Once the H1N1 influenza outbreaks begin - and Maryland health officials have no doubt that they will - this series of nondescript scientific laboratories, located past security guards instructed not to let anyone in without an official escort, will certainly be humming.
Here, inside the state office complex on Preston Street in Baltimore, dozens if not hundreds of polyester swabs will arrive each week, containing what doctors believe is evidence of swine flu's resurgence. Lab workers will then determine whether it is the flu - H1N1 or seasonal, or something else entirely - and whether the virus seems to be gaining strength. One of the most important roles these labs may play in the H1N1 pandemic will be determining whether this new flu has developed resistance to the antiviral medications stockpiled to make the sick well again.
Maryland is one of a dozen states that will be testing samples of the swine flu virus for hints that it has mutated. As summer turns into fall, what most worries flu experts is that the only tool to fight the H1N1 virus will no longer be available to at least slow the march of the disease that could affect as many as half of Americans.
"That information is very valuable," said Dr. Robert A Myers, deputy director of the state public health laboratory. "We're trying to get this information in quickly."
Last week, in its first week of drug resistance testing, none of the 20 samples examined at the Maryland lab had become resistant to Tamiflu or the other antiviral medications. A handful of tests around the world have revealed a virus that is resistant to these drugs, but so far they have been isolated cases and do not appear to have spread.
Drug resistance has been a problem in the past. In March, a study in the Journal of the American Medical Association showed that more than 98 percent of the influenza A virus that circulated last winter was resistant to Tamiflu. If prescribed within 48 hours of the onset of symptoms, antiviral medicines can reduce the severity of flu and shorten its duration by about a day.
Yesterday, reporters were given a tour of the facility that will provide some of the first confirmation that swine flu, which never left Maryland, is picking up steam. Doctors say they might be seeing an uptick in swine flu cases in Maryland, which peaked in June. There have been no cases of seasonal influenza detected in the state since spring.
