Recombinomics Commentary 21:21
December 5, 2009
In the USA outbreak, which involved four severely immuno-compromised patients, cases occurred in a two-week period between mid-October and early November. Three of the four cases were fatal, but the role of H1N1 infection in contributing to these deaths is uncertain. 
The above comments are from the WHO update on transmission of H274Y are hospitals in the United States and United Kingdom.  As indicated above, the virus was not only was fit enough to transmit human to human, but also lead to fatal infections in the majority of those infected.  Although these patients had underlying conditions, the death of three of four demonstrates that the virus is quite virulent.

However, as was seen in comments on the receptor binding domain change in Ukraine which was detected in all four fatal cases, these dramatic developments are discounted in WHO reports.  The outbreaks in hospitals are characterized as being somewhat different from the general population. However, although these patients are more likely to develop serious illness, the majority of the human population is naïve for this virus, so initial infection rates would be similar.  The immuno-compromised patients are monitored ore closely, so detection in these patients would be increased, but they would be representative of initial infections.

Like the general population, the reports of cases of H274Y have increased dramatically in the past few weeks, how, in contrast to what is implied in the report, is the rate of detection that is alarming.  In the US, that rate has increased almost 10 fold in the past few weeks.


•  77 more deaths, 378 deaths to Dec. 3 (Link)
•  Ontario reports declining trends, but 9 more deaths (Link)

•  Hong Kong: Parainfluenza outbreak in school under close watch (Link)

•  Death toll now 627 after 9 new deaths recorded yesterday (Link)
•  Rajasthan confirms 4 more deaths, 73 total now (Link)

•  17 new cases, 5 in military hospital, 11 children hospitalized in past 24 hrs (Link)

•  Banting has 30 sick, 10 confirmed cases, 3 ICU, 77 confirmed deaths (Link)

•  Maldives MOH confirms H1N1 on 11 of 13 islands (Link)

•  1st death confirmed in Gaza Strip and 5 others sick (Link)

Sri Lanka
•  Sabaragamuwa University suspends classes for death, illnesses (Link)

United States
•  US: Swine flu lingers, making traditional flu season unpredictable (Link)
•  US: A/H1N1 deaths still above epidemic threshold in U.S. (Link)
•  H1N1 is a nightmare for U.S. pork producers (Link)
•  OR: 1 new death, 5 new hospitalizations (Link)

•  Swine flu spawns an email phishing scam that’ll give you a nasty virus (Link)
•  H1N1 pandemic continues (Link)
•  Johns Hopkins Study shows Sickle Cell sufferers at higher risk of severe H1N1  (Link)

•  Recombinomics:  H1N1 Tamiflu Resistant Cluster in Pennsylvania (Link)