Silent Spread of H1N1 RBD Change L194I

Tuesday, December 31, 2013
By Paul Martin
December 30, 2013

The emergence of H1N1 as the dominant sub-type in the US has raised concerns that it has effectively escaped from the immunological response generated by its emergence in 2009 as well as subsequent vaccinations. Moreover, reports on severe and fatal cases, which initially appeared in eastern Texas has raised concerns that virulence has also increase.

Media attention on eastern Texas began with a report that a flu-like illness in Conroe, Texas had killed four of eight cases, while the other four were hospitalized and two were near death. The cases were designated as a mystery disease cluster because initial testing was negative for influenza. However, retesting of the four surviving identified H1N1 in two and the retest results on the other six has not been released. However, six H1N1 deaths were confirmed in the Houston area and now media reports have increased the death toll to 13.
Moreover, severe and fatal cases were reported in Austin, Texas, where two pregnant cases had died and 5 additional adults were on ECMO machines. The maxing out of ECMO machines also signaled more severe cases, and media reports cite 5 more deaths in the Dallas area. Almost all of these cases have been young or middle age adults. A pediatric death was also reported in Houston, while at least one child was on an ECMO machine in Austin.

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