Recombinomics Commentary 23:21
November 9, 2009
"There are a lot of unknowns," he said. The crew of experts will collect samples from patients and send them to the WHO's influenza collaborating center in London for diagnosis. The WHO may have more information on Nov. 4, Hartl said.
The above comments were made on Oct 30. The WHO update of the next day indicated that H1N1 had already been confirmed in two labs in Kyviv and samples were being sent to a WHO collaborating center, Mill Hill. Since H1N1 had already been lab confirmed twice, and multiple reports of symptoms of fatal cases left little doubt that the patients had died from hemorrhagic pneumonia, the main unknown question was the sequence of the H1N1. Thus, it seemed likely that comments on sequences would be made on Nov 4.
In the Nov 3 update, WHO acknowledged that the samples had been received in Mill Hill and it seemed that data would soon be announced, baring sample degradation. When Mill Hill announce confirmation of H1N1 in 15 samples it seemed likely that sequence results would soon follow.
There was no announcement on Nov 4, but there was a press conference on Nov 5, indicating that analysis was still ongoing, but there were no "big mutations" and the virus was antiviral sensitive. Thus, at least the initial sequencing of all eight gene segments had been completed and an initial analysis had already been made.
If there were no obvious changes, it seems that an announcement would have been made last week. The number of cases was approaching 1 million (see map), and the number of fatalities had already exceeded 100, including six health care workers. The infections were spreading east toward Kyviv and neighboring countries had an excessive number of cases, and deaths were mounting in Belarus.
This morning a clinical description of 90 fatal cases again supported hemorrhagic pneumonia, which once again raised concern about genetic changes.
However, there has only been silence on the sequences and they have not been made public. These delays suggest significant changes have been found, and these changes are undergoing further analysis, such as receptor binding testing.
An update on the sequences is long overdue.