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Ukraine H1N1 D225G in North Carolina

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The CDC has released another series of H1N1 sequences at GISAID.  Included was A/North Carolina/53/2009 which has D225G. Details on this patient were not provided, but the sample was collected in mid-October when there was an H1N1 outbreak at Duke Medical Center.  At least four patients had H1N1 with H274Y.  Those sequences were also released at GISAID and 5 sequences had H274Y as well as the HA marker Y233H.  In addition, three of the sequences had D225G or D225N.  At least three of the patients died, so it is likely that some or all had D225G/N, as well as H274Y.

NC/53 did not have these markers, but it had D225G as well as the marker found in Ukraine (and Russia and Norway), A1281G.  Thus, NC/53 provides a link between D225G in Ukraine, Norway, and Russia and D225G in North Carolina.  However, sequences from Australia also provide linkages because it has markers found in Australia isolates with D225G and D225N, but also has Y233H, which was in the H1N1 from the hospitalized patients.  The Australian sequence also had a regional marker that defines the cluster of D225G sequences in Zhejiang, China, providing linkages between Sydney Australia, Raleigh-Durham. North Carolina, and Zhejiang, China.

Moreover, in North Carolina D225G was on at least two different sub-clades, which is also true for D225G/N in Australia.  Similarly, in Ukraine D225G/N was on multiple sub-clades in multiple combinations requiring multiple introductions, all of which is most easily explained by homologous recombination.

Thus, the rapid movement of D225G/N like the movement of H274Y in seasonal H1N1 as well as pandemic H1N1 highlights the central role of recombination in the rapid evolution of influenza.

The failure of WHO and consultants to recognize this very common mechanism of influenza evolution continues to be hazardous to the world’s health.

http://www.recombinomics.com/News/02011001/D225G_NC.html


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