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Euro Surveill. Author's reply: Association of D222G substitution in haemagglutinin of 2009 pandemic influenza A (H1N1) with severe disease

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  • Euro Surveill. Author's reply: Association of D222G substitution in haemagglutinin of 2009 pandemic influenza A (H1N1) with severe disease

    Author's reply: Association of D222G substitution in haemagglutinin of 2009 pandemic influenza A (H1N1) with severe disease (Euro Surveill, extract, edited)

    [Source: EuroSurveillance.org, <cite cite="http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19535">Eurosurveillance - View Article</cite>. Extract, edited.]

    Eurosurveillance, Volume 15, Issue 14, 08 April 2010 - Letters

    Author's reply: Association of D222G substitution in haemagglutinin of 2009 pandemic influenza A (H1N1) with severe disease

    A Kilander 1, R Rykkvin 1, S G Dudman 1, O Hungnes 1
    1. Department of Virology, Norwegian Institute of Public Health, Oslo, Norway

    Citation style for this article: Kilander A, Rykkvin R, Dudman SG, Hungnes O. Author's reply: Association of D222G substitution in haemagglutinin of 2009 pandemic influenza A (H1N1) with severe disease. Euro Surveill. 2010;15(14):pii=19535. Available online: http://www.eurosurveillance.org/View...rticleId=19535

    Date of submission: 07 April 2010


    To the editor:

    We appreciate the response to our paper made by Dr. Mak and colleagues, whose data from Hong Kong SAR appear to be in good agreement with what we have seen in Norway.

    In our original study, we observed a significantly higher frequency of D222G in patients with severe outcomes (including fatal) compared to patients with mild disease. In fact, in both our data set and the Hong Kong data, mutant viruses were not found among several hundred mild cases. Furthermore, as can be seen from our published data, the frequency may be higher also in fatal outcomes (eight of 27 cases) versus severe non-fatal outcomes (three of 34 cases). Comparing these frequencies results in p=0.078 with Fisher?s exact test (two-sided) and p=0.046 with the Mid-P Exact test (two-sided). It would be interesting to know if the new data from Hong Kong SAR can corroborate this observation. Mak et al. report four fatal D222G cases and five non-fatal severe D222G cases, but one would also need to know the total number of fatal cases versus non-fatal severe cases analysed to make the comparison. Hopefully, this information can be obtained.

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