pandemic influenza A (H1N1) vaccine in other developed countries.

CECC advised that to prevent needle shock from vaccination, one should not receive the vaccine on an empty stomach and one should sit in an upright position to receive the vaccine. After the vaccination, one should remain in a nearby area to be observed for a minimum of 30 minutes. Further, one should seek immediate medical attention if he/she experiences a persistent fever or severe allergic reactions where he/she may feel difficulty in breathing, asthma, dizziness, fast heart beat, and other symptoms after the vaccination and report the reaction to the local health bureau or the Communicable Disease Reporting and Consultation Hotline, 1922.The Vaccine Safety Task Force at CECC will investigate and follow up on any vaccine adverse events following the pandemic influenza A (H1N1) vaccination.