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Clonal Expansion of 2012 H1N1 H274Y In Texas and Mexico
Recombinomics Commentary 15:30
May 15, 2012

Resistance to neuraminidase inhibitors has been low or undetectable throughout most of the season; however, a slight increase in levels of resistance to oseltamivir has been reported in influenza A(H1N1)pdm09 isolates in the USA. Most (11/16) of these oseltamivir resistant cases have been from the state of Texas, where influenza A(H1N1)pdm09 has been the most common virus circulating.

The above comments from the May 10, 2012 WHO influenza update on influenza cites H274Y (Tamiflu resistance), which was also noted in the Week 17 update from the WHO Pan American Health Organization.

The presence of H274Y was also seen in recently released (by CDC at GISAID) Texas H1N1pdm09 NA sequences, where all cases since late January (A/Texas/23/2012, A/Texas/24/2012, A/Texas/26/2012, A/Texas/29/2012, A/Texas/30/2012) had H274Y. 

Similarly, all H1N1pdm09 sequences from Mexico since mid-January, 2012 (A/Mexico/689/2012, A/Mexico/1474/2012, A/Mexico/1818/2012, A/Mexico/2440/2012), also had H274Y, and were from the same sub-clade circulating in Texas. 

These sequence matches signal clonal expansion of oseltamivir resistant H1N1pdm09 in Texas and Mexico on the most dominant sub-clade circulating in the United States and Mexico.

The fixing of this change in this large region raises pandemic concerns.

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