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Paradigm Shift Intervention Monitoring
The National Influenza Centre
in Tehran has released four more sets of pH1N1 sequences from patients
infected in mid-December, 2010. Like the three sets of sequences
from patients infected in early
December, all had S186P or S188T.
The sequence with S186P, A/Karaj/5660/2010, had a large number of HA changes and mapped to the same branch as A/Shahriar/5336/2010. Like a series of UK sequences and the two sequences (A/Pennsylvania/16/2010 and A/Pennsylvania/17/2010) from fatal cases in Lehigh, Pennsylvania, all had G541A, T598C, T933C, T1020C, G1206A, T1374G, and C1464T, signaling clonal expansion. These sequences were distinct from A/Bandar Abbas/5096/2010, which also had S186P as well as A1172G which was found in 5 of the sequences from the UK.
The three sequences with S188T (A/Karaj/5685/2010, A/Karaj/5718/2010, A/Tehran/5675/2010), were similar to the earlier sequences with S188T, A/Karaj/5327/2010, which was related to sequences from Russia (A/Moscow/IIV-33/2010), Thailand (A/Thailand/594/2010 and A/Thailand/742/2010), and Brunei (A/BRUNEI/218/2010). All had a series of markers define this sub-clade and they all also had G605C, T0156C, G1171A, and G1403A, which was present in all of the UK sequences with S188T.
Thus, although the 7 sequences from Iran fall on three separate branches, and are from multiple locations in Iran, all sequences have S186P or S188T.
The National Influenza Centre in Tehran is to be commended for the timely release of these important sequences to the scientific community.
These sequences provide additional support for the fixing of S186P or S188T in pandemic H1N1 in 2011, and strongly support immunological escape.