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.
Reposted from Bloom lab
Excellent summary thread here by @scottehensley.bsky.social. To add a few more important notes, the sequence (GISAID EPI_ISL_19548836) is ambiguous at *both* site Q226 (as Scott mentions above) and site E190 (H3 numbering)

Both these sites play an important role in sialic acid binding specificity

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