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Paradigm Shift Intervention Monitoring
The instituto de Diagnostico y
Referencia Epidemiologicos in Mexico has released three sets of
sequences (at Genbank) from patients in Chihuahua, Mexico, including
the fatal case (36M) from the Juarez traffic station, A/Mexico/InDRE1945/2011.
All three HA sequences (A/Mexico/InDRE1946/2011
are closely related to each other and have S165N and A189T, which is
also found in recent (2011) isolates in the US. Earlier sequences
with these markers were circulating in Galicia, Spain a year ago.
The sequence from the fatal case also has D225N, which is a change associated with Ukraine and Russian fatalities in 2009 (and was frequently found in association with D225G).
It is likely that this emerging sub-clade is present throughout Mexico and Venezuela, but only the three sequence from Chihuahua have been released thus far.
More sequences from severe and fatal cases in Mexico and Venezuala, as well as 2011 sequences from the US, which have been withheld by the CDC, would be useful.