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. 2019 Nov;25(11):2108-2111.
doi: 10.3201/eid2511.190757. Epub 2019 Nov 17.

Human-to-Human Transmission of Influenza A(H3N2) Virus with Reduced Susceptibility to Baloxavir, Japan, February 2019

Emi Takashita, Masataka Ichikawa, Hiroko Morita, Rie Ogawa, Seiichiro Fujisaki, Masayuki Shirakura, Hideka Miura, Kazuya Nakamura, Noriko Kishida, Tomoko Kuwahara, Hiromi Sugawara, Aya Sato, Miki Akimoto, Keiko Mitamura, Takashi Abe, Masahiko Yamazaki, Shinji Watanabe, Hideki Hasegawa, Takato Odagiri

Human-to-Human Transmission of Influenza A(H3N2) Virus with Reduced Susceptibility to Baloxavir, Japan, February 2019

Emi Takashita et al. Emerg Infect Dis. 2019 Nov.

Abstract

In 2019, influenza A(H3N2) viruses carrying an I38T substitution in the polymerase acidic gene, which confers reduced susceptibility to baloxavir, were detected in Japan in an infant without baloxavir exposure and a baloxavir-treated sibling. These viruses' whole-genome sequences were identical, indicating human-to-human transmission. Influenza virus isolates should be monitored for baloxavir susceptibility.

Keywords: H3N2; I38T substitution; Japan; antimicrobial resistance; baloxavir; baloxavir acid; baloxavir marboxil; cap-dependent endonuclease inhibitor; family cluster; human-to-human transmission; influenza; influenza A(H1N1)pdm09; influenza virus; polymerase acidic; respiratory infections; viruses; whole-genome sequencing.

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Figures

Figure
Figure
Clinical timeline of 2 siblings infected with mutant influenza A(H3N2) viruses encoding the polymerase acidic I38T substitution, Japan, February 2019. Whole-genome sequences of A/Kanagawa/IC18144/2019 (isolate no. EPI ISL 346656) and A/Kanagawa/IC18141/2019 (isolate no. EPI ISL 345215) are available from the GISAID EpiFlu database (http://www.gisaid.org).
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