RECOMBINOMICS

[dothedd]

Rapid Spread of H1N1 In Venezuela Increases Concerns
Recombinomics Commentary 15:50
March 29, 2011

The Matthias is one of the 69 confirmed infections in Miranda, but the virus is spread to 18 states: In eight cases are positive Carabobo, Mérida sum 189, Capital District 77, Trujillo 15, 10 Táchira, Lara 7, Guarico , Aragua, Vargas, Yaracuy and Cojedes 5 each, 4 Zulia, Amazonas 3, Nueva Esparta, Anzoátegui, Barinas and two each, and Sucre and a Portuguese.

The above translation describes the rapid spread of H1N1 in Venezuela. These confirmed cases are in addition to four fatal cases and a similar number of suspect cases. It is likely that the outbreak in Venezuela is related to the outbreak in Mexico, which started in Chihuahua, but rapidly spread throughout the country.

The appearance of cases in Mexico at the end of the flu season has remarkable similarities with the start of the H1N1 pandemic two years ago. The current cases in northern Mexico are said to be linked to H1N1 cases in Texas and New Mexico. The CDC has not released any 2011 sequences from either state and only one sequence has been released from Texas for the entire 2011/2011 season. That sequence had S188T, which is the dominant sub-clade in the United States and was also dominant in the H1N1 outbreak in the United Kingdom.

Release of the US sequences is long overdue. Sequences from severe and fatal cases in Mexico and Venezuela should also be released immediately.

[dothedd]

H1N1 Death Toll Grows To Five In Venezuela
Recombinomics Commentary 17:00
March 29, 2011

After being in delicate health conditions of pregnant lady died yesterday at noon, when she was treated in the Intensive Care Unit of Central Hospital, on suspicion of having the H1N1 virus. This was her third pregnancy and her baby also died

Women with 33 weeks of gestation, which was sent to a private center of Columbus died Monday in the ICU. The lady was admitted last Saturday night in the emergency room of the Central Hospital.

For their serious health conditions the same was sent to the hospital ICU where she remained until noon Monday when he died. It was known that his death was caused by the severe respiratory presented, which makes it suspicious of the H1N1 virus.

The above translation describes another death in Venezuela, which is likely to be due to H1N1. If confirmed, this would be the fifth confirmed fatality. However, the number of deaths is significantly higher than the confirmed cases and signals a spike in severe and fatal cases in Venezuela.

Mexico has also seen a spike in cases and five deaths, adding to similarities with the start of the pandemic 2 years ago.

The increases in severe and fatal H1N1 case in Venezuela and Mexico raise concerns that a new sub-clade has emerged, which will be poorly recognized by the current vaccine which targets California/7/2009, which was isolated two years ago. Moreover the 2011 vaccine for the southern hemisphere has the same target, as does the 2011/2012 vaccine for the northern hemisphere.

Release of sequences from 2011 isolates from the United States is long overdue, as are sequences from severe and fatal cases in Mexico and Venezuela.

[dothedd]

Systematic Under-reporting Of H1N1 Tamiflu Resistance
Recombinomics Commentary 19:00
March 30, 2011

Clinically and epidemiologically relevant resistance (>50% of viral quasi-species in the original clinical material harbour the H275Y mutation) are reported weekly in HPA weekly influenza reports, to the European Centre for Disease Prevention and Control (ECDC) via the European Surveillance System (TESSy) and to the World Health Organization (WHO) headquarters and the WHO Regional Office for Europe. Clinical specimens with quasi-species harbouring <50% resistant virus are reported back to clinicians as resistant for patient management but not internationally, according to the agreed WHO strategy (Technical consultation meeting (8 September 2010) proceedings paper under preparation by the WHO).

Only cases with >50% resistant viruses in the sample will be designated resistant and reported publicly, nationally and internationally, by the HPA.
Presumptive (screening) diagnosis of oseltamivir resistance will be reported within HPA and the devolved administrations, but not disseminated further. This will enable the reference laboratory to be aware of all viruses they should be testing for confirmation. Such data will not be used to form the numerator of resistant cases nationally. Treatment outcome in cases with low proportions of resistant virus (<50% H275Y viruses in the sample) may be affected and will be reported to the clinician involved, but will not be reported nationally, in accordance with suggested protocols for reporting to WHO (WHO technical discussion Hong Kong 2010).

The above comments from a Eurosuveillance article or the HPA website describe the failure to report clinical samples with Tamiflu resistance (H274Y) levels below 50%. This high cut-off is little more than a political decision to hide the true levels of H274Y in H1N1 detected in clinical samples. Clinicians are told of the resistance, because a level of 49%, 30%, or even 10% would be little different than a level of 100% because H274Y would jump to 100% in a matter of minutes or hours after the start of Tamiflu treatment. Similarly, high levels of resistance would silently spread from patient to patient because the H1N1 would be considered as Tamiflu sensitive, when sequence data clearly demonstrated the resistance (as a mixture or quasi-species).

Moreover, WHO and consultants would maintain that the appearance of H274Y was “spontaneous” and due to random “copy errors”. This claim was also put forward by Roche, the Tamiflu manufacturer. The “spontaneous” mutation claim did not match the rapid appearance of the resistance. In Singapore a patient switch from Tamiflu sensitive to Tamiflu resistant in two days. Similarly, contacts of confirmed patients would be given prophylactic Tamiflu and develop symptoms 5-6 days later, which was an incubation period that is only slightly longer than wild type. Rapid appearance of resistance in immuno-compromised patients has also been frequently described.

However, in the above instances, the rapid appearance of the resistance was inconsistent with a “spontaneous” mutation or “copy error” which would produced a fully resistant sequences in a much longer time frame (weeks or months).

Unfortunately, these misrepresentations are not limited to H274Y. Other important changes, such as G158E associated with immunological escape, or D225G, associated with a more virulent infection are frequently found as mixtures and grow more efficiently in cells with gal 2,3 receptors such as chicken embryos or human lung. Thus, mixtures can be under-reported in “consensus” sequences or viruses isolated in mammalian cells and selected against these clinically important changes.

The technical considerations can be used to deny transmission of these important changes, and grossly under-represent the levels of these changes in target populations.

Although lab to lab variations, as well as the rapid appearance of Tamiflu resistance made it clear that many of the reported sequences were subjected to heavy bias, the above descriptions indicate this bias was mandated by the WHO and consultants, leading to surveillance reports that hijack science to generate and distribute thinly veiled propaganda pieces.

These propaganda pieces and authors continue to be hazardous to the world’s health.

[dothedd]

Mexico City Starts Chihuahua and Texas H1N1 Traveler Checks
Recombinomics Commentary 22:30
March 30, 2011

Mexico City strengthened its operational check travelers arriving
Chihuahua and Texas by plane or bus, to avoid an outbreak of influenza.

"We don't want one more death in this situation," said Health Secretary Francisco Osuna.

The above translation suggests that the situation in Mexico is markedly worse than the recently reported deaths would indicate. Confirmation of cases has been problematic. The fatal index case was not confirmed, even though he was the partner of a confirmed case, raising concerns that the H1N1 circulating in Mexico represents a sub-clade that has markedly evolved away from the H1N1 reported in earlier isolates in the United States.

The USDA released a series of pandemic H1N1 sequences from swine in Costa Rica collected in November, 2010 which had significantly evolved away from the pandemic H1N1 sequences. These sequences had a number of changes flanking receptor binding domain position 190, raising concerns that the sequences could jump back into humans and could avoid most of immunity generated against the pandemic H1N1 currently circulating in humans.

The recent outbreaks in Mexico and Venezuela appeared at the end of the flu season for the northern hemisphere. In Mexico, most influenza A had been H3N2, but levels had peaked in late 2010. Recent activity, prior to the current outbreak had been minimal.

The recent cases have produced an unusually high number of severe and fatal cases, which may account for the extraordinary travel checks in Mexico City. Although these types of checks are unlikely to be successful, the implementation of such actions gives the appearance of control, which is also true for the decision to begin a massive vaccination program. Vaccinations were tried in 2009, but had no effect because the seasonal H1N1 was very different from pandemic H1N1.

The same would be true for the Costa Rica swine, which had a large number of receptor binding domain changes. The jump of pandemic H1N1 back to swine allows for dramatic evolution, driven by recombination, as described for the Costa Rican swine.

Release of sequences from the cases in Mexico and Venezuela is now overdue.

[jarhead1976]

So Glad I have the vaccine, I think. Great info dothedd.

[dothedd]

Morning JH:

K4U JH, for recognizing the value in this thread.

Just the facts folks!

DTDD


JH:

I just posted an update below ... NOTE: The latest data from Europe raises concerns that the rapidly evolving H1N1 will lead to vaccine failures and rapid spread of novel sub-clade, such as the recently reported activity in Mexico and Venezuela.

[dothedd]

H1N1 Deaths Spread To Baja California
Recombinomics Commentary 00:50
March 31, 2011


In Low California, José Bustamante Moreno, secretary of Health, said that two sick patients have presented himself; one of them died

The above translation describes an H1N1 death in Baja, California. Like Chihuahua, the dead and severe cases represent a large percentage of detected cases. Media reports in Mexico are now starting to mention multiple “mutations” which again suggests that the H1N1 has evolved considerably.

The sequences from swine in Costa Rica as well as a large array of reassortants (primarily H1N2) which have swapped genes with pandemic H1N1 raise concerns of additional jumps back to human. This likelihood is increased because the genes circulating in swine have circulated previously in humans.

The Costa Rica swine sequences had pandemic H1 and N1, but there were many changes that would create serotyping issues and would have limited cross reactivity with protective antibodies.

This recent history, coupled with the large number of severe and fatal cases in Mexico, relative to the total number of cases identified raises, concerns that an evolved sub-clade has jumped back to humans from swine.

The appearance of this sub-clade would be likely to happen at this time of year for the same reasons the 2009 pandemic began in late season. Competing flu genomes are declining now in the northern hemisphere, creating an environment favorable for the emergence of a new sub-clade.

This level of concern has led to travel checks on those arriving in Mexico City from Chihuahua and Texas. However, the H1N1 has already spread throughout Mexico, so such checks are unlikely to succeed.

Release of sequences from the outbreaks in Mexico and Venezuela is now overdue.

[dothedd]

S188T Low Reactors In European H1N1
Recombinomics Commentary 02:30
March 31, 2011

Mill Hill has released 32 HA sequences (at GISAID) from H1N1 isolates largely collected from patients in Europe between late December 2010 and February 2011. 27 of the sequences had S188T, while another had S186P, consistent will earlier reports demonstrating the dominance of the sub-clade containing S188T. However, 18 of the sequences (56% of total), also had a change a positions 56-59 (2, 3, 10, 3 respectively) signaling “low reactor” status. These changes, in addition to S188T, strongly suggested that H1N1 was rapidly evolving away from immunological responses direct to wild type sequences or the 2009 or 2009/2010 H1N1 vaccine target (A/California/7/2009). However, 17 of the 18 changes were present as mixtures (quasi-species) which may be modulated by isolation techniques. The high level of low reactor sequences as mixtures was also seen in recent sequences from Germany.

Moreover, there were also 7 changes at positions 225 and 226 (D225G, D225N, Q226R) in the latest sequences, signaling additional evolution at key positions in the receptor binding domain.

Multiple assays and labs have shown that these changes can lead to increased growth in cells with gal 2,3 receptors such as chicken embryos in eggs or human lung. Thus, the high frequencies reported in the recent isolates may be present in collections made by other labs which use mammalian cells to isolate virus for sequencing.

Recent reports indicated that WHO affiliated labs do not report H274Y mixtures (Tamiflu resistance) when mixtures represent less than 50% of the signal. It is unclear if this under-reporting for H274Y extends to the mixed signals for the markers described above.

The increased evolution of the recent sequences in Europe may play a role in the emerging H1N1 in Mexico and Venezuela. H274Y would lead to poor responses to Tamiflu treatment, and additional changes may target the patient’s lung, producing a poor prognosis.

Recent sequences from the United States have not been released by the CDC. H3N2 and influenza B sequences from 2011 were released last week, but the last release for H1N1 sequences was February 2, 2011, and most of those sequences were collected prior to 2011.

The latest data from Europe raises concerns that the rapidly evolving H1N1 will lead to vaccine failures and rapid spread of novel sub-clade, such as the recently reported activity in Mexico and Venezuela.

Release of sequences from the United States, Mexico, and Venezuela is overdue.

[jarhead1976]

Like most life forms you have to adapt and overcome or they die .. That is exactly what this virus does. Every time it infects one host, man or animal, it is exposed to one more variable. Having raised hogs we can only hope exposure produces some natural immunity. The term genetic drift comes to mind found in the natural theory of molecular evolution!

[dothedd]

JH:

I grew up on a farm and I too understand natural immunity. However, it's the bio-weapons that are of concern to me. That said, I don't spend a lot of time fretting over things that are not in my control.

H5N1 is the one of CONCERN.

The following are an interesting read:

Baxter [Pharma] Caught Shipping Vaccines With Live Avian Flu Virus To 18 Countries Worldwide

Czech newspapers are questioning if the shocking discovery of vaccines contaminated with the deadly avian flu virus which were distributed to 18 countries by the American company Baxter were part of a conspiracy to provoke a pandemic.

The claim holds weight because, according to the very laboratory protocols that are routine for vaccine makers, mixing a live virus biological weapon with vaccine material by accident is virtually impossible.

“The company that released contaminated flu virus material from a plant in Austria confirmed Friday that the experimental product contained live H5N1 avian flu viruses,” reports the Canadian Press.

Baxter flu vaccines contaminated with H5N1 - otherwise known as the human form of avian flu, one of the most deadly biological weapons on earth with a 60% kill rate - were received by labs in the Czech Republic, Germany, and Slovenia.

Initially, Baxter attempted to stonewall questions by invoking “trade secrets” and refused to reveal how the vaccines were contaminated with H5N1. After increased pressure they then claimed that pure H5N1 batches were sent by accident. This was seemingly an attempt to quickly change the story and hide the fact that the accidental contamination of a vaccine with a deadly biological agent like avian flu is virtually impossible and the only way it could have happened was by wilful gross criminal negligence.

“Was this just a criminal negligence or it was an attempt to provoke pandemia using vaccination against flu to spread the disease - as happened with the anti-B hepatitis vaccination with vaccines containing the HIV virus in US? - and then cash for the vaccines against H5N1 which Baxter develops? How could on Earth a virus as H5N1 come to the ordinary flu vaccines? Don’t they follow even basic precautions in the american pharma companies?” states the translation.

The fact that Baxter mixed the deadly H5N1 virus with a mix of H3N2 seasonal flu viruses is the smoking gun. The H5N1 virus on its own has killed hundreds of people, but it is less airborne and more restricted in the ease with which it can spread. However, when combined with seasonal flu viruses, which as everyone knows are super-airborne and easily spread, the effect is a potent, super-airbone, super deadly biological weapon.

As the Canadian Press article explains, “While H5N1 doesn’t easily infect people, H3N2 viruses do. If someone exposed to a mixture of the two had been simultaneously infected with both strains, he or she could have served as an incubator for a hybrid virus able to transmit easily to and among people.”

There can be little doubt therefore that this was a deliberate attempt to weaponize the H5N1 virus to its most potent extreme and distribute it via conventional flu vaccines to the population who would then infect others to a devastating degree as the disease went airborne.

The Canadian Press article states, “That mixing process, called reassortment, is one of two ways pandemic viruses are created,” but then claims that there is no evidence that this is what Baxter were doing, despite there being no clear explanation as to why Baxter has samples of the live avian flu virus on its premises in the first place.

However, to reiterate, the key aspect of this story is that it is virtually impossible for live avian flu virus to find its way into a vaccine by “accident”.

As health expert Mike Adams points out, “The shocking answer is that this couldn’t have been an accident. Why? Because Baxter International adheres to something called BSL3 (Biosafety Level 3) - a set of laboratory safety protocols that prevent the cross-contamination of materials.

As explained on Wikipedia (http://en.wikipedia.org/wiki/Biosaf…):

“Laboratory personnel have specific training in handling pathogenic and potentially lethal agents, and are supervised by competent scientists who are experienced in working with these agents. This is considered a neutral or warm zone. All procedures involving the manipulation of infectious materials are conducted within biological safety cabinets or other physical containment devices, or by personnel wearing appropriate personal protective clothing and equipment. The laboratory has special engineering and design features.”

Under the BSL3 code of conduct, it is impossible for live avian flu viruses to contaminate production vaccine materials that are shipped out to vendors around the world.

This leaves only two possibilities that explain these events:
Possibility #1: Baxter isn’t following BSL3 safety guidelines or is so sloppy in following them that it can make monumental mistakes that threaten the safety of the entire human race. And if that’s the case, then why are we injecting our children with vaccines made from Baxter’s materials?

Possibility #2: A rogue employee (or an evil plot from the top management) is present at Baxter, whereby live avian flu viruses were intentionally placed into the vaccine materials in the hope that such materials might be injected into humans and set off a global bird flu pandemic.

Experimentation of human beings is becoming the norm throughout the world by Pharamceuticals companies who hold profits over safety. A recent report in the Telegraph covered the trials in Poland which killed 21 people. The medical staff, from the northern town of Grudziadz, are being investigated over medical trials on as many as 350 homeless and poor people last year, which prosecutors say involved an untried vaccine to the highly-contagious virus.

Authorities claim that the alleged victims received £1-2 to be tested with what they thought was a conventional flu vaccine but, according to investigators, was actually an anti bird-flu drug.

The director of a Grudziadz homeless centre, Mieczyslaw Waclawski, told a Polish newspaper that last year, 21 people from his centre died, a figure well above the average of about eight.

Spreading bird flu would create an instantaneous surge of demand for bird flu vaccines. The profits that vaccine companies such as Baxter International could reap out of such a panic are astronomical.

In addition, as we have previously reported, those that have a stake in the Tamiflu vaccine include top globalists and BIlderberg members like George Shultz, Lodewijk J.R. de Vink and former Secretary of Defense Donald Rumsfeld.

Authorities in both Europe and the U.S. have openly detailed plans for martial law, quarantine and internment should a bird flu pandemic occur.

The other motivation, as we have exhaustively documented on this website for years, is the fact that elites throughout history have openly stated that they want to see a world population reduction of around 80 per cent. Shocking stories like this take the plausibility of that narrative out of the realms of conspiracy theory and into the dangerous reality of conspiracy fact.

“Baxter is acting a whole lot like a biological terrorism organization these days, sending deadly viral samples around the world. If you mail an envelope full of anthrax to your Senator, you get arrested as a terrorist. So why is Baxter — which mailed samples of a far more deadly viral strain to labs around the world — getting away with saying, essentially, “Oops?”, Adams conclude

This is not the first time that vaccine companies have been caught distributing vaccines contaminated with deadly viruses.

In 2006 it was revealed that Bayer Corporation had discovered that their injection drug, which was used by hemophiliacs, was contaminated with the HIV virus. Internal documents prove that after they positively knew that the drug was contaminated, they took it off the U.S. market only to it on the European, Asian and Latin American markets, knowingly exposing thousands, most of them children, to the live HIV virus. Government officials in France went to prison for allowing the drug to be distributed. The documents show that the FDA colluded with Bayer to cover-up the scandal and allowed the deadly drug to be distributed globally. No Bayer executives ever faced arrest or prosecution in the United States.

May 17, 2009

A Lethal Mixture: Swine and Bird Flu. Can We Trust Baxter, GSK and the WHO?

By John Stone

The most recent paroxysm in the swine flu saga begs some interesting questions which scarcely ought to be swept aside. Last week veteran Australian scientist, Adrian Gibbs, author of 250 peer review studies raised the issue whether H1N1 virus could have been created in a lab error. Of course, denials were rapid. ABC News reported (HERE.)

“"Technically it's plausible but not likely," (said) Christopher Ohl, an associate professor of medicine at Wake Forest University School of Medicine, and a specialist in infectious diseases.

“"In this case I'm not concerned that this virus represents anything other than a naturally occurring mixture of viruses happening in nature," concluded Dr. Julie Gerberding, an infectious disease expert and the former director of the CDC...

“Regardless of the validity of Gibb's claims, he and several experts say that just bringing the idea of laboratory security to the public's attention is important.

“ "There are lives at risk," Gibbs said. "The sooner this idea gets out, the better."

“In 2001, foot-and-mouth disease led to the slaughter of more than 6 million animals, all after a vial went missing from a research laboratory in the United Kingdom.

“Since then, however, experts said lab security and regulations have been getting tighter and better.

“"Laboratories have a lot of security from having this happen, and it's very unlikely," Ohl said of the new theory about swine flu's origin.”

But have things improved since 2001? Probably the scariest story this year has so far been overlooked by the media at large. On February 27 an article appeared in the Toronto Sun by Helen Branwell, ‘Baxter: Product contained live bird flu virus’ (HERE.)

“The company that released contaminated flu virus material from a plant in Austria confirmed Friday that the experimental product contained live H5N1 avian flu viruses.
“And an official of the World Health Organization’s European operation said the body is closely monitoring the investigation into the events that took place at Baxter International’s research facility in Orth-Donau, Austria.

““At this juncture we are confident in saying that public health and occupational risk is minimal at present,” medical officer Roberta Andraghetti said from Copenhagen, Denmark.

““But what remains unanswered are the circumstances surrounding the incident in the Baxter facility in Orth-Donau.”

“The contaminated product, a mix of H3N2 seasonal flu viruses and unlabelled H5N1 viruses, was supplied to an Austrian research company. The Austrian firm, Avir Green Hills Biotechnology, then sent portions of it to sub-contractors in the Czech Republic, Slovenia and Germany.

“The contamination incident, which is being investigated by the four European countries, came to light when the subcontractor in the Czech Republic inoculated ferrets with the product and they died. Ferrets shouldn’t die from exposure to human H3N2 flu viruses...”
According to science columnist Mark Henderson writing in the London Times on May 4, the real danger from the new swine flu virus H1N1 would be if it combined with the previous big viral scare, avian flu H5N1:

"The biggest worry would be if a person or a pig became infected with both swine flu and H5N1 avian flu at the same time. As the former is highly transmissible but does not appear to be particularly lethal, while the latter is highly virulent but does not spread easily, a reassortment between the two could generate a very dangerous strain."

Of course, it would not be wise on its own to take anything Henderson says too seriously, bearing in mind his boss is a director of pharmaceutical giant GlaxoSmithKline (HERE) and he is associated with the pharmaceutical lobby organisation Sense About Science (HERE.) However, bearing in mind the Toronto Sun story of February it is not exactly encouraging that WHO and the CDC have chosen Baxter as well as GlaxoSmithKline to develop a vaccine against H1N1 (HERE.)

So many aspects of these stories are not re-assuring. There have been no further reports on the Baxter bird flu fiasco since February, which at best sounds like criminal negligence of a high order – meanwhile the WHO and CDC remain silent. Health officials have failed to deny that the swine flu virus could have been created in a laboratory, but merely claim that such a security lapse is unlikely, when we know a much worse one occurred within the last 3 months. And Julie Gerberding, out-going director of CDC, fails to deny that swine flu is man-made but only tells us that she is “not concerned”.

John Stone, based in London, is a Contributing Editor to Age of Autism.

www.ageofautism.com/2009/05/a-lethal-mixture-swine-and-bird-flu-can-we-trust-baxter-gsk-and-the-who.html

[dothedd]

Rapid H1N1 Evolution In Mexico Raises Pandemic Concerns
Recombinomics Commentary 18:30
March 31, 2011


The virus has experienced a multiple mutation

The official said that so far it is a probable theory in which the human influenza virus has mutated or have features of two different viruses

The above translation describing the H1N1 in Mexico increases concerns that the circulating virus is a sub-clade that has evolved away from the pandemic H1N1 which was initially reported 2 years ago (the first confirmed cases in the United States were identified with samples collected on March 30, 2009 and today, 2009). In addition to the cases in southern California, Mexico was reporting fatal atypical pneumonia cases that were poorly characterized, in part because the H1N1 was of swine origin and failed to react with sub-typing reagents directed at human flu sequences.

This year there have also been problems with lab confirmation. The index case (26M) died with swine flu symptoms, but H1N1 was not confirmed. In contrast, his partner (33M) also died with swine flu symptoms, but H1N1 was confirmed. These difficulties can be due to an evolved H1N1 which reacts poorly with reagents directed against earlier H1N1 isolates.

Recently the USDA released sequences from a series of swine isolates from Costa Rica. These were pandemic H1N1 sequences, but had significant evolution away from the sequences commonly found in human cases. The Costa Rica sequences had a number of changes flanking the receptor binding position at position 190 and would likely evade immune responses to earlier infections or vaccinations. The Costa Rica had a large number of synonymous and non-synonymous changes, which could have reduced the sensitivity of testing reagents leading to false negatives as seen in the index case.

Moreover, a high percentage of reported cases have died or have been hospitalized, raising concerns that the current H1N1 circulating in Mexico is more virulent than earlier sub-clades.

The comments translated above suggest that initial sequencing on severe and fatal cases has been completed.

Release of these sequences is overdue.

[jarhead1976]

Dothedd good morning, I am only just getting your point! Thank you for the information. I think what you are saying is that "global biological terrorism" has started. Once again greed over the value of human life seems apparent. With everything else going on in the world . Financial terrorist , controlling the stock market. Instability in the middle east , japan in total melt down I see your point about not worrying about things not in my control! . Remarkable information ... Respects.

[dothedd]

DITTO ... YOU GOT IT!

K4U

[dothedd]

P.S.

I'm dedicated to enjoying what is left -- and my time setting at my computer posting about it will soon come to an end. In the meantime ... I'm flying out of Dodge in a couple of weeks for a month, [perhaps +], so my posts will be 'few' during that time.

God bless,

BATTRINA!

[dothedd]

H1N1 Death Cluster Grows In Juarez MexicoTraffic Department
Recombinomics Commentary 03:05
April 1, 2011

Corners, head of the Sanitary District, announced that it raised the rate of people with human influenza virus H1N1 positive nine people, including also became known unofficially as 3 elements of the Municipal Traffic Division are hospitalized due to be infected the virus, while it was mentioned that one of them is in intensive care fighting for his life.

It should be noted that the information unofficially, he explained that the three elements, besides the two who lost their lives, are assigned to East Station.

The above translation indicates that the H1N1 cluster at the Juarez traffic division continues to grow. In addition to the two fatalities, three more cases have been announced, including one in critical conditions. All five cases are from the same station. These cases demonstrate the high rate of severe and fatal cases, again suggesting that the H1N1 in Mexico is a novel sub-clade. The high rate of severe and fatal cases extends to confirmed cases in the northern Mexico state of Chihuahua.

Recent media reports suggest that the sequences have a large number of changes, which may explain the difficulty in diagnosis these cases beyond atypical pneumonia as well as confirming the H1N1 infection in the index case (26M). His partner (33M) also died, but H1N1 was lab confirmed.

The spread of this strain in Texas and New Mexico is not clear. Only one H1N1 sequence from Texas has been made public and it was collected on November 30. It is likely that the cases in northern Mexico as well as adjacent states in the US have distinctive changes, signaling a new sub-clade. The CDC has withheld H1N1 sequences from the US. The last release for H1N1 sequences was February 2, 2011, although H3n2 and influenza B sequences (largely from 2011) were released by the CDC over a week ago.

The release of the US and Mexico H1N1 sequences from severe and fatal cases is long overdue.

[dothedd]

H1N1 Spreads to Puebla Near Mexico City
Recombinomics Commentary 18:50
April 1, 2011

The Mexican state of Puebla, east of the capital, three cases of influenza A H1N1, officials said.

Chedraui Jorge Aguilar, head of the state Health Department confirmed the cases as part of a resurgence of the disease.

The above translation describes the confirmation of the cases of H1N1 in Puebla, just east of Mexico City, raising concerns that the H1N1 will rapidly spread in the capital.

The emergence of h1n1 at this time of the year is unusual because the flu season in Mexico was ending. H3N2 dominated but peaked in late 2010 and the level of influenza was low and declining prior to the recent upsurge, first reported in Juarez in Chihuahua. Similarly, influenza levels in the United States were also declining and the H1N1 in the US did not produce high levels of H1N1 in northern Mexico.

The surge in cases at this time of year matches events in 2009 when the H1N1 pandemic emerged between mid-March and early April. Like 2011, the initial cases were difficult to characterize and cases were diagnosed as atypical pneumonia.

Although lab confirmations are still problematic, the atypical pneumonia cases generate a high hospitalization and death rate raising concerns that the H1N1 has significantly evolved and is now harder to detect and is producing more severe illness.

The CDC has withheld 2011 H1N1 sequence from the US, and Mexico has not released sequences from recent severe and fatal cases.

The time for release of these sequences is long overdue.

[dothedd]

H1N1 Spreads to El Salvador
Recombinomics Commentary 06:10
April 2, 2011

The Deputy Minister for Health Policy, Eduardo Espinoza, today confirmed a third case of H1N1 flu.

"Indeed, it was reported the third case. Antiguo Cuscatlan and is consulted at the Department of Health Barrios is a female person, 36 years, "explained Evans.

The first reported case this year was a minor (3 years), treated at the Hospital Bloom, while in the second, reported last week, it was a woman of 43 years.

The above translation describes the spread of H1N1 to El Salvador.
Like for Mexico and Venezuela, the beginning of April is an unlikely time for an increase in influenza activity. It is late for the northern hemisphere season and early for the southern hemisphere season.
Increases in H1N1 in El Salvador are almost certainly linked to the increased activity in Mexico to the north and Venezuela to the south.

The new sub-clade is quickly spreading throughout North and South America. Trinidad and Tobago has issued an alert and other countries will soon follow suit.

There have been difficulties in confirming and sub-typing this new sub-clade, so the number of cases is grossly under-represented by lab confirmed cases.

Anecdotal reports describe increases in atypical pneumonia deaths, which are difficult to confirm. The above translation reports an increase in frequency of confirmed H1N1 cases, and these numbers are expect to rise sharply in the near term.

Release of sequences from these cases as well as severe and fatal cases in Mexico and Venezuela is useful. The release of 2011 H1N1 sequences from the United States is long overdue.

[dothedd]

Mexico Reviews Atypical Pneumonia Deaths
Recombinomics Commentary 18:15
April 2, 2011

the doctors said that to expand their prevention efforts on Monday will begin a special review of death certificates issued by the Registry Office in recent weeks and whose causes are accentuated acute respiratory infections.

This, he notes, as a way to verify that all suspected cases have been addressed, thus ensuring that in case some find it questionable death, initiated investigation into the matter and, if necessary, implement special actions in a certain region.

The above translation describes the review of recent pneumonia deaths in Mexico. The H1N1 index case in Juarez was diagnosed as atypical pneumonia and not H1N1 confirmed. Subsequent cases, including his partner, were also diagnosed as atypical pneumonia, signaling an evolved H1N1 that is not easily detected with routine testing. The rapid evolution has been mentioned in media reports.

The pneumonia deaths also signal targeting of lungs, which can also limit lab confirmation since most samples are from the upper respiratory tract. The lung targeting leads to more severe and fatal cases as well as difficulties in treating these cases, as was seen in cases with D225G.

The emphasis on death certificates raises concerns that the number of deaths is markedly higher than the lab confirmed cases and the spread of the H1N1 is greater than indicated by the confirmed cases.

These latest developments highlight the seriousness of the outbreak and require the immediate release of sequences from these cases.

[dothedd]

Novel H1N1 Sub-clade In Chihuahua Mexico
Recombinomics Commentary 14:50
April 3, 2011

The instituto de Diagnostico y Referencia Epidemiologicos in Mexico has released three sets of sequences (at Genbank) from patients in Chihuahua, Mexico, including the fatal case (36M) from the Juarez traffic station, A/Mexico/InDRE1945/2011. All three HA sequences (A/Mexico/InDRE1946/2011 and A/Mexico/InDRE1947/2011) are closely related to each other and have S165N and A189T, which is also found in recent (2011) isolates in the US. Earlier sequences with these markers were circulating in Galicia, Spain a year ago.


The sequence from the fatal case also has D225N, which is a change associated with Ukraine and Russian fatalities in 2009 (and was frequently found in association with D225G).


It is likely that this emerging sub-clade is present throughout Mexico and Venezuela, but only the three sequence from Chihuahua have been released thus far.


More sequences from severe and fatal cases in Mexico and Venezuala, as well as 2011 sequences from the US, which have been withheld by the CDC, would be useful.

[dothedd]

Withheld Novel H1N1 Sequences Raise Pandemic Concerns
Recombinomics Commentary 02:05
April 4, 2011

The recently released sequences from Chihuahua, Mexico identify an emerging sub-clade that appears to have spread throughout Mexico, Venezuela, and multiple countries in Central and South America. This new sub-clade is associated with a high frequency of severe and fatal cases, which may be linked to the D225N found in the fatal case (but not the two other sequences from Chihuahua).

This sub-clade was circulating in the spring is 2010 in Galicia, Spain, and was also in a few additional sequences (from Cape Town, A/CapeTown/29/2010 and El Salvador, A/El Salvador/798/2010). This sub-clade was also seen in 2011 sequences from the United States (A/Arizona/AF21768/2011, A/Florida/AF21771/2011, A/New Jersey/AF21791/2011, A/North Carolina/AF21796/2011, A/South Carolina/AF21803/2011). These recent sequences were released by the Air Force as part of their surveillance program of military personnel and dependents.

However, the distribution of this sub-clade in the United States in 2011 is not well understood because the CDC has withheld its collection of 2011 sequences from the United States. Its last release of pH1N1 from the US was February 2, 2011 and was largely composed of sequences from samples collected in 2010.

In the past 9 weeks, the US pneumonia and influenza death rate has been at or above the epidemic threshold. Reports of atypical pneumonia and a high hospitalization and death rate linked to the sub-clade in Chihuahua has raised concerns that this sub-clade has contributed to the high P&I rate reported in the United States and the sub-clade may emerge as a significant problem. Some of the Chihuahua cases were epidemiologically linked to travel from New Mexico and Texas, increasing concerns that this sub-clade may be emerging in the United States also and may be considerably more common and widespread than represented by the Air Force samples, which did not include any sequences from Texas or New Mexico.

The CDC should release its 2011 H1N1 sequences and the Air Force should release 2011 H1N1 sequences from Texas, where the program is based (Brooks AFB).

[dothedd]

Withheld Novel H1N1 Sequences Raise Pandemic Concerns
Recombinomics Commentary 02:05
April 4, 2011


The recently released sequences from Chihuahua, Mexico identify an emerging sub-clade that appears to have spread throughout Mexico, Venezuela, and multiple countries in Central and South America. This new sub-clade is associated with a high frequency of severe and fatal cases, which may be linked to the D225N found in the fatal case (but not the two other sequences from Chihuahua).

This sub-clade was circulating in the spring is 2010 in Galicia, Spain, and was also in a few additional sequences (from Cape Town, A/CapeTown/29/2010 and El Salvador, A/El Salvador/798/2010). This sub-clade was also seen in 2011 sequences from the United States (A/Arizona/AF21768/2011, A/Florida/AF21771/2011, A/New Jersey/AF21791/2011, A/North Carolina/AF21796/2011, A/South Carolina/AF21803/2011). These recent sequences were released by the Air Force as part of their surveillance program of military personnel and dependents.

However, the distribution of this sub-clade in the United States in 2011 is not well understood because the CDC has withheld its collection of 2011 sequences from the United States. Its last release of pH1N1 from the US was February 2, 2011 and was largely composed of sequences from samples collected in 2010.

In the past 9 weeks, the US pneumonia and influenza death rate has been at or above the epidemic threshold. Reports of atypical pneumonia and a high hospitalization and death rate linked to the sub-clade in Chihuahua has raised concerns that this sub-clade has contributed to the high P&I rate reported in the United States and the sub-clade may emerge as a significant problem. Some of the Chihuahua cases were epidemiologically linked to travel from New Mexico and Texas, increasing concerns that this sub-clade may be emerging in the United States also and may be considerably more common and widespread than represented by the Air Force samples, which did not include any sequences from Texas or New Mexico.

The CDC should release its 2011 H1N1 sequences and the Air Force should release 2011 H1N1 sequences from Texas, where the program is based (Brooks AFB).

[dothedd]

Novel Chihuahua H1N1 Sub-clade In Pennsylvania With D225G
Recombinomics Commentary 20:50
April 5, 2011


The recently released sequences from Chihuahua, Mexico have raised concerns that the re-emerging sub-clade would rapidly spread and cause more severe disease. The sub-clade has one receptor binding domain (RBD) change, A189T, as well as three additional non-synonymous changes (N34D, S165N, and V275I).

The concerns were increased by the presence of D225N in the sequence, A/Mexico/InDRE1945/2011, from a fatal case (36M). This case was part of a cluster in the traffic department in Juarez. The partner of the above case also died, and a third co-worker was in critical condition, raising concerns that the D225N was linked to this cluster and c`ause the severe and fatal cases.

The above sub-clade was seen in a small number of human cases in the US in the spring of 2010. However, in addition to the spring cases, one isolate from August, A/Pennsylvania/07/2010, was more closely related to the Chihuahua sub-clade. The clinical status of the case (23F) was not known, but the sequence has D225G. Previously, sequences from autopsy lung samples collected in Ukraine in 2009 had a high frequency of D225G and D225N, raising concerns that the emergence of a sub-clade with a high frequency of isolates with these changes would lead to an increase in severe and fatal case.

Moreover, these changes may lead to immunological escape which would drive the spread of this sub-clade.

The current extent of spread in the US is not known. Recently the Air Force released 2011 H1N1 sequences from military personnel and dependents. This sub-clade was present in cases found throughout the US (NJ, NC, SC, FL, AZ). However, sequences from Texas were not released by the Air Force, and the CDC has withheld the release of 2011 isolates from patients throughout the US. Epimiological data links the outbreak in Chihuahua with travel from New Mexico and Texas.

The sub-clades with A189T and an additional change at position 225 (D225G or D225N) have parallels with the emergence of H3N2 with adamantine resistance. The H3N2 sub-clade was characterized by S193F and D225G. Moreover, the co-circulation of the S188T and A189T sub-clades could lead to sequences with both RBD changes, which have been seen in recent sequences from North Carolina (A/North Carolina/AF21793/2010) and the country of Georgia (A/Georgia/51/2011).

Therefore release of 2011 sequences from severe and fatal cases in the United States, as well as Mexico and Venezuela is overdue.

[dothedd]

Severe and Fatal H1N1 Cases Increase In Chihuahua Mexico
Recombinomics Commentary 01:30

April 7, 2011

Of the 45 people, 7 are in stable clinical condition, 3 are serious, 6 have died, 10 are hospitalized and 29 are recovering at home.

24 people have been reported in hospitals in the Health Services Chihuahua, four in hospitals belonging to the Chihuahua Institute of Health, one was attended in the ISSSTE, 11 by the IMSS and 5 in private clinics.

The municipalities that have more cases are Chihuahua and Ciudad Juarez with 17 to 28 respectively .

The above translation describes the 45 lab confirmed H1N1 cases in Chihuahua, Mexico. Not included is the first fatality (26M) who was the partner of the first lab confirmed fatality (36M). These two fatalities were part of a cluster of cases in the traffic department in Juarez, which also included a critical case. The HA and NA sequences from the fatal case (36M) were recently released and the HA sequence, A/Mexico/InDRE1945/2011, contains D225N. Two other HA sequences, (A/Mexico/InDRE1946/2011 and A/Mexico/InDRE1947/2011), from nonfatal cases were also released. They were closely related to the fatal case, but neither had D225N. One exactly matched with fatal cases with the exception of D225N. The other sequence had two synonymous differences. Thus, at the protein level all three sequences were identical, other than the presence of D225N in the fatal case. One of the newly acquire polymorphisms in this sub-clade was A189T.

Thus, there major sub-clade circulating in North America had S186P, S188T, or A189T. The changes, which are adjacent to receptor binding position 190 are similar to changes in seasonal H1N1 which emerged in 2008. Virtually all isolates had A193T along with at least one change at positions 187, 189, or 196, raising concerns that the changes in pandemic H1N1 will facilitate immunological escape.

In the fatal case, the combination of A189T with D225N is similar to the H3N2 combination of S193F and D225N, which is the combination that drove the fixing of adamantine resistance (S31N in M2) and has been dominant in H3N2 ever since.. Thus, the H1N1 combination may lead to dominance of that sub-clade, and D225N on a pandemic H1N1 background may lead to more severe and fatal cases as seen in the recently released sequence. Moreover, the presence of D225N in the nasopharyngeal swab sample may signal increased transmission. In the Ukraine, D225N and D225N were frequently detected in lung autopsy samples.

The high frequency of hospitalized and fatal cases is supported by the above figures for Chihuahua. More sequences from these severe and fatal cases would be useful.

[dothedd]

Novel H1N1 With D225N Raises Pandemic Concerns
Recombinomics Commentary 13:05
April 7, 2011

The steady increase in severe and fatal cases in Chihuahua, Mexico raises concerns that a novel H1N1 sub-clade is spreading throughout the Americas and worldwide. The increase in cases in Mexico at the end of the flu season has striking parallels with the 2009 outbreak. The decline in H3N2 cases creates an opportunity for variants to arise and become dominant, which was supported by the recently released sequences from patients in Chihuahua.

Of greatest concern was the presence of D225N in the H1N1 sequence from the fatal case (36M), A/Mexico/InDRE1945/2011, from the traffic department. The index case for the cluster was the partner of the above case and was diagnosed as a fatal atypical pneumonia. The failure to identify influenza A or H1N1 increased concerns that the sub-clade was generating false negatives. Reports indicate at least one additional co-worker was in critical condition, signaling transmission of a deadly sub-clade. This was supported by the presence of D225N in the sample which was from the upper respiratory tract (nasopharyngeal swab).

The other two HA sequences (A/Mexico/InDRE1946/2011 and A/Mexico/InDRE1947/2011) lacked D225N, but were otherwise identical to the above sequence at the protein level. The sequence had A189T, a receptor binding domain change that may be linked to immunological escape. Similar changes were seen in the 2008 seasonal H1N1 sequences evolving away from the immunological response to Brisbane/59/2007, which raises concerns that the aggressive vaccine campaign initiated in Mexico and Venezuela will have limited effect. The current H1N1 target is California/7/2009, and a number of studies indicated the current H1N1 has evolved away from that sequence.

Anecdotal reports cite additional examples of D225N in severe and fatal cases, raising concerns that this sub-clade transmits. The emergence of the current H3N2 sub-clade involved the acquisition of two similar changes, S189F and D225N. Thus, D225N on the appropriate influenza genetic background readily transmits in humans, and the novel sub-clade in Chihuahua has A189T coupled withD225N in the fatal case.

The 2011 H1N1 from the United States has been withheld by the CDC. A small series released by the Air Force indicated the novel sub-clade was widespread in the United States, although the 2011 sequences lacked D225N. However, a closely related 2010 sequence from Pennsylvania, A/Pennsylvania/07/2010, had D225G, which has been linked to severe and fatal H1N1 cases.

Release of 2011 H1N1 sequences from the United States, including Texas and New Mexico, is long overdue

[dothedd]

Emergence of Novel H1N1 In the United States in 2011
Recombinomics Commentary 15:35
April 7, 2011


Savannah McCann came home from Desert Hills Elementary the morning of Jan. 18 after vomiting, and had spent the rest of the week resting, with an occasional cough and fever, under her family's and doctor's care.

It was about 10 minutes after her father got home from work Saturday that the third-grader suddenly said she was having trouble breathing. "We called 911," her father, Brent McCann said Tuesday. "Her breathing got more and more shallow."

Just 15 minutes after her first complaint, she had died.


"She took her last breath as the EMTs walked in," said her mother, Melanie McCann.

The little girl was taken to MountainView Regional Medical Center and given heavy doses of epinephrine, but the efforts failed to revive her. Doctors said the influenza mutation appeared to have suddenly attacked Savannah's liver, kidneys and brain, her mother said.

"She had no other health issues, none, that's how absolutely awful that virus is," Melanie McCann said.

The above comments describe the fatal H1N1 infection of an 8 year old girl in Las Cruces, New Mexico in January, 2011, raising concerns that the novel sub-clade circulating in Juarez, Mexico was previously circulating in the United States. The Chihuahua outbreak has been epidemiologically linked to travelers from Las Cruces, New Mexico and Odessa, Texas indicating the sub-clade was present in the southern United States prior to the March outbreak in Chihuahua. Additional sequence data from military personnel and dependents also identified the sub-clade in multiple states in early 2011 including New Jersey, North Carolina, South Carolina, Florida, and Arizona. Moreover, the most recent 2010 United States isolate was from Pennsylvania, which had D225G.

Pennsylvania has reported the highest number of influenza deaths in the country. However, many were reported as unsubtypable. However, the week 13 report has a dramatic jump in H1N1 cases in the Pittsburgh (Allegheny County) and Philadelphia metropolitan areas, with 1603 and 934 respectively, in contrast to week 10 numbers, which showed 93 and 24. This dramatic change may be more related to testing than to new cases and may be linked to data from Chihuahua, where initially testing failed to identify H1N1 (cases were initially described as atypical pneumonia and index case was not H1N1 confirmed, although the case’s partner was also fatally infected and confirmed).

Thus, the emerging sub-clade may have been more widespread than reported due to testing problems and lack of 2011 sequences from the United States.

Moreover, the timing of the outbreak in Chihuahua and Venezuela may reflect an evolutionary advantage for the emergence of this sub-clade, as H3N2 levels decline and the advantage for H1N1 at this time of year, as was seen in the 2009 outbreak in Mexico.

Release of 2011 sequences from the United States is long overdue.

[dothedd]

Novel H1N1 Vaccine Breakthrough Raises Pandemic Concerns
Recombinomics Commentary 22:50
April 8, 2011


The recent H1N1 outbreaks in Mexico and Venezuela have raised concerns that a novel and virulent H1N1 is rapidly spreading throughout the region. This concern has generated serious vaccination campaigns in both countries. However, recently released sequence by the US Air Force included five isolates with the novel sub-clade. Included in the five were two isolates from vaccinated patients (44M and 37M) in Arizona, A/Arizona/AF21768/2011, and New Jersey, A/New Jersey/AF21791/2011, respectively.

The novel sub-clade contains four non-synonymous changes, N34D, S165N, A189T, and V275I, which are present in all of the recent isolates (mid 2010 through 2011). The New Jersey HA sequence has only the four changes noted above, indicating all novel sub-clade members have all changes required to generate a vaccine breakthrough (failure). This failure is likely linked to A189T, which is adjacent to receptor binding position 190, and S165N, which creates a new glycosylation site. Thus, it is ikely that the vaccination efforts in Chihuahua, Mexico and Venezuela will have limited success.

Moreover, anecdotal reports indicates that the novel sub-clade in Mexico is also causing outbreaks in Venezuela as well as multiple countries in Central and South America, signaling rapid spread of this H1N1 sub-clade in a pattern that mirrors the spread of H1N1 in 2009.

In addition, anecdotal reports indicate D225N is over-represented in these cases, raising concerns of an increased frequency of severe and fatal cases, as seen in Chihuahua, Mexico.

Release of 2011 sequences by the CDC, as well as other countries reporting an increase of H1N1 activity in the past several weeks is overdue.

[dothedd]

Silent Spread of D225N in Novel H1N1 in Chihuahua Mexico
Recombinomics Commentary 14:50
April 9, 2011


Two cities are primarily affected: Juarez and Chihuahua. Between March 22 and April 4, there have been 142 cumulative cases of ILI and severe acute respiratory infection (SARI) identified (24% of which were confirmed to be influenza A/H1N1 2009) and seven deaths (all adults, previously healthy, with the exception of one with COPD and one who was pregnant), of which six were confirmed to have influenza A/H1N1 2009. The Institute of Diagnosis and Epidemiological Reference (InDRE) of Mexico carried out genetic sequencing of the first three pandemic (H1N1) 2009 influenza cases (two fatal cases and one mild),.......

The above comments are from the Pan American Health Organization week 12 report describing the H1N1 outbreak in Juarez and Chihuahua, Mexico. As noted previously, the seven fatalities were largely previously healthy young adults and the three sets of sequences at Genbank represent three of the first cases identified. The above comments indicate two of the three samples were from fatal cases, which are likely to be A/Mexico/InDRE1945/2011 and A/Mexico/InDRE1946/2011. These two sequences are virtually identical. The only HA difference is the presence of D225N in Mexico/InDRE1945. All three samples were collected from the upper respiratory tract (pharyngeal swabs) and it is likely that a low respiratory tract collection from the second fatal case would also yield D225N. Moreover, the dates of collection and age of the patients (36M and 29M) combined with the close relationship at the nucleotide level suggests that both fatalities were from the traffic department in Juarez and signal transmission of a lethal H1N1 carrying D225N.


The "missing" D225N is similar to sequence data from the Duke Medical Center death cluster. Four patients were infected with the same H1N1 which had H274Y in NA and a rare polymorphism in the HA, Y233H, and these markers were present in all four patients, who were on the same floor of the hospital. Three of the four died within a day or two of each other. The index case had D225G. The second fatal case had D225N, while the thrid cases was wild type at position 225. These differences are virtually certainly linked to the timing and location of the sample collected, and all four patients had both D225G and D225N.


Anecdotal reports suggest that the novel sub-clade in Chihuahua, Mexico is rapidly spreading in Mexico as well as Central and South America, raising serious pandemic concerns. Media reports describe the appearance of H1N1 in San Pedro Sula, Honduras and PAHO week 12 report notes seven severe acute respiratory infection deaths in the same area, which are likely due to the same novel sub-clade reported above for Chihuahua, Mexico, in addition to H1N1 outbreaks in Venezuela and El Salvador.


Moreover, anecdotal reports indicate D225N in the novel sub-clade is widespread in these countries.


Release of 2011 sequences from the United States as well as severe and fatal cases in Mexico, Central, and South America, would be useful.

[dothedd]

H1N1 Death Cluster in San Pedro Sula Honduras
Recombinomics Commentary 16:50
April 9, 2011

Seven SARI deaths were reported this week in San Pedro Sula.

Influenza A H1N1 has reappeared in Honduras, according to the chief warden of Health, Dr. Thomas Guevara.

"Through him we have the virological surveillance of respiratory diseases, reported a case last week of H1N1 detected in San Pedro Sula", he said.

The above comments on seven fatal SARI (Severe Acute Respiratory Illness) cases described in the week 12 Pan America Health Organization report, coupled with the media report on confirmed H1N1 in the San Pedro Sula, strongly suggests that the H1N1 sub-clade circulating in Mexico in association with a high frequency of severe and fatal cases is also causing a high rate of deaths in Honduras.

Three sets of sequences were recently released from samples from patients in Chihuahua, including two fatal cases. One of the sequences had D225N, and it is likely that D225N would also be found in the lungs of the other fatality, since both sequences were identical for the rest of the gene and it is likely that both fatalities with traffic officers in the same unit.

Anecdotal reports indicate this sub-clade is rapidly spreading in Central and South America, and D225N is frequently detected. Moreover, the Chihuahua data suggests that the D225N would be detected at a higher frequency in samples collected from the lower respiratory tract.


Recently released sequences from the United States, from vaccinated patients, support vaccine breakthrough driven the receptor binding domain change A189T, as well as the new glycosylation site at S165N, which may mask antigenic sites. The four non-synonymous HA changes in the isolate from New Jersey, A/New Jersey/AF21791/2011, are present on all novel H1N1 sequences, suggesting that the vaccination campaigns in Mexico and Venezuela, as well as neighboring countries, will have limited impact on the spread of this deadly sub-clade.


More information on the seven fatal cases in Honduras, including epidemiological and demographic data, as well as sequences from severe and fatal cases throughout the region, would be useful.

[dothedd]

H1N1 Red Alert in Tamaulipas Mexico

Recombinomics Commentary 00:15
April 10, 2011


After the appearance of 120 suspected cases of H1N1 influenza, the Ministry of Health in Tamaulipas lit red lights, said the health secretary, Norberto Treviño García Manzo.

The above translation describes a red alert in Tamaulipas, Mexico due to a spike in suspected H1N1 cases. Tamaulipas shares a northern border with Texas and is east of Chihuahua, raising concerns that the novel H1N1 is rapidly spreading. The concerns are fueled by the proximity of the Chihuahua outbreak, as well as the timing, because influenza activity is usually declining in northern Mexico at this time of the year.


The recently released H1N1 sequences from two fatal cases in Chihuahua raise concerns that the receptor binding domain change, D225N, is transmitting. Anecdotal reports of outbreaks in Central and South America describe the same novel sub-clade and frequent detection of D255N in severe cases.


The D225N is in association with another receptor binding domain change A189T, as well as S165N, which adds a new glycosylation. These additional changes likely contribute to the vaccine failures reported by the US Air Force descriptions of novel H1N1 isolates in personnel and dependents.


These recent reports of H1N1 outbreaks and deaths in countries south of Mexico, including Honduras, El Salvador, and Venezuela at this time of year have significant parallels with the spread of pandemic H1N1 two years ago. However, the frequency of severe and fatal cases is higher in the current outbreak, which is almost certainly linked to the transmission of D225N.


Release of 2011 H1N1 sequences from US patients, as well as severe and fatal cases from the countries listed above, would be useful.

[dothedd]

Mexico Initiates H1N1 ICU Training Courses
Recombinomics Commentary 02:15
April 10, 2011


The objective of this training is to update the medical staff is in the emergency departments of hospitals, on the behavior of the flu outbreak in the state, and the correct treatment to be given to those suspected of infection with the virus H1N1 influenza.

Inaugurating the course, Dr. Angel Villaseñor Benavides, director general of Chihuahua Health Services said the Ministry of Health acted immediately and according to the protocol to control the outbreak that began in Ciudad Juarez.

The above translation describes the initiation of training courses on ICU care of H1N1 patients based the lessons learned from the Chihuahua outbreak. This training is in response to the rapid spread of severe and fatal H1N1 cases throughout Mexico. A red alert was issued for another northern state, Tamaulipas, due to the report of 120 patients with H1N1 symptoms.

The recently released sequences from three patients, including two fatal cases, signaled transmission of D225N on a novel H1N1 genetic background. This novel sub-clade was also reported in vaccinated patients in New Jersey and Arizona, earlier this year. The current distribution of this sub-clade in the United States is unclear because 2011 H1N1 sequences have been withheld by the CDC.


However, multiple countries in Central and South America, including Honduras, El Salvador, and Venezuela have reported recent increases in H1N1 activity, and anecdotal reports indicate the novel sub-clade has spread beyond the countries listed above, and the frequency of D225N is uncommonly high.


These outbreaks are happening at the end of the 2010/2011 flu season for the northern hemisphere, and prior to the start of the 2011 flu season for the summer hemisphere, as was seen for the spread of the pandemic H1N1 in 2009.


Release of sequences from the above and neighboring countries is overdue. The three sequences from Chihuahua define an emerging novel sub-clade with receptor binding domain changes A189T and D225N, as well as the acquisition of a new glycosylation site due to S165N.


In addition more detail on the clinical and epidemiological aspects of this expanding and alarming outbreak would be useful.