NA Dual Combination 106I and 248N; 22 PF11 Sequences; 1 in United States

Human-fit Seasonal H1N1 from 2008 and 2009 typically demonstrates the H275Y TamiFlu Resistance marker and a NA Triple Combination at 106, 248 and 286:

106I, 248N, 286G

As of today, GenBank shows only one sequence on file from the United States demonstrating a match to the NA Dual Combination of 106I and 248N and the consensus interior region:

• A/Louisiana/03, sampled on 2009-05-01 from a 1 year old female

Only 22 total sequences worldwide match 106I, 248N and the interior consensus region (146 residues).

• Italy (1: Italy127)
• Russia (2: Ekaterinburg01 & Almati01)
• US (1: Louisiana03)
• Asia (18)
• Japan (15, including TamiFlu Resistant Osaka180)
• China (2: Shanghai71T & Nanjing1)
• Korea (1: Korea01)
  

The US Louisiana03 is an exact amino acid match to Almati01 and all of the Japanese sequences but the Osaka180 (variance 275Y).  Louisiana03 matches the two Chinese sequences exactly at the amino acid level, varies from Ekaterinburg01 by only 259D, varies from Italy127 by only 256L and varies from Korea01 by only 319R.

Europe, North America and Asia are now penetrated with the NA Dual Combination of 106I and 248N in the PF11 reservoir matching 2008 and 2009 H1N1 Seasonal Influenza and laying the groundwork for additional TamiFlu Resistance.

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