Paradigm Shift Intervention Monitoring
twitter
Commentary
WHO Denials On H1N1 D225N Raise Pandemic Concerns
Recombinomics
Commentary 20:30
April 27, 2011
Preliminary tests reveal no significant changes in the pandemic (H1N1) 2009 virus based on investigations of samples taken from patients in Ukraine.
Dr. Nancy Cox, director of the Influenza Division at the US Centers for Disease Control and Prevention (CDC), said global H1N1 data so far do not show a clear association between the mutation and severe illness.
"If you look globally you can see that this mutation is neither necessary nor sufficient for a severe or fatal outcome," Cox told CIDRAP News.
The above comments on HA position 225 changes (D225G and D225N) create a pattern of denials that raise serious questions about scientific analysis carried out by WHO and its consultants.
The first comment from a April 6, 2011 PAHO update on Mexico regarded sequences from two fatal cases in Chihuahua. One sequence had D225N, which is a change that had been detected at high frequency in direct sequencing of autopsy lung samples from patients in Ukraine. Additional autopsy lung samples had D225G, while other samples had both changes. The association of D225G was clear in the first series of 11 HA sequences. Four were from fatal cases and all four had D225G, which was not detected in the other 7 samples from milder cases. Subsequently two more sequences from fatal cases were released, and both had D225N, which also was not detected in milder cases. However, comments in the second paragraph above , from a WHO November 17, 2009 press release issued just prior to the release of the sequence denied the significance of these chnages.
This dramatic linkage led to analysis of samples from Norway, which had a similar association, and the third set of comments above was made in response to the March 4, 2010 publication of the association between D225G and severe or fatal cases and was after the release of a large series of sequences from autopy lung samples from Ukraine patients, which had a high frequency of D225G, D225N, or both.
Just prior to the release of those sequences the WHO published a detailed report on D225G claiming that it was spontaneous and not linked to clusters of cases, which was refuted a few weeks later by the Ukraine data, fom a large series of fatal cases in Ukraine. The D225G and D225N clustered phylogentically as well as in time and space with regard to the samples collected in October, 2009. Similar data was released for patients in Russia in late 2009. These data raised serious questions about the WHO's abilty to analyze data or assign risks.
Several subsequent studies found this tight association with D225G and severe or fatal cases which was also seen for D225N. Thus, the basis for the WHO claim on April 6, 2011 is unclear, and the basis became less clear with the release of five for HA sequences from the same sub-clade, which had one sample with D225N and D225G. Anecdotal data also indicated at least five more samples with D225N had been identified and all samples with D225N had come from severe or fatal cases.
Two weeks after the April 6, 2011 report, the WHO issued a pandemic alert and cited the spread of H1N1 which coincided in time and space with reports of the Chihuahua sub-clade with D225N.
Thus, it is clear that the D225N in the Chihuahua sub-clade is causing serious issues, which was contradicted in the earlier report. The pattern of such statements and denials continue to increase pandemic concerns, including the abilty of WHO and consultants to.scientifically evlauate genetic changes and associated risks.
Media link
Recombinomics
Presentations
Recombinomics
Publications
Recombinomics
Paper
at Nature Precedings