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Commentary

Ukraine Dead Increase to 282 - Still No Sequences
Recombinomics Commentary 07:37
November 15, 2009

1,347,538 Influenza/ARI

73,373 Hospitalized

282 Dead

The above totals are from Saturday's report from the Ukraine Ministry of Health.  The increase of 17 fatalities over Froday's report is slightly lower that the daily average of 25 for the prior 4 days.  However, weekend reductions were seen earlier.

The newly reported cases again are widespread and include eastern regions of Ukraine, which had lower numbers and included the only regions which have not exceeded the epidemic threshold (see map).  The large number of cases was explained in part by delayed treatment and initial lack of access to stockpile Tamiflu.  However, the more recent fatalities in western Ukraine and the daily increases raise concerns that there are significant changes in the sequences, which have not been addressed.

Initial remarks from the WHO suggested more would be know on Nov 4, which is when initial sequencing should have been completed.  Although comments on Nov 4 indicted there were no large changes, the comments did not address single nucleotide changes, such as recently described receptor binding domain changes, including D225G, D225N, and D225E.

The steady increase in fatalities through Ukraine and the withholding of the H1N1 sequences from hemorrhagic patients continues to raise concerns.

The WHO silence on sequences is deafening.

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