TY - JOUR T1 - Neuraminidase Inhibitor Resistance in Influenza: Assessing the Danger of Its Generation and Spread A1 - Handel, Andreas A1 - Longini, Ira M, Jr. A1 - Antia, Rustom Y1 - 2007/12/07 N2 - Author Summary Neuraminidase Inhibitors (NI) are currently the most effective drugs against influenza. Recent cases of NI resistance are a cause for concern. A number of studies have reported the fraction of treated patients from which resistant virus could be isolated. While these results provide some assessment of the danger of NI resistance, a more quantitative understanding is preferable. We specifically want to know how likely it is that an infected, treated patient infects another person with the resistant strain, and how likely it is that the resistant strain subsequently spreads. Knowing these quantities is important for studies of the population-wide emergence of resistance. While these parameters can often be estimated from epidemiological data, such data is lacking for NI resistance in influenza. Here, we use an alternative approach that combines data from influenza infections of human volunteers with a mathematical framework. We find that the initial generation of resistant cases is most likely lower than the fraction of resistant cases reported. However, our study also clearly shows that the results depend strongly on the role the immune response plays, an issue that needs to be addressed in future studies. JF - PLOS Computational Biology JA - PLOS Computational Biology VL - 3 IS - 12 UR - https://doi.org/10.1371/journal.pcbi.0030240 SP - e240 EP - PB - Public Library of Science M3 - doi:10.1371/journal.pcbi.0030240 ER -