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Juarez Mexico H1N1 Death Cluster Raises Pandemic Concerns
Recombinomics Commentary 01:30
March 28, 2011

The latest victim was Isidrio Gutiérrez Palma, Road Agent Juarez, who was the officer's patrol partner Aaron Rodolfo Caballero, who also died on Tuesday for the same reason.

The PRI in the local Congress legislator confirmed that Liz Aguilar also contracted the H1N1 virus, for which he was subjected to treatment and is stable.

The above translation confirms the relationship between two of the fatal cases in Juarez.  Although media reports have cited a breathalyzer interlock device on their shared patrol car, the two agents undoubtedly had many common source for potential infection.  The fact that both young adults (33M and 26M) died is of considerable concern, as is the initial diagnosis of atypical pneumonia

The diagnosis suggests that there was difficulty confirming that the pneumonia was caused by pandemic H1N1 suggesting the virus has continued to evolve, leading to reduced sensitivity in with the reagents widely distributed.
These changes raise concerns that a new sub-clade will emerge that will limit the utility of current vaccines as well as antibodies generated against earlier versions of H1N1.  Moreover, the new sub-clade may have additional receptor binding domain changes and/or changes like D225G may be more prevelant.  The infection of a local legislator suggests the H1N1 has spread rapidly, and the number of severe and fatal cases may be markedly higher than the number recently reported..

Release of sequences from the severe and fatal cases is critical.  The CDC’s release of H1N1 sequences is lagging.  Last week the released 2011 H3N2 and influenza B sequences, but the lats release of H1n1 sequences was February 2, 2011 (and the vast majority of those sequences was from 2010.

2011 H1N1 sequences, including recent isolates from Mexico and Venezuela, should be released immediately.

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