近年来，网络上一直出现流感抗病毒药物耐药的说法，这一说法是否属实？ 1月23日，智通财经（www.thepaper.cn）记者从复旦大学附属华山医院感染科张文宏团队获悉，其团队 联合国内多家研究机构，完成了一项覆盖近4000例中国患者的真实世界研究。该研究首次全面评估了抗 流感药物"玛巴洛沙韦"自2021年在中国上市后，流感病毒对其敏感性的变化状况。 研究结果显示，在中国大陆，所有已知与玛巴洛沙韦敏感性降低相关的突变总体检出率仅为0.05%。值 得注意的是，在全球其他地区曾有报道的标志性耐药突变I38T，在本研究中未被检测到。这表明，尽管 I38T是明确的耐药性突变位点，但由于其显著降低的病毒适应性，该突变株在自然传播中不具备竞争优 势。 这也是中国首个针对玛巴洛沙韦耐药性的基础研究成果，填补了国内该领域基础研究的空白。同时，研 究结果与中国疾病预防控制中心流感周报中玛巴洛沙韦耐药率为0的监测结果形成呼应，进一步验证了 该药物在国内临床应用的有效性和安全性，更建立了基础研究与临床监测的互补体系，对推动流感防控 科学化、精准化具有重要意义。 值得一提的是，本次研究的样本中，儿童占比44.6%。研究发现，个别突变 ...

Core Viewpoint - The effectiveness of antiviral drug Oseltamivir against A(H3N2) influenza remains intact despite rising flu cases in China, with a significant proportion of reported cases linked to this strain [1][5]. Group 1: Flu Activity and Statistics - As of the end of November 2025, China reported a total of 4,351 influenza-like illness outbreaks, with 3,313 cases (approximately 76.14%) associated with A(H3N2) [1][3]. - The ILI percentage in southern provinces reached 10.3% in the 48th week of 2025, an increase from 7.8% the previous week and higher than the same period in 2022, 2023, and 2024 [3]. - Northern provinces reported an ILI percentage of 9.1% in the same week, up from 8.6% the previous week, also exceeding the levels of the previous three years [3]. Group 2: Antiviral Drug Resistance - The National Influenza Center's analysis indicated that 3.9% of A(H1N1)pdm09 strains showed reduced sensitivity to neuraminidase inhibitors, while all A(H3N2) and B strains remained sensitive [5]. - Oseltamivir is still widely used and effective against A(H3N2), with clinical observations suggesting that resistance issues are not significant at this time [5][6]. Group 3: Antiviral Drug Guidelines - The "Chinese Influenza Treatment and Drug Prevention Clinical Practice Guidelines (2025 Edition)" states that antiviral drugs should be considered a supplementary measure to vaccination for flu prevention in community settings [6][7]. - Routine use of antiviral drugs for pre-exposure prevention is not recommended due to potential for inducing resistance and associated costs, with specific exceptions for high-risk groups [7].

Core Viewpoint - The article highlights the significant increase in flu activity across China, with many provinces experiencing high levels of flu cases, leading to a surge in demand for flu vaccines and antiviral medications [3][4][5]. Vaccine Supply and Demand - Flu vaccine demand has surged, particularly in northern provinces like Beijing, Liaoning, and Shaanxi, with reports of full appointment schedules for vaccinations [5][6]. - While the supply of quadrivalent flu vaccines is stable, there is a noted shortage of innovative vaccines such as nasal spray and subunit vaccines in some areas [5][6]. - The availability of flu vaccines for children aged 6-35 months remains stable, with sufficient stock reported across various community health service centers [5][6]. Antiviral Medication Demand - There has been a dramatic increase in the demand for antiviral medications, with sales figures showing a 22-fold increase in flu medication sales since the onset of the flu season [8][9]. - Specific antiviral products like Oseltamivir and other flu medications have seen sales growth of 4.5 times and 5 times, respectively, in the latest week [9]. - The current flu season is characterized by the predominance of the H3N2 strain, but existing antiviral treatments remain effective against the circulating strains [9][10]. Regulatory Actions - To ensure the stability of antiviral medication supply and pricing, regulatory authorities in various regions, including Beijing and Qinghai, have initiated special inspections to prevent price gouging [10].

Core Viewpoint - The article emphasizes the importance of understanding the flu and its prevention methods, particularly the risks associated with the misuse of antiviral medication Oseltamivir and the necessity of flu vaccination as the most effective preventive measure [2][3][5][10] Group 1: Misuse of Oseltamivir - There are claims that long-term use of Oseltamivir can prevent flu, which experts strongly oppose, stating that the drug should not be used casually [2] - Oseltamivir is effective only when taken within 48 hours of flu symptoms appearing, and its use for post-exposure prevention is limited to high-risk groups [2][3] - Misuse of Oseltamivir can lead to adverse effects such as nausea and potential neuropsychiatric reactions, as well as the risk of developing drug-resistant virus strains [3] Group 2: Understanding Flu vs. Common Cold - The article clarifies that flu is a serious respiratory illness caused by the influenza virus, distinct from common colds caused by other viruses, with significant differences in symptoms and complications [4][5] - Flu symptoms include high fever, muscle aches, and severe fatigue, while common colds typically present milder symptoms [4][5] - The World Health Organization reports that flu can lead to 3 to 5 million severe cases and 290,000 to 650,000 respiratory disease-related deaths annually [5] Group 3: Immunity and Vaccination - Immunity from a previous flu infection lasts only 6 to 8 months, not a lifetime, due to the virus's ability to mutate [6][7] - Vaccination is recommended for everyone aged 6 months and older, with the timing of vaccination being crucial for effectiveness [8][10] - Individuals with mild cold symptoms can receive the flu vaccine, but those with fever or severe symptoms should postpone vaccination [8][9]