Ok, this is actually concerning. The sequence of the hospitalized teen with H5N1 has been released. Both of these mutation sites are known to impact α2,6 binding that is needed for human to human transmissibility.
Need top experts on H5N1 to immediately to look into this.
Need top experts on H5N1 to immediately to look into this.
https://twitter.com/jbloom_lab/status/1857817755199877451
⚠️The right mutations at these sites can, on paper, significantly increase h-h transmission. That's why there needs to be immediate focus on this sample. It's somewhat unclear if the mutations occurred in this patient or prior to their infection.
It is also concerning that this is the first severe case we've had in North America out of many now. Is it a coincidence that these potentially h-h supporting mutations are linked to the most severe outcome?
I'd like to see some more clarification of the exact mutations at 190 and 226, and what the predicted shift is for each. It's also been suggested that there may be both the original amino acids AND the mutations in the same sample. This might suggest they evolved in this pt. 
The details regarding this case are also concerning. This is the first very severe case in NA and in a healthy teen.. is that related to the mutations or a coincidence? This patient also had no known exposure history to wild or farmed animals
https://x.com/JPWeiland/status/1856543155451011338
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