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Suspect H1N1 Death in
Romania Near Ukraine Border
Oana Grigore, communications director for Health, said they did not confirm any cases of death by influenza A/H1N1 virus, adding that if the patient died in Botosani it is a man of 47 years, smoking, obesity , which was not seen by any doctor.
The above translation described a suspect swine flu death in northern Romania near the southern border of Ukraine (see map). This report follows a similar report from Belarus regarding a doctor who died in southern Belarus, near the northern border of Ukraine.
However, it is not clear if these recent reports reflect spillage of the H1N1 in Ukraine, or simply represents deaths identified through enhanced surveillance. Ukraine has now reported over 1 million influenza/ARI cases, including 174 deaths. The cause of these alarming numbers has been said to be later treatment, but the magnitude of the outbreak raises concerns that there have been genetic changes leading to enhanced transmission and increase lethality from hemorrhagic pneumonia.
The recent description of 90 hemorrhagic pneumonia cases has left little doubt that these deaths were due to H1N1 due to lab confirmation on a sub-set and an age distribution which matches H1N1 outbreaks worldwide.
The genetic changes can be addressed through sequence analysis, but the sequences and/or a description of the sequences has been delayed.
Release of sequences is overdue.