Ukraine Dead Increase to 299 – Still No Sequences! WHO Evades Ukraine Sequence Questions at News Conference.

• We are all still waiting for the WHO to release the DNA sequences. It will be a great help to all. The symptoms and severity far exceed that of A/H1N1. So, I doubt this is just the swine flu! It is also getting quite apparent that Big Pharma is making use of the situation in Ukraine to sell more of their A/H1N1 vaccines!
   
  Recombinomics Commentary 22:55
  November 15, 2009
   
  1,364,939 Influenza/ARI
  75,862 Hospitalized
  299 Dead
   
  The above numbers represent the latest update for the Ukraine Ministry of Health.  Once again the number of dead increased by 17, but weekend numbers tend to be lower than weekday reports.  The 199 dead are almost double the 155 reported week ago.  The increased number of dead includes those from locations in central and eastern Ukraine.  Last Sunday 13 of the 27 reporting regions had not exceeded the epidemic threshold, but today only 5 regions remained below the threshold (see map).
   
  There has been more recent media coverage which have suggested that the high number of fatal cases was linked to late treatment or a lack of Tamiflu.  However, at least 6 of the fatalities were healthcare workers and most of the reported deaths were after the warning was issued and schools were closed down, suggesting that many, if not most cases, were not due to late treatment.  The initial WHO report indicated the time between disease onset and hospitalization was 5-7 days, but the more recent report from Ukraine cited a 3-7 day lag, which again suggested that many die in spite of awareness, modest time differentials between symptoms and hospitalization, and appropriate treatment.
   
  Moreover, 90 of the initial cases were describe as having a hemorrhagic component, which again raises concerns about small genetic changes, especially in the receptor binding domain. Answers to questions about such changes have been evasive, and the sequences have not been released by Mill Hill.
   
  The sequence silence remains deafening, and erodes public confidence in agencies controlling these samples and sequences.
   
  WHO Evades Ukraine Sequence Questions at News Conference
  Recombinomics Commentary 12:23
  November 15, 2009
  Phil Serafino, Bloomberg: Dr Shindo……..I have a second question also which may not be your area of expertise but have you heard anything about the mutation of the virus or has it changed at all – are we looking at anything different than a few months ago.
   
  Dr Shindo: Well, I can answer that question first. The virus is quite stable. It hasn’t changed……..
   
  Joseph: This is Joseph from Kuala Lumpur – I am from the Sun Media……I just want to ask whether or not any slight mutation even a drift variant has been noticed so far.
   
  Dr Shindo: Amazingly this virus is very stable and part of the reason, virologists (are saying) is because of the lack of pre-existing immunity in population so that virus doesn’t have to mutate to escape from people’s immunity. So it’s quite stable.
   
  The above comments are from the WHO update on Thursday, announcing new recommendations on the use of anti-virals to treat pandemic H1N1. The two questions above are reporters who were looking for comment on small changes in H1N1 in general, and Ukraine sequences in particular.  A week earlier Keiji Fukuda made some general comments about the sequences, noting that final analysis would “probably take a couple of days” but in general there were no “big mutations”.  However, “big mutations” just refers to reassortment, and there have been no examples of big mutations due to reassortment.  All sequences reported thus far have the same original constellation of flu genes, one Human, PB1; two avian (PA and PB2); and seven swine (North Americana and Eurasian).
   
  The reporters were asking about “small” mutations, such as drift mutations or those affecting the receptor binding domain.  Sequence changes in the receptor binding domain are already published.  One position (225) is of interest because it was associated with the spread and dominance of amantadine resistance (S31N) in seasonal H3N2.  That particular change D225N, has been reported in two sequences from New York, as well as two recent sequences from Sau Paulo, both of which were from necropsy tissue from fatal H1N1 cases.  Similarly, the same position changed during the 1918 pandemic to D225G.  That change has also been reported from the lungs of two other patients who dies in Sau Paulo.  Moreover, a third change at that position (D225E) was seen in the Tamiflu resistant sequence identified in Hong Kong from a San Francisco traveler who had not been treated with Tamiflu.  That polymorphism is widespread and frequently reported in patients from Spain.  Thus, the questions on small changes in sequences were focused on specific small changes, by the answers to the questions were just general comments on the stability of the virus and did not address specific changes in the Ukraine sequences.
   
  The failure of WHO to release the Mill Hill sequences or to even comment on the presence or absence of such specific changes raises questions.  The delay in release of data or comments has led to wild speculation at conspiracy web sites, which is widely carried over the internet, creating significant confusion among those readers, as well as the general public concerned about the excessive and continuing deaths in Ukraine (see map).  These concerns have been heightened by accelerating numbers of H1N1 hospitalizations and deaths throughout the northern hemisphere,
   
  Non-responsive answers on the general stability of the H1N1 will not reduce these concerns. Release of the Ukraine sequences is long overdue.

   

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