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Paradigm Shift Intervention Monitoring
It seems likely that influenza virus
(H1N1) 2009 virus infection
will predominate in the impending winter influenza epidemic in the southern hemisphere and that the currently available influenza vaccine will be adequate for control of the epidemic. - Mod.CP
The above ProMED comments on the WHO H1N1 pandemic alert are curious. The alert is based on the rapid spread of the Chihuahua sub-clade leaqding to multiple outbreaks in North and South America which “have generated a significant demand on health services”.
Sequences representing 2011 precursors to the Chihuahua sub-clade were recently released bu the United States Air Force and included cases that had been vaccinated with A/California/07/2009, the current H1N1 vaccine target. The earlier sequences had the key non-synonymous changes (N34D, S165N, A189T, V275I) indicating the vaccine escape seen in the Air Force dependents would extend to the Chihuahua sub-clade, which has the above changes as well as K149N and additional receptor binding domain changes, D225N and D225G.
The Chihuahua sub-clade has led to massive vaccination campaigns in Mexico and Venezuela and addition countries in North and South America, including El Paso, which is across the border from Juarez when two traffic officers, who were partners, died from Chihuahua H1N1.
A/California/07/2009 is the current target for the northern hemisphere and has shipped for the 2011 season in the southern hemisphere, and is in production for the 2011/2012 northern hemisphere. This selection was largely based on the fatally flawed antigenic characterization test which lacks sensitivity and reproducibility.
Usually the vote on the vaccine target is unanimous, but there was one abstention on the vote for A/California/07/2009 for the 2011/2012 season in the United States.
Production of vaccine with a new H1N1 target is long overdue.