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Nepal Fatal Cluster Raises Concerns
Recombinomics Commentary 16:37
January 20, 2010

After a couple's death, paramedics have suspected possible swine flu (H1N1 virus) outbreak in a remote Sinhasain village of Dailekh district.

Bhim Bahadur Thapa Magar, 50, and his wife Maisara, 55, of Banskatiya of Sinhasain-7 died on Tuesday evening. They were suffering from common cold.

According to Health Assitant Binod Kathayat, more than 15 others are receiving treatment at the local health post for serious common cold.

"They are suffering from the cold that looks serious," Bhakta Bahadur Malla of District Health Office. "So we have deployed a team of two including the in-charge at Ram Karnali Health Post Geharaj Khanal and Health Assistant Khem Raj Buda with necessary medicine."

The above comments describe another fatal H1N1 cluster, in Nepal, which follows a similar cluster in Romania.  Reports of receptor binding domain changes at position 225 (D225G and D225N) continue to increase along with associated deaths.  India recently confirmed that the three cases with D225G were fatal and the WHO update indicated 50% of sequences with D225G were from fatal cases.

The designation of an isolate with D225G as a low reactor raises concerns that the increasing immunity to H1N1 will select for isolates with D225G.

Sequence data on the isolates from the above fatal cluster would be useful.

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