This dramatic jump in deaths raises concerns that the current H1N1 is more virulent and lethal than the H1N1 circulating in the fall. The early appearance of that virus dramatically increased the P&I, which then declined as the H1N1 levels declined. However, the current jump is well ahead of such a corresponding jump in H1N1, which would support a more lethal H1N1.
Recent reports from Tennessee have described a higher frequency of children with H1N1 entering the ICU as well as a higher percentage dying. These results are early, but mimic the increase in case fatality rate in eastern Ukraine in association with the release of sequences from Oct/Nov which had a strong association of D225G/N with fatal cases, who had significant lung damage.