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Commentary
H1N1
D225G Transmission In Singapore
Recombinomics
Commentary 16:54
July 26, 2010
Recent sequences (collected June 30, 2010) from Nanjing, China also support transmission of D225G and raise concerns this polymorphism is become more common and more easily transmitted. HA with D225G can bind to 2,3 receptors which are found on human lung cells, which may lead to increased concentrations of H1N1 in lung and an unfavorable outcome, as seen in severe and fatal cases.
The emergence of D225G In the current season was anticipated as more of the human population develops immunity to wild type sequences. Mill Hill has designated a Ukraine sequence with D225G as a “low reactor”, which supports the emergence of D225G. In China, D225G was found in association with G158E, another marker linked to low reactors.
Recent reports from India have described an increase in H1N1 cases as well as an increase in severe or fatal cases. Earlier sequences from India had D225G, raising concerns that levels of this marker are on the rise in India also.
WHO has maintained that D225G did not transmit, based on a lack of clustering in time and space. However, the recent sequences from Singapore and Nanjing, China show such clustering, as did prior sequences from Ukraine and Russia.
A revised WHO and CDC “working hypothesis” on D225G is long overdue.
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