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Commentary
Reported Ukraine
Fatalities Increase To 155
Recombinomics
Commentary 02:08
November 9, 2009
48,972 Hospitalized
155 Dead
The above numbers represent the latest figures from Ukraine. The increases over the weekend have slowed, but it is unclear if this reduction in the rate of increases is due to an improving situation, or just fewer reports received because of the weekend. Although Lviv still has a wide lead in all categories (see map), including 155,895 cases, the city of Kiev is now up to 60,366 and when combined with the 47,802 cases in the Kiev Oblast, the Kiev city/oblast has increased to more than 100,000 cases, which is higher than any oblast, other than Lviv. The low number of deaths there, 5, may just be a trailing number, since the largest increases in Kiev were in the past few days.
Poland is now reporting schools with high absenteeism, although media reports and government comments continue to cite contributions from seasonal flu, even though all countries in Europe are reporting seasonal flu levels at less that 1% of flu positives. Worldwide, seasonal H1N1 has been crowded out, and low levels of H3N2 in eastern Asia are rapidly declining, suggesting the H1N1 swine flu will be the dominant influenza A in humans for years or decades.
The lack of a more detailed report on the sequences generated by Mill Hill continues to cause concern. Initial reports suggested there was no reassortment or anti-viral resistance markers identified, but reports did not exclude small changes, including acquisition of receptor binding domain changes such as polymorphisms at HA position 225 (D225E, D225G, and D225N). D225N was linked to the global expansion of amantadine resistant H3N2, and D225G was isolated from lungs of fatal cases in Sau Paulo, Brazil, as well as pandemic isolates from 1918 (A/New York/1/1918) and 1919 (A/London/1/1919).
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