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Paradigm Shift Intervention Monitoring
The US CDC has released a
series of recent sequences (at GISAID) from the US and other locations
in Asia and South America. Many of the US sequences were similar
to sequences in the UK and had S186P or S188T. The sequences with
S186P fell into two major branches, with sequences from the UK on both
branches. The two major branches had G451A, T598C, and
C1464T. One branch also had T933C, T1020C, G1206A, and T1374G
(see matches here).
This branch had two identical sequences from Pennsylvania (A/Pennsylvania/16/2010 and A/Pennsylvania/17/2010), which were from the two previously described Lehigh Valley fatal cases (45M and 22M). Other sequences from this branch were from Wisconsin, as well as Iran, Bhutan, Bangladesh, and England (Whitechapel, Manchester, Newcastle-upon-tyne, County Durham).
The two cases from Lehigh Valley were previously healthy young adults who were moved to the ICU and placed on ventilators and died within days of each other. The Pennsylvania Department of Health had issued an advisory, which was followed by a press release from Montgomery County, citing three more deaths in two young adults and a child.
The matches between the Lehigh death cluster and those in the UK suggest this sub-clade is associated with deaths, which is likely linked to the receptor binding domain changes, which are associated with immunological escape, and provide additional information on the spread of these S186P sub-clades.