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Commentary

Ukraine Fatalities Spike to 727 - One Day Total 29
Recombinomics Commentary 23:55
December 31, 2009

3,753,896 Influenza/ARI

212,349 Hospitalized

727 Dead

The above totals are from the Ukraine Ministry of Health website, indicating the spike in deaths is incrasing.  The 727 dead are 29 higher than yesterday's report and brings the total deaths in the past 96 hours to 94.  The rate of one death per dour for the past four days is similar to the rate at the beginning of the outbreak in October.

The five deaths in Donetsk again were the highest, but four deaths in Crimea was associated with the curtailing of holiday activities in an attempt to control the spread (see map).  The increases in deaths in Ukraine has attracted international attention because sequences from initial cases had receptor binding domain changes at position 225 (D225G and D225N).  These results have led to further analysis by other countries, and sequences released from lung samples for patients in three regions of Russia also had D225G, raising concerns that the change was becoming more widespread, which could lead to a catastrophic wave in the upcoming weeks.

The recent sequences from Russia are distinct from each other signaling continued expansion of D225G/N via recombination, which is also happening with the Tamiflu resistance marker H274Y.  Patients with both markers have increased concerns that a much more virulent H1N1 could also be resistant to Tamiflu and Peramivir.

These evolving developments continue to increase concerns, WHO proclamations notwithstanding.

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