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2012 Guizhou H5N1 Recombination and RBD Changes
Recombinomics Commentary 21:45
February 2, 2012

The WHO Chinese National Influenza Center has released HA, NA, and MP sequences (at GISAID) from the most recent confirmed H5N1 case (39M) from Guizhou Province in China, A/Guizhou/1/2012, representing the first 2012 human H5N1 sequence.  The sample was collected on January 22, 2012, the date of the patient’s death, and the center is commended for the rapid release of these important sequences.  Like the December case from Shenzhen, China, A/Guangdong-Shenzhen/1/2011, this cases has no reported contact with poultry.  However, unlike the earlier case, which was related to clade sequences frequently reported in wild birds in Hong Kong at this time of year, the Guizhou sequence was most closely related  to 2009 environmental samples from Guizhou poultry markets which were clade  Most human H5N1 cases in China prior to 2008 were clade 2.3.4.
Although this case was from a different sub-clade than the Shenzhen case, it also had a number of receptor binding domain changes flanking position 190 (A188E, A189T, T199I, I202V).  In addition the sequence has S133L, which has been found in prior severe and fatal cases in China and southeast Asia (see list here).  However, the current HA sequence had a cluster of changes (C434T, A435G, G438A, T445G), which produced S137A in addition to S133L.  This cluster of synonymous and non-synonymous was found in clade 2.2.1 F sequences in Egypt, clade 2.1 sequences in Indonesia, and recent sequences in clade and in China and Vietnam (see list here) strongly supporting recombination, since all isolates had the identical cluster of acquisitions on multiple genetic backgrounds.

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