D225G and D225N In Utah Patient Raises Pandemic Concerns Recombinomics Commentary 23:55 December 6, 2009 The CDC has put HA sequences, A/Utah/42/2009, from a Utah patient (28F) on deposit at Genbank, which has D225G and D225N. Moreover, the sequence from the original sample gives mixed signals at tandem positions, revealing significant heterogeneity that the codon. A clone for the original sample has D225G. D225N and D225G have been identified in necropsy lung samples from Brazil (A Sao Paulo/53845/2009 and A/Sao Paulo/53838/2009 have D225N while A/Sao Paulo/53225/2009 and A/Sao Paulo/53206/2009 have D225G) raising concerns that these polymorphisms are associated with more severe disease.

The severity may be linked to viral load, because D225G and D225N were present as mixtures in early cases in the US in California and Texas. In fact the vaccine target, A/California/7/2009 was a mixture for D225G, as were several other isolates isolated at about the same time in Texas and California. Other isolates in the same areas, as well as New York, did not give mixed signals, but D225G was found in milder cases.

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