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Paradigm Shift Intervention Monitoring
First US 2013
H3N2 Sequence Has T128A
The Virginia sequence is closely related to A/Iowa/14/2012, which is one of the two H3N2 sequences this season that the CDC has designated as a low reactor, indicating the current H3N2 vaccine poorly recognizes this sequences, which is almost certainly largely due to the loss of the glycosylation site at position 126, which was also linked to the spread of H3N2 in 2003-04. In addition to the 2013 Virginia sequence, the CDC also released 6 additional December 2012 sequences, and 4 of the 6 are closely related to the Virginia sequence and have T128A (A/New Hampshire/21/2012, A/Wisconsin/51/2012, and A/Kansas/16/2012).
In addition to these four recently released December sequences, other US sequences with an H3 identical to the Virginia sequence include A/New York/47/2012, A/Oklahoma/3059/2012, and A/Pennsylvania/20/2012. Moreover, other 2013 isolates have an identical H3 sequence includes those from Germany (A/Nordrhein-Westfalen/1/2013), France (A/Clermont-Ferrand/14/2013), and Denmark (A/Denmark/17/2013 and A/Denmark/25/2013).
In addition to the 2013 sequences which are identical to the Virginia H3 sequences, earlier 2012 H3 sequences are also identical. These include sequences from France (A/Nord Pas de Calais/2000/2012, A/Poitiers/2407/2012, A/Annecy/2806/2012, and A/Paris/1966/2012), Senegal (A/Dakar/15/2012, A/Dakar/14/2012, A/Dakar/04/2012), Spain (A/Lisboa/SU15/2012), Denmark (A/Denmark/74/2012 and A/Denmark/113/2012,).
Moreover, a large series of sequences which have T128A and are closely related to the Virginia sequences are widespread including sequences that differ by a single nucleotide including sequences from the United States (A/Massachusetts/15/2012, A/Texas/82/2012, A/Iowa/15/2012), Denmark (A/Denmark/50/2013, A/Denmark/88/2012, A/Denmark/77/2012), Greece (A/Athens GR/14/2013), China (A/Hong Kong/8118/2012), Senegal (A/Dakar/16/2012), and France (A/Paris/1987/2012).
Other closely related sequences with T128A include all 10 recent sequences from England as well as many more sequences from the United States and the countries listed above (see full list below).
This sub-clade is becoming increasing widespread and will further lower the effectiveness of the current vaccine, which was at 55% in the United States, based on early collections, when the frequency of T128A was lower, as well as the frequency of 45% in Canada, where H3N2 dominates.
Recent H3 sequences with T128A (including 2004-05 vaccine target, A/Wyoming/03/2003)
EPI417291 A/SOUTH AUSTRALIA/167/2012
EPI417273 A/SOUTH AUCKLAND/120/2012
EPI417222 A/New Hampshire/21/2012
EPI417029 A/Nord Pas de Calais/2000/2012
EPI417025 A/Haute Normandie/2022/2012
EPI417001 A/Athens GR/14/2013
EPI416522 A/Schleswig Holstein/7/2012
EPI416155 A/North Carolina/28/2012
EPI416152 A/New York/47/2012
EPI404965 A/New York/39/2012
EPI404947 A/Rhode Island/08/2012
EPI404927 A/New York/39/2012
EPI401735 A/New York/37/2012
EPI394823 A/North Carolina/21/2012
EPI391234 A/Hong Kong/8118/2012
EPI390126 A/reassortant/NYMC X-147
EPI382778 A/Hong Kong/8146/2012
EPI382725 A/Hong Kong/8118/2012
EPI269372 A/NYMC X-147 (Puerto Rico/8/1934-Wyoming/03/2003)
EPI241911 A/NYMC X-149C6(Puerto Rico/8/1934-Wyoming/03/2003)