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Q196K and S227R In Fatal H5N1 Case In Shenzhen China
Recombinomics Commentary 03:45
January 4, 2012

The WHO Chinese National Influenza Center in Beijing has released HA, NA, PB1, NP, and MP sequences (at GISAID) from the fatal H5N1 case (39M) in Shenzhen City, Guangdong Province in China (A/Guangdong-Shenzhen/1/2011). 

The WHO Chinese National Influenza Center is congratulated for its rapid release of these important sequences.

The HA sequence has several receptor binding domain
(RBD) changes, including S227R, which had been reported previously in wild birds in Hokkaido and Fukushima, Japan raising transmission concerns, as seen in S227N in Hong Kong and Turkey.  In addition, the sequence has Q196K, which has been reported in vaccine resistant H5N1 in EgyptQ196R has been reported in an H5N1 cluster in Iraq. These RBD  chnages are in addition to V223I and M230I seen in prior clade isolates from wild birds as well as  2010 H5N1 cases in Hubei, A/Hubei/1/2010,  and Hong Kong, A/Hong Kong/6841/2010H5N1 also has D225G, which targets the lung.

Moreover, although the sequence is clade, the HA cleavage site has acquired an R to yield IERRRKR.

These changes raise serious transmission issues.  Release of the PB2 sequence and status of position 627 would be useful.

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