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Ukraine Dead Increase
to 213 - Still No Sequences
The above figures are from the latest update from the Ukraine Ministry of Health. The biggest increase in cases was again in Kiev, with 6958 new cases report in the past 24 hours. The 83,243 reported cases is the second highest, which again signals the spread of the virus to the east. Lviv oblast still has the most cases, 171,781, and deaths, 81. Only 7 of the 27 reporting locations have not crossed the epidemic threshold, and now most locations have reported deaths (see map). The jump in reported deaths to 213 represents an increase of 24 in 24 hours and raises concerns that the death toll will continue to rise due to the large number of patients who are still hospitalized (25,968 of the hospitalized patients above have been discharged).
The deaths include the 90 who were detailed previously, but media reports claim that only 17of the 213 are due to swine flu, which is due to the limited testing / collection of samples. These under-representations of swine flu cases and deaths are widespread and create continual confusion. The only flu circulating in Europe is swine flu, which accounts for the vast majority of the more than 1 million cases listed above.
The number of cases and fatalities is unusually high, and has raised concerns about the sequences of the H1N1 circulating in Ukraine. Although earlier announcements from WHO indicated details on the sequences would be forthcoming, such information has been delayed. The recent release of H1N1 sequences from fatal cases in Sau Paulo, Brazil with receptor binding domain changes at position 225 (D225N and D225G) have raised concerns that similar changes will be present in the Ukraine sequences, leading to more virulence resulting in the hemorrhagic pneumonia described in fatal cases when both lungs were destroyed. Although such cases have been reported previously, the number of such cases in Ukraine was unusually high.
The sequences at Mill Hill should be released immediately.