Paper on D225N in US and Ecuador published
Severe disease reported in 3 patients with mutated H1N1
Two cases of pandemic 2009 H1N1 flu with a mutation in the virus's hemagglutinin (HA) earlier this year indicate the mutation may be associated with more severe disease, according to a study in the Journal of Clinical Virology. US researchers reported on two patients from Ecuador and one from Washington, DC, who were infected by a 2009 H1N1 variant with a mutation within the primary HA receptor-binding site. All required mechanical ventilation, and one died. The D222N mutation was confirmed in two of the patients, but all the isolates were found to be from a subclade phylogenetically homologous with strains associated with recent deaths in Chihuahua, Mexico. The authors conclude, "Previously, enhanced virulence associated with the change, D222G, has been clinically linked to severe morbidity and mortality. Initial observations of the prevalence of a novel sub-clade of strains in the Americas suggest that viruses with a re-emergent D222N mutation may too correlate with severe clinical manifestations."
Oct 28 J Clin Virol abstract
http://www.sciencedirect.com/science/ar ... 3211003672http://www.cidrap.umn.edu/cidrap/conten ... uscan.html