What to Watch in Ukraine H1N1 Severity

Recombinomics had a good article today detailing that while the WHO is so far indicating they see no "big" mutations or changes in the sampling they've done in the Ukraine so far, Recombinomics reminds us that even "small" changes can lead to dramatic results - quoted below:

However, the changes seen in Ukraine do not require "big" mutations. Small mutations, such as SNP can have profound effects for a virus like pandemic H1N1.

That virus normally circulates in swine, and has recently jumped to humans. It already has many characteristics with the 1918 pandemic strain. Both are swine H1N1 that jumped to humans. Such species jumpers can increase efficiencies with small changes. One good example is position 627 in the PB2 gene. That position comes in two forms. When there is glutamic acid (E) at that position, the PB2 enzyme copies the viral genetic material most efficiently at 41 C, the body temperature of a bird. However, if that position has a lysine (K), the enzyme is most active at 33 C, the temperature of a human nose in the winter. The swine H1N1 has an E, which may be why it goes well in lung, which is 37 C and closer to the optimal replication temperature of 41C. However, a single change that produced the most efficient replication at 37C would lead to even higher levels in the lungs, which could lead to frequent cytokine storms, like those in 1918, instead of the less frequent level seen in Ukraine.

Just in case you haven't been following the severity of H1N1 in the Ukraine, here's today's update from Recombinomics:

Reported Cases in Ukraine Double Again To 871,037
Recombinomics Commentary 22:54
November 6, 2009

871,037 Influenza/ARI Cases

39,603 Hospitalized

135 Deaths

The above numbers from the latest update from Ukraine (see map) continue to alarm. More than half of the Oblasts and cities listed exceed the epidemic threshold, including Kiev and Kiev Oblast, raising concerns that the increase in case numbers will accelerate. Moreover, hospitalization of 39,603 raises concerns that the number of deaths will also accelerate, since 11% of hospitalized cases in California died.

Click the link for more detail about the hemorrhagic pneumonia being seen there. Granted, these people have very sub-standard living and medical care conditions that can cause delayed or non-existent medical care, but we still need to be aware of any mutations or changes in the H1N1 virus if it is found in this region.