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Commentary
H1N1
Pennsylvania Deaths Raise Concerns
Recombinomics
Commentary 14:30
January 26, 2011
The above comments are from the Pennsylvania week 3 report, which confirm a large jump in reported deaths for week 2. No week 2 report was published, but 11 deaths were listed as the season total in the week 1 report, which was leading the country. An alert for Montgomery County had been issued due to three recent deaths, and the 70 hospitalized cases in week 1 represented a dramatic jump from the 23 reported in the prior week. However, the graph of hospitalized cases was not updated with cases in week 2 or week 3, raising concerns that there has been a spike in such cases due to H1N1 in eastern Pennsylvania.
Earlier an alert was issued for Lehigh County due to an H1N1 outbreak that led to two reported H1N1 deaths. The CDC released sequences from these two cases (A/Pennsylvania/17/2010 and A/Pennsylvania/16/2010), 45M and 22M respectively. Both sequences were identical and were closely related to sequences from the UK which had S186P. This week a third sequence, A/Pennsylvania/34/2010, was released at GISAID by the CDC, which was identical to the above two sequence. It was also from a 45M and collected on November 16, 2010, so it is unclear if this third sequence is from a third case, or a second isolate from the earlier index case.
Additional sequences from the CDC on isolates from October and November were almost exclusively from isolates with S186P or S188T, raising concerns that these sub-clades will lead to a spike in hospitalizations and deaths in the upcoming weeks.
An update on the hospitalization in weeks 2 and 3, as well as a clarification on the serotypes and deaths recorded for week 2 would be useful.
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