Ukrainian disease is viral disstressindroma - toxic strain A/N1N1

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Translated from Russian courtesy Google:
Ukrainians do not die from pneumonia, but from viral disstressindroma - expert

November 12, 2009 15:41

All victims of the virus in Bukovina (22 persons aged 20 to 40 years) died not from bilateral pneumonia, as previously thought, but as a result of viral disstressindroma, ie total lung injury: first comes the cardio-pulmonary insufficiency, and then developed cardiogenic shock, which causes cardiac arrest and death. On this Monday, 11 November, the newspaper "Doba" said Chief of the Chernivtsi regional forensic bureau, PhD, Professor Victor Bachinsky.

"During the bilateral pneumonia monitor specific morphological picture. Regarding these deaths, there is no such morphological picture. The virus, which causes death, is very aggressive, he did not strike the trachea, and immediately gets into the lungs and causes strong swelling and continuous hemorrhage. Causes such a state of mixed types of parainfluenza and influenza A/N1N1. This is a very toxic strain, which has not yet been worked out by the Ministry of Health method of treatment ", - said Victor Bachinsky.

According to him, an urgent need to change the treatment standards, because those used so far, the results have not given - in intensive care unable to save all people infected with the virus. Not justified in this situation and ALV apparatus - the death rate of people attacked is 100%.

In view of this, a group of professors of Chernivtsi Medical University appealed to the Ministry of Health and NSDC to demand to review the standards of treatment of patients in Bukovina. Scientists-morphological sent to Kiev reports, studies and taken from seriously ill and died from the virus of tests.

Victor Bachinsky, part of the initiators of the treatment group, notes that the virus is extremely toxic, it is able to penetrate not only through inhalation but also through the eye membrane. Therefore Chernovtsy scientists recommend in any case not to give up the masks and the period of the epidemic even wearing goggles. An important condition to prevent deterioration of the situation is also the observance of quarantine regime.

Withheld Ukraine Sequences Raise Pandemic Concerns

Withheld Ukraine Sequences Raise Pandemic Concerns
Recombinomics Commentary 02:30
November 7, 2009
Right now we know that many clinical specimens and viruses have been sent to one of the WHO collaborating centres for further study. We don't know the results of those studies, and it will probably take a couple of days for the full analysis of those viruses to be available. But in the meantime, what we do not have is any evidence of viruses there or anywhere else as showing any big mutations. I raise this point because I have seen in some media reports that there are reports that WHO or other groups are saying that there are mutations and I want to point out that these are rumours and factually, untrue.

The above comments from Keiji Kukuda offer some general comments on the Ukrainian H1N1 sequences at Mill Hill in London. He specifically says WHO doesn't see any "big" mutations in the samples being sequenced, which would refer to reassortment or Tamiflu resistance. 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.

However, the rapid spread of H1N1 in Ukraine (see map), coupled with the high frequency of hemorrhagic pneumonia raise concerns that a small change is leading to a more virulent virus. Similarly, the rapid spread of the virus could also be affected by a small change in another gene, such as HA, which controls entry of the virus to cells and influences tissue tropism.

Mill Hill has acknowledged that they have at least 15 H1N1 positive samples from Ukraine, which would identify a Ukranian specific change. The delay in the announcement of sequence results raises concerns that such changes have been detected, and such changes are undergoing further analysis.

The number of cases in Ukraine continues to expand. The number of patients with H1N1 symptoms is now approaching 1 million. Cases have been increasing at almost 200,000 per day, so it is likely that tomorrow's report will have over 1 million cases. This rapid spread increases concern that the 15 sequences at Mill Hill contain one or more of these small changes, which has led to a delay in the announcement of sequence results.

More detail on the sequences at Mill Hill is overdue. The rapid spread of H1N1 in Ukraine demands rapid sequence results. Continued delay will only increase concerns.

Cases of infected patients in Ukraine double to just under ½ million in two days

Reported Cases in Ukraine Double in Two Days
Recombinomics Commentary 14:34
November 4, 2009

478,456 Influenza/ARI

24,003 Hospitalized

60 Ventilators

81 Deaths

The above numbers are from the latest update from Ukraine. The number of infected patients has almost doubled to just under ½ million, compared to the report two days ago (see map). Hospitalized patients also have spiked higher, to 24K from 15K. ICU cases are not listed, but 60 on ventilators are. However, most (37) of those on ventilators are Chernivisti Oblast, but Lviv, which has the most fatalities and cases, has none, suggesting the data is incomplete or there are significant shortages of ventilators. The number of dead has risen to 81, but media reports describe additional fatalities, include those in the Kiev Oblast.

The explosion of cases again raises concerns that the number of fatalities is significantly higher than the 81 listed. Media reports have described an equal number of pneumonia fatalities which were not considered flu related. The basis of these exclusions remains unclear. Similarly, anecdotal reports suggest the number of fatalities is markedly higher than the 81 in the table.

The rapid rise in reported infections, hospitalizations, and deaths in the past few days raise concerns that the virus is transmitting very efficiently. Spikes in cases have been reported throughout the northern hemisphere, but the spike in fatalities and the frequency in hemorrhagic cases in Ukraine have raised concerns.

Earlier media reports suggest that an update by WHO might be issued today and include preliminary analysis of samples sent to Mill Hill in London.

Daily updates on the rapidly evolving situation in Ukraine, including sequence analysis, would be useful.
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