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Commentary

Ukraine Cases Spike - D225G and D225N Found
Recombinomics Commentary 23:55
December 8, 2009

2,187,836 Influenza .ARI

132,178 Hospitalized

472 Dead

The above numbers, from the Ukraine Ministry of Health represent a spike in cases yielding a daily increase of 86,578.  The jump was widespread, but the biggest jumps were Donetsk increased 12,586 to 160,212 and Dnipropetrovsk which increased 9.813 to 149,358 (see map).  This jump may be signaling a move into the real winter season.

Ukraine is under close scrutiny because sequences released by Mill Hill at GISAID had D225G in all four fatal cases and CDC sequences at GISAID identified D225N in new cases, which were also likely fatal, so all HA sequences from fatal cases in Ukraine have had a receptor binding domain change at position 225 (D changing to either G or N).  Since the same changes had been seen previously in Sao Paulo, Brazil over the summer, and now cases were being identified in severe and fatal Scandinavian countries,

The finding D225G or D225N in all fatal cases in Ukraine clearly demonstrates that the changes are transmitting, comments from Scandinavian officials notwithstanding.  More detail on the new patients and sequences would be useful.

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