100% Case Fatality Rate on pH1N1 Clade2 Lineage (HA 142V & NA syn204A)

Sequences discussed in this analysis are variously stored publicly at GenBank and at GISAID. We gratefully acknowledge the authors, originating and submitting laboratories of the sequences from GenBank and from GISAID’s EpiFlu™ Database on which this research is based. A GISAID-generated list is detailed in a linked spreadsheet for completeness in citation.

Last Update
2011-10-25

HA 142V appears on 22 pH1N1 human sequences geographically spanning 5 countries covering 16 cases documented from 2009-07-20 (Italy) to 2011-02-04 (Russia).  Researchers produced multiple sequences for 5 cases.  These 22 sequences delineate on the last day of 2010 from low polymorphic count genetics onto highly polymorphic Clade2: 188T backgrounds.  The 9 most current HA 142V sequences share 6 HA revisions and 5 NA revisions demonstrating capable transmission.

At a minimum, 7 of those sequences represent fatalities.  These fatality sequences were generated from 2 independent labs.  The subjects were geographically dispersed (Nizhnii Novgorod and Vladimir: >100 miles distant).  Non-fatality sequences (2) with HA 142V on similar Clade2 backgrounds are on file in a similar region of the world (Tula, Russia and Slovenia).  Of 9 Clade2 sequences with HA 142V, 7 are noted as fatal (78% Case Fatality Rate).  5 of those 9 Clade2 sequences carry Receptor Binding Site revisions between HA aa225 and aa230, including 225G, 225N and 230I.  Although the amino-level Ultimate Origin investigation for Valine at aa142 continues, many H5N1 sequences demonstrate the 2nd Base Codon donation potential (atg, ctt, ctg, ttg) to create the pH1N1 142V (GtT).

An examination of the Neuraminidase segments provides additional sectioning to the fatalities.  The NA segments are hyper-morphic and zoonotic.  Each Clade2 fatality with HA 142V carries NA syn204A. The 2 Clade2 non-fatality HA 142V-bearing sequences do not demonstrate the NA syn204A.  All NA syn204A (GCa) pH1N1 sequences (7) are in cross-segment combination with HA 142V on a very common Clade2: 188T background. 

Potential animal progenitors are found on 18 sequences in Avian and Mink hosts across several serotypes (H4N4, H5N4, H7N1, H8N4, H10N4).  The databases do not yet appear to demonstrate NA syn204A (GCa) on an Avian H1N1 sequence.  Future Avian H1N1 deposits may very well demonstrate that this value has crossed to human pH1N1 via an Avian H1N1 bridge (intermediate) from one of the noted H4N4, H5N4, H7N1, H8N4 or H10N4 serotypes.

7 human fatalities on 7 cases across 2 cities and 2 labs each bearing the rare HA 142V and the rarer NA syn204A merit attention as a potential “flashfire” candidate due to the 100% Case Fatality Rate (CFR) of this transmissible combination found on the most dominant pH1N1 Clade.  Furthermore, this group of sequences demonstrates a superset of revisions (HA and NA) with significant homology to the Avian H1N1 pool.  Each pH1N1 chimera strain that is in mid-stride between host species, that is “confused”, holds the potential for variant clinical symptoms and outcomes.   Early detection of "flashfire" strains (High CFR) via increased surveillance is essential to public health planning.

Case Fatality Rates for HA 142V

44% CFR Overall (7 of 16)
78% CFR on Clade2 (2010-12-31 to 2011-02-14) (7 of 9)
78% CFR in Northern Hemisphere from 2010-12-31 to 2011-02-14 (7 of 9)
100% CFR with NA syn204A (7 of 7)

Hemagglutinin Statistics for HA 142V

Total HA: 123 Polymorphisms (2 to 14) on 22 HA Segments
. . . . . . . . with 30 Distinct Values
. . . . . . . . Averaging ~5.6 Polymorphisms per HA Segment

Total HA Clade2: 88 Polymorphisms (8 to 14) on 9 Segments
. . . . . . . . . . . . with 24 Distinct Values
. . . . . . . . . . . . Averaging ~9.8 Polymorphisms per Clade2 HA Segment

HA 142V is not found as a singleton polymorphism, even on short fragments. 100% of HA 142V-bearing pH1N1 human sequences (22) also carry either HA 188T (9), syn194L (12) or 225E (1, Origin pH1N1).

Neuraminidase Statistics for HA 142V

Total NA: 94 Polymorphisms (1 to 12) on 20 Segments
. . . . . . . . with 20 Distinct Values
. . . . . . . . Averaging ~4.7 Polymorphisms per HA Segment

Total NA Clade2: 81 Polymorphisms (7 to 12) on 9 Segments
. . . . . . . . . . . . with 19 Distinct Values
. . . . . . . . . . . . Averaging ~9.0 Polymorphisms per Clade2 NA Segment

100% of the available related NA segments (20) carries NA syn416D.

Clade2 Shared Polymorphisms

HA Background: 100N, 142V, 188T, syn338G, 377K, 454N (6 common)
NA Background: [76S (8), 77E (1)], syn240T, 241I, 369K, syn377P, syn416D (5 common)

Sequences

. . . . RussiaTulaCRIE_KEE_2011_02_04 (
. . . . . . . . Clade2: 188T
. . . . . . . . GISAID HA EPI335282
. . . . . . . . 10 Polymorphisms (5 Amino and 5 Silent)
. . . . . . . . 100N,
. . . . . . . . 142V,
. . . . . . . . syn154L (CTg) [Rare to pH1N1 Human (3 Total: 2 on Clade2)]
. . . . . . . . . . . . . . . . . . [H1N1 Avian Farm
. . . . . . . . . . . . . . . . . . . . . with #1T, syn202V
. . . . . . . . . . . . . . . . . . . . . . . . & extensive pH1N1υ polymorphisms],
. . . . . . . . . . . . . . . . . . [H1N1 swine],
. . . . . . . . . . . . . . . . . . [H7N7 Avian and Human (tcg)],
. . . . . . . . . . . . . . . . . . [H9N2 Avian 2009 & Human 2009
. . . . . . . . . . . . . . . . . . . . . with pH1N1υ polymorphisms],
. . . . . . . . . . . . . . . . . . [S9, M9, S7],
. . . . . . . . . . . . . . . . . . [WSN1933, WSZ1933],
. . . . . . . . . . . . . . . . . . [1918],
. . . . . . . . 188T,
. . . . . . . . syn202V (GTc) [H1N1 Avian Farm
. . . . . . . . . . . . . . . . . . . . . with extensive pH1N1υ polymorphisms],
. . . . . . . . . . . . . . . . . . [H6N1 Avian],
. . . . . . . . . . . . . . . . . . [S9],
. . . . . . . . . . . . . . . . . . [H1N1 Human 1943, 1946, 1951],
. . . . . . . . . . . . . . . . . . [WSN1933, WSZ1933],
. . . . . . . . . . . . . . . . . . [1918],
. . . . . . . . syn338G (GGc),
. . . . . . . . 377K,
. . . . . . . . 454N,
. . . . . . . . syn474C (TGt),
. . . . . . . . syn542S (TCc))

. . . . RussiaTulaCRIE_KEE_2011_02_04 (
. . . . . . . . GISAID NA EPI335288
. . . . . . . . 7 Polymorphisms (3 Amino and 4 Silent)
. . . . . . . . syn51Q (CAg) [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 76S [H1N1 Avian
. . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . syn240T (ACc),
. . . . . . . . 241I,
. . . . . . . . 369K,
. . . . . . . . syn377P (CCa),
. . . . . . . . syn416D (GAc))

. . . . RussiaVladimirIIV35_T_27M_2011_01_31_f (
. . . . . . . . Clade2: 188T
. . . . . . . . GISAID HA EPI324794
. . . . . . . . 14 Polymorphisms (10 Amino and 4 Silent)
. . . . . . . . 1T [42 pH1N1,
. . . . . . . . . . . . . only 9 from 2010-2011 Season (NH)],
. . . . . . . . . . [H1N1 Avian Farm
. . . . . . . . . . . . . with extensive pH1N1υ polymorphisms],
. . . . . . . . . . [H6N1 Avian (agc)]
. . . . . . . . . . [H7N7 Avian & Human Fatality],
. . . . . . . . . . [H9N2 Avian & Human (agc, agt, atc)],
. . . . . . . . . . [Netherlands2457b_2009_11_07_xL
. . . . . . . . . . . . . . . . . . with 225N,
. . . . . . . . . . IndiaHyderabad51_2009_05
. . . . . . . . . . . . . . . . . . with syn144A],
. . . . . . . . . . [H1N1 swine],
. . . . . . . . . . [S9, M9, S7],
. . . . . . . . . . [1976],
. . . . . . . . . . [WSN1933, WSZ1933],
. . . . . . . . . . [1918],
. . . . . . . . 100N,
. . . . . . . . 142V,
. . . . . . . . 157Q mix wt,
. . . . . . . . 188T,
. . . . . . . . 225G mix wt,
. . . . . . . . 225N mix wt,
. . . . . . . . 225S mix wt,
. . . . . . . . syn338G (GGc),
. . . . . . . . 377K,
. . . . . . . . 454N,
. . . . . . . . syn474C (TGt),
. . . . . . . . syn515Q (CAa) [H5N1 Avian & Human wt],
. . . . . . . . syn527L (TTa) [H5N1 Avian])

. . . . RussiaVladimirIIV35_T_27M_2011_01_31_f (
. . . . . . . . GISAID NA EPI324795
. . . . . . . . 9 Polymorphisms (3 Amino and 6 Silent)
. . . . . . . . syn51Q (CAg) [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 76S [H1N1 Avian
. . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . syn204A (GCa),
. . . . . . . . syn240T (ACc),
. . . . . . . . 241I,
. . . . . . . . syn291V (GTa) [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 369K,
. . . . . . . . syn377P (CCa),
. . . . . . . . syn416D (GAc))

. . . . RussiaNizhniiNovgorodCRIE_BLM_L_2011_01_26_TmX_f (
. . . . . . . . Clade2: 188T with 230I
. . . . . . . . GISAID HA EPI339320
. . . . . . . . 10 Polymorphisms (7 Amino and 3 Silent)
. . . . . . . . 77N [Recently Novel to Clade1.Upsilon],
. . . . . . . . . . . . [Emergent on pH1N1 Clade 1 (189T)
. . . . . . . . . . . . . . . . with 124N, 233H, 275A],
. . . . . . . . . . . . [H1N1 Avian
. . . . . . . . . . . . . . . . with syn42G, 159T,
. . . . . . . . . . . . . . . . . . . . 188T, 189T, syn346G, 453K],
. . . . . . . . . . . . [Rare to H1N1 US Swine with 124N (6)],
. . . . . . . . 100N,
. . . . . . . . 142V [H5N1 Avian (atg, ctg)],
. . . . . . . . 188T,
. . . . . . . . 230I (ATt) [H9N2 Avian & Human wt],
. . . . . . . . . . . . [H10N7 Avian 2008
. . . . . . . . . . . . . . . . with #1V, 87N, syn94Y, 100N, syn102E,
. . . . . . . . . . . . . . . . . . . 156E, 157E, 163T, 165N,
. . . . . . . . . . . . . . . . . . . syn177L, 188T, syn221P, syn207S, syn213F,
. . . . . . . . . . . . . . . . . . . 225G, 230I, 233H, 237I, syn239P,
. . . . . . . . . . . . . . . . . . . syn338G, syn346G, syn356H,
. . . . . . . . . . . . . . . . . . . syn390N, syn391T],
. . . . . . . . syn338G (GGc),
. . . . . . . . 377K,
. . . . . . . . 454N,
. . . . . . . . syn474C (TGt) [H2 2009],
. . . . . . . . . . . . . . . . . . [H3N8 Canine 2007, Equine 2009, Swine],
. . . . . . . . . . . . . . . . . . [H5N1 wt],
. . . . . . . . . . . . . . . . . . [H5N2 Avian],
. . . . . . . . . . . . . . . . . . [H9N2 2009],
. . . . . . . . . . . . . . . . . . [H1N1 Avian 2010],
. . . . . . . . . . . . . . . . . . [H1N1 swine 2010],
. . . . . . . . syn542S (TCc) [H2, H5, H9N2],
. . . . . . . . . . . . . . . . . . [H1N1 Avian Farm
. . . . . . . . . . . . . . . . . . . . . with pH1N1υ polymorphisms])

. . . . RussiaNizhniiNovgorodCRIE_BLM_L_2011_01_26_TmX_f (
. . . . . . . . GISAID NA EPI339322
. . . . . . . . 10 Polymorphisms (4 Amino and 6 Silent)
. . . . . . . . syn51Q (CAg) [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 76S [H1N1 Avian
. . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . syn111K (AAa) [H1N1 Avian Farm],
. . . . . . . . syn204A (GCa),
. . . . . . . . syn240T (ACc) [H1N1 Avian Farm],
. . . . . . . . 241I [H1N1 Avian Farm],
. . . . . . . . 275Y mix wt,
. . . . . . . . 369K [H1N1 Avian
. . . . . . . . . . . . . . . . with syn111K, syn240T, 241I],
. . . . . . . . syn377P (CCa) [H5N1 Avian],
. . . . . . . . . . . . . . . . . . . [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . with 241I],
. . . . . . . . . . . . . . . . . . . [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . exclusive of syn240T (ACc)],
. . . . . . . . syn416D (GAc) [H5N1 Avian Emergent 2011],
. . . . . . . . . . . . . . . . . . . [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . with syn51Q, syn240T, 241I],
. . . . . . . . . . . . . . . . . . . [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . with syn111K, syn377P])

. . . . RussiaNizhniiNovgorodCRIE_LAV_L_2011_01_24_f (
. . . . . . . . Clade2: 188T
. . . . . . . . GISAID HA EPI335268
. . . . . . . . 9 Polymorphisms (6 Amino and 3 Silent)
. . . . . . . . 100N,
. . . . . . . . 142V,
. . . . . . . . 188T,
. . . . . . . . 225G,
. . . . . . . . syn338G (GGc),
. . . . . . . . 377K,
. . . . . . . . 454N,
. . . . . . . . syn474C (TGt),
. . . . . . . . syn542S (TCc))

. . . . RussiaNizhniiNovgorodCRIE_LAV_L_2011_01_24_f (
. . . . . . . . GISAID NA EPI335295
. . . . . . . . 8 Polymorphisms (3 Amino and 5 Silent)
. . . . . . . . syn51Q (CAg) [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 76S [H1N1 Avian
. . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . syn204A (GCa),
. . . . . . . . syn240T (ACc),
. . . . . . . . 241I,
. . . . . . . . 369K,
. . . . . . . . syn377P (CCa),
. . . . . . . . syn416D (GAc))

. . . . RussiaNizhniiNovgorodCRIE_OAV_L_2011_01_24_f (
. . . . . . . . Clade2: 188T
. . . . . . . . GISAID HA EPI335280
. . . . . . . . 8 Polymorphisms (5 Amino and 3 Silent)
. . . . . . . . 100N,
. . . . . . . . 142V,
. . . . . . . . 188T,
. . . . . . . . syn338G (GGc),
. . . . . . . . 377K,
. . . . . . . . 454N,
. . . . . . . . syn474C (TGt),
. . . . . . . . syn542S (TCc))

. . . . RussiaNizhniiNovgorodCRIE_OAV_L_2011_01_24_f (
. . . . . . . . GISAID NA EPI335294
. . . . . . . . 8 Polymorphisms (3 Amino and 5 Silent)
. . . . . . . . syn51Q (CAg) [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 76S [H1N1 Avian
. . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . syn204A (GCa),
. . . . . . . . syn240T (ACc),
. . . . . . . . 241I,
. . . . . . . . 369K,
. . . . . . . . syn377P (CCa),
. . . . . . . . syn416D (GAc))

. . . . RussiaNizhniiNovgorodCRIE_UBA_L_2011_01_23_f (
. . . . . . . . Clade2: 188T
. . . . . . . . GISAID HA EPI335274
. . . . . . . . 12 Polymorphisms (9 Amino and 3 Silent)
. . . . . . . . 50I,
. . . . . . . . 100N,
. . . . . . . . 142V,
. . . . . . . . 188T,
. . . . . . . . 225G mix wt,
. . . . . . . . 225N mix wt,
. . . . . . . . 225S mix wt,
. . . . . . . . syn338G (GGc),
. . . . . . . . 377K,
. . . . . . . . 454N,
. . . . . . . . syn474C (TGt),
. . . . . . . . syn542S (TCc))

. . . . RussiaNizhniiNovgorodCRIE_UBA_L_2011_01_23_f (
. . . . . . . . GISAID NA EPI335301
. . . . . . . . 12 Polymorphisms (5 Amino and 7 Silent)
. . . . . . . . syn51Q (CAg) [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 76S [H1N1 Avian
. . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 149F,
. . . . . . . . syn152R (AGa) [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . syn204A (GCa),
. . . . . . . . syn240T (ACc),
. . . . . . . . 241I,
. . . . . . . . syn291V (GTa) [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 305A,
. . . . . . . . 369K,
. . . . . . . . syn377P (CCa),
. . . . . . . . syn416D (GAc))

. . . . Slovenia414_75F_2011_01_19 (
. . . . . . . . Clade2: 188T
. . . . . . . . GISAID HA EPI331063
. . . . . . . . 9 Polymorphisms (5 Amino and 4 Silent)
. . . . . . . . 100N,
. . . . . . . . 142V,
. . . . . . . . syn179L (CTg),
. . . . . . . . 188T,
. . . . . . . . syn338G (GGc),
. . . . . . . . 377K,
. . . . . . . . syn448L (TTg),
. . . . . . . . 454N,
. . . . . . . . syn467C (TGt) mix wt [H1N1 Avian Farm])

. . . . Slovenia414_75F_2011_01_19 (
. . . . . . . . GISAID NA EPI331064
. . . . . . . . 8 Polymorphisms (4 Amino and 4 Silent)
. . . . . . . . 77E [H1N1 Avian],
. . . . . . . . syn162P (CCc) [H1N1 Avian],
. . . . . . . . syn240T (ACc),
. . . . . . . . 241I,
. . . . . . . . 242I,
. . . . . . . . 369K,
. . . . . . . . syn377P (CCa),
. . . . . . . . syn416D (GAc))

. . . . RussiaNizhniiNovgorodCRIE_PAV_L_2011_01_10_f (
. . . . . . . . Clade2: 188T
. . . . . . . . GISAID HA EPI339341
. . . . . . . . 8 Polymorphisms (5 Amino and 3 Silent)
. . . . . . . . 100N,
. . . . . . . . 142V,
. . . . . . . . 188T,
. . . . . . . . syn338G (GGc),
. . . . . . . . 377K,
. . . . . . . . 454N,
. . . . . . . . syn474C (TGt),
. . . . . . . . syn542S (TCc))

. . . . RussiaNizhniiNovgorodCRIE_PAV_L_2011_01_10_f (
. . . . . . . . GISAID NA EPI339342
. . . . . . . . 10 Polymorphisms (5 Amino and 5 Silent)
. . . . . . . . syn51Q (CAg) [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 76S [H1N1 Avian
. . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 115L,
. . . . . . . . syn204A (GCa),
. . . . . . . . syn240T (ACc),
. . . . . . . . 241I,
. . . . . . . . 322L [H1N1 Avian with syn240T, 241I],
. . . . . . . . 369K,
. . . . . . . . syn377P (CCa),
. . . . . . . . syn416D (GAc))

. . . . RussiaNizhniiNovgorodCRIE_NGV_L_2010_12_31_f (
. . . . . . . . Clade2: 188T
. . . . . . . . GISAID HA EPI339312
. . . . . . . . 8 Polymorphisms (5 Amino and 3 Silent)
. . . . . . . . 100N,
. . . . . . . . 142V,
. . . . . . . . 188T,
. . . . . . . . syn338G (GGc),
. . . . . . . . 377K,
. . . . . . . . 454N,
. . . . . . . . syn474C (TGt),
. . . . . . . . syn542S (TCc))

. . . . RussiaNizhniiNovgorodCRIE_NGV_L_2010_12_31_f (
. . . . . . . . GISAID NA EPI339314
. . . . . . . . 9 Polymorphisms (4 Amino and 5 Silent)
. . . . . . . . syn51Q (CAg) [H1N1 Avian
. . . . . . . . . . . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 76S [H1N1 Avian
. . . . . . . . . . . . . . with syn240T, 241I],
. . . . . . . . 115L,
. . . . . . . . syn204A (GCa),
. . . . . . . . syn240T (ACc),
. . . . . . . . 241I,
. . . . . . . . 369K,
. . . . . . . . syn377P (CCa),
. . . . . . . . syn416D (GAc))

. . . . Moldova93_CS_2010_01_05 (
. . . . . . . . GISAID HA EPI278150
. . . . . . . . 3 Polymorphisms (2 Amino and 1 Silent)
. . . . . . . . 142V,
. . . . . . . . syn194L (CTt) [H1N1 Avian],
. . . . . . . . 324I (aTC) [H1N1 Avian],
. . . . . . . . . . . . . . [H3N2 Avian with 159S],
. . . . . . . . . . . . . . [H3N2 Canine with syn287G],
. . . . . . . . . . . . . . [H3N8 Avian Emergent],
. . . . . . . . . . . . . . [H6 Avian],
. . . . . . . . . . . . . . [S8],
. . . . . . . . HA Truncated after aa396)

. . . . Moldova93_CS_2010_01_05 (
. . . . . . . . GISAID NA EPI278149
. . . . . . . . 1 Polymorphisms (0 Amino and 1 Silent)
. . . . . . . . syn416D (GAc))

. . . . KazakhstanTaraz01_2009_12 (
. . . . . . . . GISAID HA EPI235349
. . . . . . . . 6 Polymorphisms (4 Amino and 2 Silent)
. . . . . . . . 4Y,
. . . . . . . . syn111V (GTa) [H1N1 Avian],
. . . . . . . . . . . . . . . . [H9N2 Human (Gca)],
. . . . . . . . 142V,
. . . . . . . . syn194L (CTt) [H1N1 Avian],
. . . . . . . . 225G,
. . . . . . . . 324I (aTC) [H1N1 Avian],
. . . . . . . . . . . . . . [H3N2 Avian with 159S],
. . . . . . . . . . . . . . [H3N2 Canine with syn287G],
. . . . . . . . . . . . . . [H3N8 Avian Emergent],
. . . . . . . . . . . . . . [H6 Avian],
. . . . . . . . . . . . . . [S8])

. . . . KazakhstanAlmaty373_9M_2009_11_28 (
. . . . . . . . GISAID HA EPI277103
. . . . . . . . 2 Polymorphisms (1 Amino and 1 Silent)
. . . . . . . . 142V,
. . . . . . . . syn194L (CTt) [H1N1 Avian],
. . . . . . . . HA Truncated after aa293)

. . . . KazakhstanAlmaty373M_9M_2009_11_28 (
. . . . . . . . GISAID NA EPI277104
. . . . . . . . 1 Polymorphisms (0 Amino and 1 Silent)
. . . . . . . . NA Truncated before aa193,
. . . . . . . . syn416D (GAc))

. . . . KazakhstanAlmaty373CX_9M_2009_11_28 (
. . . . . . . . GISAID HA EPI271067
. . . . . . . . 2 Polymorphisms (1 Amino and 1 Silent)
. . . . . . . . 142V,
. . . . . . . . syn194L (CTt) [H1N1 Avian],
. . . . . . . . HA Truncated after aa293)

. . . . KazakhstanAlmaty373CX_9M_2009_11_28 (
. . . . . . . . GISAID NA EPI271068
. . . . . . . . 1 Polymorphisms (0 Amino and 1 Silent)
. . . . . . . . NA Truncated before aa193,
. . . . . . . . syn416D (GAc))

. . . . KazakhstanAlmaty352M_9M_2009_11_23 (
. . . . . . . . GISAID HA EPI277101
. . . . . . . . 2 Polymorphisms (1 Amino and 1 Silent)
. . . . . . . . 142V,
. . . . . . . . syn194L (CTt) [H1N1 Avian],
. . . . . . . . HA Truncated after aa293)

. . . . KazakhstanAlmaty352M_9M_2009_11_23 (
. . . . . . . . GISAID NA EPI277102
. . . . . . . . 1 Polymorphisms (0 Amino and 1 Silent)
. . . . . . . . NA Truncated before aa184,
. . . . . . . . syn416D (GAc))

. . . . KazakhstanAlmaty352CX_9M_2009_11_23 (
. . . . . . . . GISAID HA EPI271065
. . . . . . . . 2 Polymorphisms (1 Amino and 1 Silent)
. . . . . . . . 142V,
. . . . . . . . syn194L (CTt) [H1N1 Avian],
. . . . . . . . HA Truncated after aa293)

. . . . KazakhstanAlmaty352CX_9M_2009_11_23 (
. . . . . . . . GISAID NA EPI271066
. . . . . . . . 1 Polymorphisms (0 Amino and 1 Silent)
. . . . . . . . NA Truncated before aa184,
. . . . . . . . syn416D (GAc))

. . . . KazakhstanAlmaty347M_18M_2009_11_19 (
. . . . . . . . GISAID HA EPI277098
. . . . . . . . 3 Polymorphisms (2 Amino and 1 Silent)
. . . . . . . . 124I [H1N1 Avian],
. . . . . . . . 142V,
. . . . . . . . syn194L (CTt) [H1N1 Avian],
. . . . . . . . HA Truncated after aa293)

. . . . KazakhstanAlmaty347M_18M_2009_11_19 (
. . . . . . . . GISAID NA EPI277099
. . . . . . . . 1 Polymorphisms (0 Amino and 1 Silent)
. . . . . . . . NA Truncated before aa184,
. . . . . . . . syn416D (GAc))

. . . . KazakhstanAlmaty347_NP_18M_2009_11_19 (
. . . . . . . . GISAID HA EPI277097
. . . . . . . . 3 Polymorphisms (2 Amino and 1 Silent)
. . . . . . . . 124I [H1N1 Avian],
. . . . . . . . 142V,
. . . . . . . . syn194L (CTt) [H1N1 Avian],
. . . . . . . . HA Truncated after aa293)

. . . . KazakhstanAlmaty347_NP_18M_2009_11_19 (
. . . . . . . . GISAID NA EPI277100
. . . . . . . . 1 Polymorphisms (0 Amino and 1 Silent)
. . . . . . . . NA Truncated before aa184,
. . . . . . . . syn416D (GAc))

. . . . KazakhstanAlmaty347CX_18M_2009_11_19 (
. . . . . . . . GISAID HA EPI271063
. . . . . . . . 3 Polymorphisms (2 Amino and 1 Silent)
. . . . . . . . 124I [H1N1 Avian],
. . . . . . . . 142V,
. . . . . . . . syn194L (CTt) [H1N1 Avian],
. . . . . . . . HA Truncated after aa293)

. . . . KazakhstanAlmaty347CX_18M_2009_11_19 (
. . . . . . . . GISAID NA EPI271064
. . . . . . . . 1 Polymorphisms (0 Amino and 1 Silent)
. . . . . . . . NA Truncated before aa184,
. . . . . . . . syn416D (GAc))

. . . . KazakhstanAlmaty347_18M_2009_11_19 (
. . . . . . . . GISAID HA EPI271061
. . . . . . . . 3 Polymorphisms (2 Amino and 1 Silent)
. . . . . . . . 124I [H1N1 Avian],
. . . . . . . . 142V,
. . . . . . . . syn194L (CTt) [H1N1 Avian],
. . . . . . . . HA Truncated after aa293)

. . . . KazakhstanAlmaty347_18M_2009_11_19 (
. . . . . . . . GISAID NA EPI271062
. . . . . . . . 1 Polymorphisms (0 Amino and 1 Silent)
. . . . . . . . NA Truncated before aa184,
. . . . . . . . syn416D (GAc))

. . . . KazakhstanAlmaty330_NP_4M_2009_11_17 (
. . . . . . . . GISAID HA EPI277095
. . . . . . . . 2 Polymorphisms (1 Amino and 1 Silent)
. . . . . . . . 142V,
. . . . . . . . syn194L (CTt) [H1N1 Avian],
. . . . . . . . HA Truncated after aa293)

. . . . KazakhstanAlmaty330_NP_4M_2009_11_17 (
. . . . . . . . GISAID NA EPI277096
. . . . . . . . 2 Polymorphisms (0 Amino and 2 Silent)
. . . . . . . . NA Truncated before aa186,
. . . . . . . . syn259E (GAg)[H1N1 Avian],
. . . . . . . . syn416D (GAc))

. . . . KazakhstanAlmaty330_4M_2009_11_17 (
. . . . . . . . GISAID HA EPI271059
. . . . . . . . 2 Polymorphisms (1 Amino and 1 Silent)
. . . . . . . . 142V,
. . . . . . . . syn194L (CTt) [H1N1 Avian],
. . . . . . . . HA Truncated after aa293)

. . . . KazakhstanAlmaty330_4M_2009_11_17 (
. . . . . . . . GISAID NA EPI271060
. . . . . . . . 2 Polymorphisms (0 Amino and 2 Silent)
. . . . . . . . NA Truncated before aa186,
. . . . . . . . syn259E (GAg) [H1N1 Avian],
. . . . . . . . syn416D (GAc))

. . . . ItalyPavia15_2009_07_20 (
. . . . . . . . GISAID HA EPI240761
. . . . . . . . 2 Polymorphisms (2 Amino and 0 Silent)
. . . . . . . . HA Truncated before aa83,
. . . . . . . . 142V,
. . . . . . . . 225E,
. . . . . . . . HA Truncated after aa338)

Please visit GeneWurx.com for insight into the latest published studies.