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Ukraine Dead Increase to 344 - Sequences Released
Recombinomics Commentary 22:45
November 18, 2009

1,502,345 Influenza/ARI

85,904 Hospitalized

344 Dead

The above tally is from the latest update from the Ukraine Ministry of Health.  The 344 dead represents an increase of 16 from yesterday's total, which is similar to recent daily increases (see map).  The steady climb in fatal cases highlights the importance of the release of sequences by Mill Hill a WHO regional center in London.

Included in the sequences from 10 isolates were four HA sequences with the receptor binding domain change, D225G, which was found in the one throat and three lung samples.  The change was not found in isolates from nasopharyngeal washes, suggesting D225G may lead to high concentrations of H1N1 in patient's lungs.  The high concentration of virus leads to a cytokine storm that destroys the lungs in a few days.

The finding of D225G in lung tissues raises concerns rergarding sequencing of isolates from nasopharyngeal swabs.  The monitoring of this important genetic change in the receptor binding domain may require sampling of lung tissues or fluids.

The relationship between the negative nasopharyngeal washes and the lung samples would be useful.

Kudos to Mill Hill and WHO for the prompt release of the panel of H1N1 sequences from Ukraine patients.

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