Swine Flu Update: Prepare for Third Wave

It ain't over til its over. The H1N1 Swine Flu pandemic which captured headlines since last spring has been circulating the globe for almost a year. In that time there have been thousands of deaths and hundreds of millions of people infected. The virus has generally proven to cause only mild illness, but there has been a wide-spread mutation, D225G, which is associated with deep destructive lung infections that often prove fatal. Spreading from the Ukraine to other parts of the world, now there are clusters in the United States. Look out for the third wave of this epidemic as winter gives way to spring. It could prove deadly if the D225G mutation becomes predominant. Do not let down your guard. It ain't over yet.

H1N1 Increases on North Carolina College Campuses

Recombinomics Commentary

February 03, 2010

After staying low for awhile, the number of H1N1 cases is slowly climbing again, said Dr. Zack Moore, an epidemiologist with the N.C. Division of Public Health.“We’re starting to see an upswing on college campuses in the last week or two,” Moore said.“(The first wave) was a very big wave, and it definitely affected students and young people more than the seasonal flu,” Moore said.It’s possible that the numbers could climb as high as they were last fall, but there is no way to predict that now, he said.The above comments on increases in pandemic H1N1 on college campuses in North Carolina are consistent with reports of an uptick in severed cases at UNC medical Center in Chapel Hill, NC. An increase in H1N1 activity in the northern hemisphere at this time of year is not unexpected, and the above cases support the spike in Pneumonia and Influenza deaths in the US, including the South Atlantic region.Moreover, there is concern about oseltamivir resistance in the region due to transmission at a summer camp followed by a fatal outbreak at Duke Medical Center. The Duke outbreak involved at least three fatal cases. Five sequences with H274Y were released and all five isolates had the rare marker, Y233H, while three had D225G or D225N, suggesting that those sequences were from the fatal cases. In addition, another isolate, which matched the Ukraine sub-clade had D225G. The status of that patient was unknown, but the collection was from North Carolina and in the same time frame as the Duke outbreak.The recent reduction in H1N1 has raised concerns that a new wave in the winter/spring would have a higher frequency of D225G which would generate more severe and fatal cases. The linkage with D225G/N with fatal cases in Ukraine is strong, and recently released sequences have a higher frequency of D225G/N, conversion of D225E to D225G, and an increase in isolates with both D225G and D225N. These increases may be linked to the Mill Hill designation of a Ukraine isolate with D225G as a "low reactor".Sequence data from the current college cases in North Carolina would be useful.Media Links
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