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D225G and H274Y in Fatal Infection in France
Recombinomics Commentary 17:30
November 27, 2009

In a statement, the Institute suggests "Reference of mutations in the genome of influenza virus A-H1N1" from these two people who had no relationship and were hospitalized in two different cities. InVS was that for one of these patients, in addition to this mutation, another known mutation that is resistant to Tamiflu, the drug used to treat people infected with the virus.

The above translation describes two fatal cases in France with D225G.  Moreover, one of the two cases also had Tamiflu resistance, presumably H274Y. 

The presence of D225G in unrelated patients at distinct locations mirrors the results in southern California in April, when swine H1N1 was initially reported in the United States. The same strain in two patients who had no link to swine or each other signaled efficient transmission.  The same is true for D225G.  It is in multiple patients in multiple countries and appearing at increasing frequencies at the same time.

The finding of Tamiflu resistance in one of the fatal infections raises additional concerns.  The circumstances surround the resistance would be useful.  The number of reports of H274Y have spiked in the past week, suggesting it too is efficiently spreading at a detectable level.

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