Haemagglutinin D222G mutation found in a fatal case of pandemic (H1N1) flu in Tunisia

• DOI: 10.1007/s00705-012-1349-0
• Publication Date: 2012-07-06T23:42:11Z
• Authors: Awatef El Moussi; Juan Ledesma; Mohamed Ali Ben H...; Francisco Pozo; Maria Teresa Cuevas; Moncef Hamdoun; Inmaculada Casas; Pilar Perez-Breña; Amine Slim
• Keywords: Male; Tunisia; Molecular Sequence Data; Mutation, Missense; Hemagglutinins, Viral; Sequence Analysis, DNA; Middle Aged; 3. Good health; 03 medical and health sciences; Fatal Outcome; Influenza A Virus, H1N1 Subtype; 0302 clinical medicine; Amino Acid Substitution; Influenza, Human; Humans; RNA, Viral; Mutant Proteins

Recently, the D222G substitution was observed in the HA of pandemic (H1N1) 2009 viruses isolated from fatal cases in several countries. We made a similar observation in one fatal case in Tunisia showing a D222G substitution in a virus isolate. The man was 47 years old and had no other subjacent pathologies or any known risk factors. He died after three days, suffering from severe respiratory symptoms of flu. The causal link of the D222G substitution in Tunisia with virulence must be verified. Further study is warranted to elucidate the intriguing relationship between the D222G substitution and severe disease. Constant molecular surveillance is important to monitor the pathogenicity of circulating strains and evaluate vaccine efficacy.