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Commentary
WHO's Deafening
Silence On H7N9 Q226L
Recombinomics
Commentary 02:45
April 2, 2013
WHO put out a report on the 3 cases today, with minimal information and no mention of receptor binding domain changes. H5N1 bird flu case reports and associated media comments would frequently not that the H5N1 isolated could not efficient transmit in human because it lacked two receptor binding domain changes, Q226L and G228S. These two changes were of interest because receptor binding domain studies highlighted the role of these two changes in the shift of receptor targets in the upper respiratory tract of birds to those of mammals. More recently H5N1 transmission studies at the CDC, EMC, and U of W started with two changes in the receptor binding domain. Two used Q226L and G228S, while one used N224K and Q226L. Thus, all three studies included Q226L.
Two of the sequences released by WHO (A/Shanghai/2/2013 and A/Anhui/1/2013) contained Q226L which has never been reported in a natural H5N1 or H7 isolate. Moreover, all three H7N9 cases also had E627K, which was also used in both of the H5N1 transmission studies which incorporated and avian PB2 (one of the studies had H5 on an H1N1pdm09 genetic background).
Thus, although two of the H7N9 case in two different provinces had Q226L, WHO silence has been deafening,.
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