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Houston Fatal and Severe H1N1pdm09 Cases Confirmed
Recombinomics Commentary 20:00
December 19, 2013

Health officials in the houston area are confirming six deaths from h1n1, commonly known as swine flu.

Richard besser is here to explain all that. People hear those numbers and get concerned. It's coming.

We're hearing from houston, six have died. There's more in hospitals that are critical ill.
Breakdown of 20 total cases in the Houston region:
•Eight in Conroe, where four has resulted in deaths and the other four are critically ill
•Ten in other parts of the region where patients are critically ill
•Two deaths in the region

The above comments (in red) are from a transcript of an ABC Good Morning America report, supporting the confirmation of H1N1pdm09 in six fatal cases in the Houston area, as well as many critical cases, which matches the media report with more specifics (in blue).  The cases liked to Conroe as well as the two additional deaths in the region have been mapped.

This cluster of deaths in the Houston raises concerns about sequence changes, such as H274Y Tamiflu resistance, which has been reported in recent clonally expanded sequences from Louisiana and Mississippi (4 and 1, respectively).  The confirmed presence of H274Y in Louisiana raises concerns that H274Y has spread to Texas, where Tamiflu is used as a first line defense.

Similarly, the rapid death of previously healthy young patients raises concerns that the Texas sequences have acquired D225G, which has been associated with severe and fatal H1N1pdm09 cases.  To date, the CDC has released only one H1N1pdm09 sequence, A/Texas/36/2013, from a sample collected from a case (36F) diagnosed this season in Texas.

This absence of sequence data from Texas raises serious surveillance concerns.  Release of sequences from the recent H1N1pdm09 deaths and severe pneumonia cases in eastern Texas (see map) would be useful.

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