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Commentary
Two of the sequences from severe or fatal cases in Mexico have D225N, raising concerns that the US patients also have D225N, which is not found in the viral isolates from their samples due to collection or isolation issues. The sequences from Mexico were generated by direct sequencing of the clinical samples, while the US sequences come from virus isolated in culture. Unreleased sequences from Mexico, as well as other countries in North and South America have D225N on a Chihuahua sub-clade genetic background, raising concerns that this receptor binding domain change is widespread and in samples represented by the CDC sequences. This emerging sub-clade with D225N has led to a pandemic alert, and recent comments from the Air Force as well as sequences from vaccinated Air Force dependents has raised concerns that massive vaccination campaigns will have limited success. The time for a new H1N1 vaccine targeting the Chihuahua sub-clade is long overdue. Media Link Recombinomics
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