A 42 year old woman who worked at the University of Texas in Austin died of the new H1N1 virus on September 27, 2009 (abcNews). Her 35 year old sister died of the new H1N1 virus October 7, 2009 (KXAN). Although we don’t know for certain that the virus was transmitted from one sister to another, the timing of the deaths is consistent with this possibility. Although it is possible that one or both sisters had underlying conditions that may have contributed to their deaths, any fatal cluster should be vigorously investigated as it may indicate that a more lethal virus has developed. Viral samples from each patient should be completely sequenced. This would allow investigators to determine whether the two sisters were infected with the same strain of virus. Live virus should also be used to infect ferrets to determine if the strain that killed these two women is more lethal than other new H1N1 strains.
If it sounds like you’ve read a blog like this before, it’s because you have. I wrote a blog describing a similar fatal cluster in Indiana. I recommended the same experiments be done. As far as I know, no reports of any such experiments have been made public. This is a mistake, imo. There was a report suggesting a lethal mutation in American cases, but which Americans were involved was never disclosed.
The overall incidence of death in Texas is not disproportionate to that state’s population. However, there have been anecdotal reports of much more severe strains in outbreaks in Texas. Is there something going on in Texas? Hard to know, at this point.
I just hope I don’t have to write any more blogs about fatal clusters.