An outbreak of H1N1 has killed more than 1,200 people in India since December of 2014. A study done by researchers at MIT has indicated that the virus may have mutated enough such that it is a more dangerous version of the virus than the strains of H1N1 that have been circulating recently. Unfortunately there is has been relatively little data gathered concerning the influenza strains circulating in India. The hemagglutanin protein of influenza, which determines its tropism, has only been sequenced from two influenza strains in India in the past two years. Thus, it is very difficult to determine the amount this new strain has changed from previous ones that had been circulating in the area. However, information from these two sequences is enough to be concerning according to the researchers at MIT.
Recent circulating strains of H1N1 in India contain a mutation in amino acid D225; mutations in this position have been linked to increased virus severity. There is also a mutation in amino acid T200A; this mutation permits hemagglutinin to bind more tightly to host glycan receptors, increasing infectivity. It is still unclear if it is the H1N1 strain with these specific mutations that is the one causing the current outbreak of influenza in India, but this possibility is very plausible. This lack of surveillance over the past few years has made it difficult to assess what the proper response to the outbreak should be. Influenza surveillance in this region should be expected to increase in the near future.