Recombinomics Commentary 16:05
December 21, 2009
As the number of H274Y cases continue to expand, the transmission of these cases comes into sharper focus.  The recently released sequences from Japan, which include eight sequences with H274Y defines a number of sub-clades with multiple examples of H274Y, signaling the transmission of H274Y.

One example involves sequences which have H274Y and D225E,  This combination of Tamiflu resistance with a receptor binding domain change is of concern because prior fixing of Adamantane resistance, S31N, in seasonal H3N2, and Tamiflu resistance in seasonal H1N1 involved receptor binding domain changes.  In H3N2 the two key RBD drivers were S193F and D225N.  In seasonal H1N1 it was A193T followed by changes in flanking positions 187, 189, and 196.

Thus, when the first example, A/Hong Kong/2369/2009,  of H274Y in a patient (San Francisco traveler to Hong Kong) who had no documented exposure to Tamiflu, had D225E, there was concern that this change would lead to more examples of this combination.  The report led to increased surveillance in northern California, which failed to pick up additional examples ofH274Y or D225E.  However, other countries screening passengers at border checks identified sequences with D225E, and most were passengers from the United States raising concerns that the US surveillance was missing milder cases with D225E, because most testing was directed at hospitalized patients.

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China
•  Flu vaccine begins for high risk groups (Link)
•  H1N1 treatment is economic worry (Link)

India
•  Govt to form response team to combat pandemics (Link)
•  Swine flu case detected (Link)
•  Swine flu claims 7 more in Gujarat (Link)

Indonesia
•  Regency Lampung Selatan: H1N1 in poulty decreased in 2009 (translated) (Link)
•  Swine Flu the Biggest Challenge For Indonesia Health Ministry in 2009 (Link)

Ukraine
•  Ukrainian President signs law on preventing spread of flu epidemic in Ukraine (Link)

United States
•  US poll shows worry about swine flu shot persists (Link)
•  Nasal swine flu vaccine recalled over potency (Link)
•  MedImmune recalling swine flu vaccine-FDA (Link)
•  Millions of H1N1 Vaccine Doses Recalled Due to Potency Problem (Link)
•  CA: San Diego Braces for More Fatalities in H1N1 Outbreak (Link)
•  KS: Kansas woman with swine flu dies; toll now 23 (Link)
•  PA: (3) New Deaths on PA DOH Website for 12.22.09 (Link)
•  VA: 700,000 swine flu vaccines heading to Va. (Link)

Vietnam
•  H5N1 in birds in Cao Bang province (Link)

General
•  Swine flu touched entire globe in 2009 (Link)
•  Blame it on Swine Flu: Hand Sanitizers Rival Pens as Most Popular Promo Product (Link)
•  Vaccine potency plunge problematic (Link)
•  The Buzzwords of 2009 (Link)
•  Profit drives drug misuse in Asia (Link)

Research
•  How H1N1 virus infects body (Link)

Commentary
•  Recombinomics: Lab Confirmed H1N1 in New York Dog (Link)
•  Helen Branswell: Experts say pandemic could have a silver lining if it knocks out other viruses (Link)

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