The multiple cases all vector from visits to a popular vacation island between July 13 and August 9. Two of the cases do not appear to be related via direct contact, potentially indicating an endemic and silent spread of a minor PF11 population carrying the human-fit virulence factor 627K in a sub-clade that may match the major circulating sub-clade there but for the Lysine recombination. Ten of twelve (83%) sample specimens from this geography fall into this sub-clade indicating the potential for dominant circulation in that area.
As this release of information via Promed is very limited, additional evalution and insight will require amendment and revision to this article as the matter is clarified on several accounts, including specification of the E627K sequence count and the various ratios confirming the certain Hydra Effect demonstrated in the study population.
In our reading, 3 distinct cases are described in the Osterhaus release. The researchers may have mentioned “two patients” because the family contact and the younger sister may have been directly evaluated by them in a clinical setting?
- Male Diabetic who may have shared activities with ill female camper, onset 2009-08-09
- Female camper, onset after returning home 2009-07-20
- Female family contact of ill camper, onset after camper returned on 2009-07-20
- Younger sister of female family contact, onset 2009-07-23
This highly interpretive post is preliminary based on inconclusive language in the press release.
No mention is made of the correlating PB2 virulence mediators 701N and 703K at this time in the information released. We suspect these to be absent due to the non-fatal clinical outcomes; however, confirmation would be useful.
As the samples were examined retrospectively, little new observational evidence will be forthcoming. Rational projections due to this 627K mid-Summer emergence in the Netherlands and the late May emergence in Shanghai71T could cause us to expect a geographically-dispersed, wild-type sub-population carrying this virulence factor.
Tenacious sub-clonal evaluation of current sequences in the United States will likely indicate mixed peaks at the PB2 residue coding for the Lysine at 627.
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