Additional cases infected with trH3N2 in Indiana and Maine

[alert]

Some sources are reporting that a sequence A/Indiana/11/2011 coming from a 59M has been deposited at GISAID of trH3N2 with the M gene from 2009 H1N1 and a collection date of October 22. Given the age and date, this is likely a new case.

A sample of A/Maine/07/2011, also trH3N2 with the M from H1N1 is also posted, from an 8M with a collection date of October 24, which may or may not be the same case earlier reported in Maine. I have yet to see an age on the previously announced case, but it is known as a male, and was ill in September, so it is not yet clear if this one is new.

[sharon sanders]

Re: Additional cases infected with trH3N2 in Indiana and Maine?

I can verify that the following case is listed in GISAID. However, there is a "?" after the comment:

"Human infection with SOIV triple reassortant H3N2 possessing an M gene from H1N1pdm.?"

I not sure what that means.


A/Indiana/11/2011
Isolate ID: EPI_ISL_98659
Passage: X1
A / H3N2
Male, 59 years old
Location: United States / Indiana
Originating Lab: Indiana State Departmnet of Health Laboratories
Collection date of sample: October 22, 2011

[sharon sanders]

Re: Additional cases infected with trH3N2 in Indiana and Maine?

There is also:

A/Maine/07/2011
EPI_ISL_98658
Passage: Original
A / H3N2
Male, 8 years old
Location: United States / Maine
Originating Lab: Maine Health and Environmental Testing Laboratory
Collection date of sample: October 24, 2011

There is also this comment:

"Human infection with SOIV triple reassortant H3N2 possessing an M gene from H1N1pdm.?"

[alert]

Re: Additional cases infected with trH3N2 in Indiana and Maine?

Thank you Sharon, as always. I have corrected the dates in my first post; the error was mine and not that of GISAID or any other source.

Given the dates in October, it seems quite likely these are both previously unreported cases.

[sharon sanders]

Re: Additional cases infected with trH3N2 in Indiana and Maine?

It seems to me that this strain is probably widely distributed. We have been tracking it for a year and it has appeared in several states. Please see this forum for a detailed description of the cases:

http://www.flutrackers.com/forum/forumdisplay.php?f=2614

I will also say that while we are tracking this flu, as we try to track all influenza, we are not going to lose our focus on H5N1. It is the most deadly of all circulating flu.

Please see current H5N1 case chart for Indonesia 2011:

http://www.flutrackers.com/forum/showthread.php?t=165518

[JimO]

Re: Additional cases infected with trH3N2 in Indiana and Maine?

What is confusing things, as it did with the two 9 yo girls in PA with trH3N2, is that A/Maine/06/2011 is reported as an 8M. Could these be two samples from the same child or two 8M cases?

There is also:

A/Maine/07/2011
EPI_ISL_98658
Passage: Original
A / H3N2
Male, 8 years old
Location: United States / Maine
Originating Lab: Maine Health and Environmental Testing Laboratory
Collection date of sample: October 24, 2011

There is also this comment:

"Human infection with SOIV triple reassortant H3N2 possessing an M gene from H1N1pdm.?"

[sharon sanders]

Re: Additional cases infected with trH3N2 in Indiana and Maine?

As to the two Maine entries in the database - there are two different sample identifications given by the sample provider and two different collection dates.

A/Maine/06/2011
EPI_ISL_97361
Passage: Original
A / H3N2
Male, 8 years old
Location: United States / Maine
Originating Lab: Maine Health and Environmental Testing Laboratory
Collection date of sample: October 10, 2011

Comment:

"Human case of SOIV H3N2 with M gene from H1N1pdm09"

Sample id given by sample provider: M00070249 ORIGINAL


----------------------------------------------


A/Maine/07/2011
EPI_ISL_98658
Passage: Original
A / H3N2
Male, 8 years old
Location: United States / Maine
Originating Lab: Maine Health and Environmental Testing Laboratory
Collection date of sample: October 24, 2011

Comment:

"Human infection with SOIV triple reassortant H3N2 possessing an M gene from H1N1pdm.?"

Sample id given by sample provider: M00072681 ORIGINAL

[alert]

Re: Additional cases infected with trH3N2 in Indiana and Maine?

And that's what is not clear about the Maine case(s). The two samples are two weeks apart. It is unusual for a single case to be actively shedding detectable virus for two weeks, especially considering we have no evidence that the case was particularly severe (we know that the October 10 case we were previously aware of was detected because of his attendance at an agricultural fair, not because of its severity). It certainly looks like it could be two different cases, but at this point there is no way to know for sure.

[alert]

Re: Additional cases infected with trH3N2 in Indiana and Maine?

It's a second case in Maine:

http://www.maine.gov/tools/whatsnew/attach.php?id=318077&an=2

Maine confirmed a second case of swine origin novel influenza A virus. The first case was confirmed on October 17th, and the second case was confirmed October 31st. Both cases had multiple exposures to pigs. These cases are the 5th and 6th recognized cases of human infection with S-OtrH3N2 with the M segment gene from the pH1N1virus.

[sharon sanders]

Re: Additional cases infected with trH3N2 in Indiana and Maine?

Thank you Sharon, as always. I have corrected the dates in my first post; the error was mine and not that of GISAID or any other source.

Given the dates in October, it seems quite likely these are both previously unreported cases.

No apology needed. We are a discussion site. We discuss.

"If you do not make mistakes, you aren't really trying." Coleman Hawkins



Thank you to everyone.


KLB for human H5N1 in Bali?

Indonesia 2011 Confirmed and Current Suspected H5N1 Cases Chart

[JimO]

Re: Additional cases infected with trH3N2 in Indiana and Maine?

Either there is H2H transmission or this strain can be fairly easily transmitted from pigs to humans. They keep refering to exposure to pigs, but have they tested any of the pigs to see if they have the same strain? If so, perhaps they should quarantene the infected pigs to prevent further human cases.

[alert]

Re: Additional cases infected with trH3N2 in Indiana and Maine?

This is a Taiwanese source, but indicates the man in his 50s may have been a veterinarian, thus giving him repeated contact with sick pigs.

Also more potential detail on the timing.

http://www.cdc.gov.tw/sp.asp?xdUrl=travel/newsdetail.asp&xItem=36174&ctnode=1448&mp=1

The United States ─ H3N2 swine flu

Source: WHO Event Information Site for IHR National Focal Point, 2011/11/2

U.S. 11 / 1 reported two cases of swine-derived H3N2 influenza cases, prior to the onset had a history of contact with pigs.

1 case of 8-year-old boy, the incidence of 10/22, 10/24 medical treatment; the other 1 case of 58-year-old male veterinarian, the incidence of 10/20, 10/21-10/24 hospital.

The United States this year, total 7 cases swine-derived H3N2 influenza cases so far in 2005 total of 15 cases.

[Giuseppe]

Re: Additional cases infected with trH3N2 in Indiana and Maine

Source: Maine Center for Disease Control and Prevention, Influenza Season 2011/2010, November 16 2011 update: http://www.maine.gov/tools/whatsnew/...id=318634&an=2


(...)

Novel Influenza A Virus

Maine confirmed a second case of swine origin novel influenza A virus.

The first case was confirmed on October 17th, and the second case was confirmed October 31st.

Both cases had multiple exposures to pigs.

These cases are the 5th and 6th recognized cases of human infection with S-OtrH3N2 with the M segment gene from the pH1N1virus.

More information can be found in a Health Alert, released 10/19/2011 accessible through: http://www.maine.gov/tools/whatsnew/...id=313425&an=1.

(...)

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