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Ukraine H1N1 Cases Explode - 507 Dead
Recombinomics Commentary 21:25
December 15, 2009

2,690,563 Influenza/ARI

156,272 Hospitalized

507 Dead

The above numbers are from today's Ministry of Health update on the H1N1 situation in Ukraine. Deaths have passed to 500 mark, but the above numbers show a major jump in cases, which are 143,961 higher than yesterday (see map).  Donetsk increased 16,352 to 225,476 and Dnipropetrovsk increased 15,236 to 297,971.  The latest figures extend a reversal of the downturn and clear represent a new wave in Ukraine.  This new wave suggests similar results will be seen in the region, setting the stage for a major peak throughout the northern hemisphere in early 2010.

In addition, media reports said that over 200 fatalities have been H1N1 lab confirmed, setting the stage for a robust sequence database.  Mill Hill released data on 10 isolates at GISAID, which included nine from hard hit western Ukraine in October.  Five of the nine were from nasopharyngeal washes and were similar to isolates from Norway.  However, all four of the HA sequences from fatal cases had D225G.  Similarly, the CDC released data on five cases.  Three matched the Mill Hill data on nasopharyngeal washes, while two were new and were likely fatal cases. Both had D225N, raising concerns that the receptor binding domain changes played a role in the fatal result.  Both of these polymorphisms are rare in pandemic HA sequences at GISAID and Genbank.  Results for other countries highlighted the linkage between RBD changes and fatal or severe outcomes.  However, since changes ar position 225 can alter receptor binding specificity, it would be useful to have multiple samples from these fatal cases.

The more than 200 confirmed fatal cases should lead to a rapid increase in the sequence database from Ukraine.

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