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Commentary
CDC Investigates Spike In H1N1 Hospitalizations In Georgia
Recombinomics
Commentary 23:00
March 29, 2010
The CDC investigation confirmed that the hospitalized cases were H1N1 and that the demographic was similar to last fall, adults with underlying conditions. The CDC noted that most had not been vaccinated and expressed a concern that the public was not taking pH1N1 seriously and the low vaccination rate would lead to unnecessary hospitalizations and deaths. The geographic distribution of the current cases may be slightly different than the fall, but that data was preliminary and the CDC suggested similar outbreaks may appear nationwide and the start of a third wave could not be ruled out.
The H1N1 was said to have not changed, but small differences can have large effects. The CDC was also involved in the H1N1 investigation in Ukraine last fall and the WHO issued a press release stating that there were no significant changes, but Mill Hill released sequences the following day, which showed that 4 of 4 fatal cases had D225G, a receptor binding domain change that was linked to increased affinity of gal 2,3 receptors, which are at high levels in human lung, and D225G had been found in two of the five 1918/1919 autopsy lung samples, including the only 1919 sequence. The CDC has also not commented on D225G/N in the Duke death cluster where 3 of the 4 patients died, so it would be useful if the CDC would simply release sequences from the recent hospitalized patients. To date there is only one public sequence from Georgia in 2010, A/Georgia/01/2010 (27F collected 2/6/2010 deposited by the CDC at GISAID), which has 8 newly acquire synonymous changes.
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