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H1N1 D225G In India
Recombinomics Commentary 12:41
January 13, 2010

CDC has released a new series of sequences at GISAID which includes one set from India.  The HA sequence had D225G, adding to the evidence for spread of the polymorphism which has been linked to case fatality rates of 100% in several countries.  Although there was not information on the stats of the patient, the sample was collected in October, when the rate of fatalities in India was accelerating

As has been seen previously, D225G has been appended onto another genetic background, supporting movement via recombination.  One genetic background has been prevalent in Ukraine, where all 8 isolates appear to be from fatal cases.  That background is prevalent in eastern Russia as well as other countries adjacent to Ukraine, including Moldova.  The recent cluster in Romania is also likely linked to D225G raising concerns that the receptor binding domain changes could become more prevalent in future waves of H1N1.  D225G was present in 1918 and 1919 fatal H1N1 lung cases and is also common in swine.  Its association with fatalities in Ukraine in previously healthy young adults whose lungs have been destroyed and have a hemorrhagic component has increased concerns.

The concerns have been concerned by attempts to explain the increases and linkage of cases with D225G to independent random events, which is the WHO working hypothesis.  This defense of a failed paradigm increases pandemic concerns. 

Release of more sequences from India, induding those from the more than 1000 lab confirmed cases, would be useful.

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