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Commentary
H1N1
Deaths Extend To Jalisco Mexico
Recombinomics
Commentary 13:30
March 29, 2011
The above translation describes an H1N1 death in Jalisco, which is far south of the five deaths reported in Chihuahua. This is the first confirmed death in Jalisco this year and reflects the differences between the United States and Mexico. In Mexico most influenza A in the 2010/2011 season was H3N2 and the cases peaked in late 2010. Currently there was little influenza circulating prior to the recent outbreak, which was first reported in Chihuahua, but has now spread throughout the country.
The reported deaths lag behind infection, which are producing a high rate of severe and fatal cases, almost exactly 2 years after the pandemic H1N1 was reported in Mexico and the United States. The first confirmed H1N1 case in the US was collected March 30, 2009. At the time previously healthy young adults were dying in Mexico due to atypical pneumonia, which was subsequently confirmed to be pandemic H1N1.
Multiple reports indicate that the outbreak in Chihuahua originated in New Mexico and Texas, where H1N1 levels are markedly higher than Mexico and are similar to H3N2 levels. However, sequence data from New Mexico and Texas has been withheld. There are no public 2011 from either state, and only one sequence for the entire 2010/2011 season, collected November 30, 2010, has been made public. That sequence has S188T, which is present in the dominant sub-clade in the United States and was responsible for the outbreak of severe and fatal cases in the United Kingdom at the end of 2010.
However, the difficulty in sub-typing the cases in Mexico raises concerns that this sub-clade has evolved further in 2011, leading to outbreaks in Mexico and Venezuela.
Release of sequences from severe and fatal cases in all three countries is overdue.
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