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Re: Human Swine Flu Infection - California
<a rel="nofollow" href="http://www.recombinomics.com/News/04220901/H1N1_CA_Swine.html">Commentary</a>Comment
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Re: Human Swine Flu Infection - California
Updated map
http://maps.google.com/maps/ms?ie=UT...3,2.905884&z=8Comment
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Re: Human Swine Flu Infection - California
Swine Flu Sickens 2 California Kids
CDC Believes Flu Was Contracted in Person-to-Person Spread
By Daniel J. DeNoon
WebMD Health News
Reviewed by Louise Chang, MD
April 21, 2009 -- Two California children got sick with a mysterious new strain of swine flu -- and the CDC thinks they got the pig virus via person-to-person contact.
Both kids, a 10-year-old boy from San Diego County and a 9-year-old girl from Imperial County, are now well. However, the girl had a 104.3-degree fever before she recovered. And the boy traveled by airplane from San Diego to Dallas while he still had flu symptoms.
Is this the first sign of a flu pandemic? That's possible, but not likely, says Lyn Finelli, DrPH, chief of flu surveillance at the CDC.
"While we have a low index of suspicion this is a pandemic, we are being careful to rule out any possibility," Finelli says. "We don't know yet."
"We have here detection of two cases of swine flu virus in children. We are trying to figure out where they came from and how serious they are," says Dan Jernigan, MD, MPH, deputy director of the CDC's influenza division.
The CDC has dozens of people tracing the children's contacts, beginning with close family members. Each of the children had two family members come down with the flu -- in both cases, one family member had the flu before the child had the flu, and one after.
All recovered, but flu virus was not obtained from any of these family members while they still had symptoms. Over the weekend, the CDC developed a specific test for the new swine flu virus; testing of the children's contacts is now under way. It's likely that the tests will reveal other people who recovered from the infection.
CDC has not activated its Atlanta-based command center. But California has, Finelli says, and is putting all available health care workers on the job of tracking down the children's contacts.
Both children attended school, and California authorities are planning to trace the children's school contacts.
Meanwhile, the 10-year-old boy remains in the Dallas area and has made a full recovery from his one-week symptoms of fever, cough, and vomiting.
So far, the CDC says, Texas health authorities have not found any new infections. The boy traveled to Texas with three other children unaccompanied by adults; crew members who assisted the children are now being tested.
The CDC is withholding the name of the airline that flew the boy and his three companions from San Diego to Dallas on April 3.
Swine flu viruses don't normally infect humans. When they do, it's almost always because of contact with an infected pig. But neither child had any direct contact with pigs.
Moreover, the viruses recovered from the children are not like the swine flu viruses common among pigs. That raises the specter of human-to-human spread of the virus, Finelli says.
"This virus is different, very different from that circulating in pigs. That was a red flag," Finelli told WebMD and several other news organizations. "The other red flag is both cases appeared almost simultaneously, 100 miles apart. When we see two cases [of swine flu] without animal contact that occur simultaneously and they have a different virus [than in pigs], we are concerned."
What worries the CDC is that the two cases might signal the beginning of a flu pandemic with a virus new to humans. But CDC spokesman Tom Skinner notes that it's the CDC's job to be worried. Several things about the cases are reassuring:- Both cases were detected by routine flu surveillance.
- Southern California has unusually excellent flu surveillance -- and there has not been a large number of flu cases from unusual flu strains.
- The virus is the H1N1 strain of swine flu. There are human strains of H1N1, raising at least the possibility of cross-protection -- especially in adults.
Swine flu last spurred headlines in 1976 when an outbreak of swine flu at Fort Dix, N.J., killed one healthy recruit, caused four cases of serious pneumonia, and spread to some 230 soldiers before it vanished.
It's still not clear where the 1976 virus came from or why it went away -- but it spurred widespread public alarm and a vaccination program that badly misfired before being terminated.
The CDC, the California Department of Public Health, and the health departments of Imperial and San Diego counties urge all of those counties' residents and visitors who develop flu-like symptoms to seek medical attention.
Doctors who see these patients are advised to send swab samples to state or local health authorities. They are also asked to get full interviews to ask about other family members or contacts who may be ill.
Here's the CDC's advice for all people who get flu-like symptoms, whether it's normal seasonal flu or swine flu:- Stay home when you are sick to avoid spreading illness to co-workers and friends.
- Children with flu-like symptoms should stay home to avoid spreading illness to classmates and staff.
- Cough or sneeze into your elbow or a tissue and properly dispose of used tissues.
- Wash your hands thoroughly with soap and warm water or use an alcohol-based hand sanitizer to get rid of most germs, and avoid touching your eyes, nose, and mouth.
- Stay healthy by eating a balanced diet, drinking plenty of water, and getting adequate rest and exercise.
The CDC announced the swine flu cases in a special MMWR Dispatch published today.
Comment
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Re: Human Swine Flu Infection - California
Source: http://www.cidrap.umn.edu/cidrap/con...2109swine.html
Human swine flu cases with unique strain raise concern
Robert Roos * News Editor
Apr 21, 2009 (CIDRAP News) ? Two California children who had not had contact with pigs recently recovered from infections with "unique" swine influenza viruses, raising concern about possible human-to-human transmission and putting health authorities on alert, the Centers for Disease Control and Prevention (CDC) reported today.
The two cases were in a 10-year-old boy in San Diego County and a 9-year-old girl in neighboring Imperial County, but they are apparently unrelated, the CDC said in an MMWR Dispatch report today.
"The viruses from the two cases are closely related genetically, resistant to amantadine and rimantadine [the two older flu antivirals], and contain a unique combination of gene segments that previously has not been reported among swine or human influenza viruses in the United States or elsewhere," the CDC report says.
The lack of any known exposure to pigs in the two cases increases the chance that the children contracted their infections from other people, the CDC said. The agency advised physicians to consider animal influenza virus infections in patients who recently were in the two California counties or had contact with pigs.
The CDC says it received reports of 12 human swine flu cases from December 2005 through January 2009, an increase from the previous long-term average of about one case every 1 to 2 years. The "vast majority" of such cases do not lead to human-to-human transmission, but all need to be investigated thoroughly, the agency states.
Illnesses began in March
The 10-year-old boy fell ill with fever, cough, and vomiting on Mar 30, according to the CDC. He was taken to a clinic, where he received symptomatic treatment, and he recovered in about a week. He had not received flu vaccine this season. The boy and his family said he had had no exposure to pigs.
Initial testing at the clinic indicated an influenza A virus but was negative for human subtypes H1N1, H3N2, and H5N1, the report says. A sample was sent to reference laboratories, which were unable to identify the subtype. The CDC received a sample Apr 14 and identified the virus as swine influenza A/H1N1.
The boy's mother had a nonfebrile respiratory illness in the first few days of April, and his 8-year-old brother was sick with a cough and fever on Apr 11, but no respiratory samples were taken during their illnesses.
In the other case, the CDC received an influenza specimen on Apr 17 that the Naval Health Research Center in San Diego had sent as a type A virus that couldn't be subtyped, according to the report. The CDC identified the virus as a swine influenza A/H1N1 isolate the same day.
The sample came from the 9-year-old girl, who got sick with a cough and fever (104.3?F) on Mar 28, the report says. She was treated at an outpatient clinic with antibiotics and an antihistamine, and she recovered uneventfully. The girl reported that she had visited a fair with a pig exhibit about 4 weeks before her illness but that she had not seen the pigs, and she reported no other exposure.
The girl's 13-year-old cousin, who was living with the family, had a flu-like illness 3 days before she got sick, and her 13-year-old brother had similar symptoms on Apr 1, the CDC reports. But neither was tested for flu while they were sick.
So far, no epidemiologic link between the two cases has been found, nor have any other cases been identified involving the new strain, the report says. Case and contact investigations by the county and states health agencies are under way.
A new combination of genes
The viruses from the two patients are similar, and the majority of their genes, including the hemagglutinin gene, are similar to those of swine flu viruses that have circulated in US pigs since about 1999, the CDC reports. But the genes for the neuraminidase (NA) and matrix (M) proteins are similar to corresponding genes of Eurasian swine flu viruses.
"This particular genetic combination of swine influenza virus segments has not been recognized previously among swine or human isolates in the United States, or elsewhere based on analyses of influenza genomic sequences available on GenBank," the report states.
While there is no formal system for monitoring what viruses circulate in US swine, viruses with this combination of genes are not known to be circulating in the country, the report adds.
Testing is under way to learn whether the two viruses are susceptible to the neuraminidase inhibitor drugs oseltamivir and zanamivir.
The CDC advises that clinicians should consider animal as well as seasonal flu virus infections in patients who live in or who visited San Diego or Imperial County or were in contact with sick people from either county in the week before their illness onset. It also urges clinicians to take a nasopharyngeal swab in such cases and to contact their state or local health department to arrange for testing at a state public health lab.
CDC. Swine influenza A (H1N1) infection in two children?Southern California, March-April 2009. MMWR Dispatch 2009 Apr 21;58 [Full text]Comment
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Re: Human Swine Flu Infection - California
Map updated to reflect 100 miles between cases
Comment
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Re: Human Swine Flu Infection - California
A young boy in San Diego County and a young girl in Imperial County have been infected with swine flu. Health officials say the strain of the disease has been seen before in the United States. KPBS Reporter Kenny Goldberg has more.
Health officials say the nine-year-old girl and the ten-year-old boy who came down with swine flu have fully recovered.
The mystery is how they got the disease in the first place.
Officials say the children have never met, nor have they had any contact with pigs.
Dr. Wilma Wooten is San Diego County's Public Health Officer. She says we do not have an outbreak of swine flu.
"What we do have," says Dr. Wooten, "Is a situation where there is a unique animal virus that has now been introduced into the human population, and we are conducting heightened surveillance and investigation to determine the source, and whether or not it's more common than we know."
Dr. Wooten says swine flu infections among humans are rare.
Kenny Goldberg, KPBS News.Comment
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Re: Human Swine Flu Infection - California
from a report on January 15, 2009 -
South Dakota has reported a case of swine flu in a human, a 19-year-old South Dakota State University student. The individual was ill five weeks ago and a specimen was collected December 4, 2008. The state Public Health Laboratory identified the A/H1 portion of the virus and just this week, the Centers for Disease Control and Prevention (CDC) influenza lab identified the swine components of the virus.
"Swine flu in humans is rare but it does occur," said Dr. Lon Kightlinger, State Epidemiologist for the department. "Most often, the cases occur in people with direct exposure to pigs, such as swine farm workers. Human to human transmission is very rare."
Nationally, the CDC typically receives about one report of swine flu virus in a human each year. The South Dakota case is believed to be the state's first case.
Kightlinger said the department is on enhanced surveillance for additional cases and is working closely with CDC and the U.S. Department of Agriculture on the case investigation.
The symptoms of swine flu in people are the same as those of seasonal human flu. They include a fever with a cough, sore throat, body aches, and tiredness. It is also possible to be infected and have no symptoms. There is a swine flu vaccine for pigs but because people seldom become infected with the virus, there is no human vaccine. Seasonal flu activity is low in Brookings and in the state this year.
Dr. Sam Holland, State Veterinarian, noted that swine viruses are often observed in routine poultry disease surveillance, due to the ever-present and circulating nature of influenza viruses. "We also know that the strains of flu viruses circulating in pigs do contain genes common to influenza viruses in humans. Influenza viruses are constantly circulating and mutating among birds, animals, and people so the occasional finding of a bird or swine virus in people or vice versa is not a surprise," said Dr. Holland.
Comment
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Re: Human Swine Flu Infection - California
The California cases have nothing to do with prior reports. The HA is from North America while the NA is from Eurasia. This constellation has never been reported previously.Originally posted by Florida1 View Post
I suspect it came from Mexico.Comment
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Re: Human Swine Flu Infection - California
from a study in 2005 -
Serologic Evidence of Human and Swine Influenza in Mayan Persons
Guadalupe Ayora-Talavera,*<sup>
</sup> Juan Manuel Cadavieco-Burgos,* and Alejandro Bernardino Canul-Armas*
*Universidad Autónoma de Yucatán, Mérida, Yucatan
Suggested citation for this article
<hr>Antibodies against influenza viruses were detected in 115 serum samples from indigenous Mayan persons from Kochol, Yucatán. Seropositivity rates were 26.9% to A/Bayern/7/95, 40.8% to A/Sydney/5/97, 1.7% to A/Swine/Wisconsin/238/97, and 79.1% to A/Swine/Minnesota/593/99. This report is the first in Mexico of the prevalence of antibodies to swine influenza virus in humans.Influenza virus type A has the capacity to infect humans, birds, swine, and other animals. Studies have repeatedly shown that influenza virus can move from 1 species to another. The pig has been proposed as an animal that could play a key intermediary role in interspecies transmission. Pigs are the only domesticated mammalian species that are reared in abundance and are susceptible to both avian and human influenza virus and allow productive viral replication (1,2).
In rural zones in the Mexican state of Yucatán, the "backyard system," a production system in which animals such as pigs, ducks, turkeys, and chickens are all raised in close proximity to humans, is common. This system is a traditional activity of indigenous Mayan persons, as well as other ethnic groups in Mexico, and provides an economical way to produce animals. The animals eat, live, and share space, water sources, and even food with humans; they may even be found inside houses. These activities create health concerns because of potential for the adaptation and reassortment of human and avian viruses.
Despite abundant evidence supporting interspecific transmission and genetic reassortment of influenza virus around the world, little is known about the influenza virus in humans and domesticated animals in Yucatán in southeastern Mexico. We describe serologic evidence of antibodies against influenza strains from humans and pigs in indigenous Mayan persons from Yucatán.
The Study
Kochol is located in east Yucatán, ≈20 km from the municipality of Maxcanu. The 1,207 residents are mostly dedicated to agricultural activities (3). The population has high illiteracy rates, poor environmental health, and crowded and inadequate housing. In Kochol, pigs are found around the town, walking in and out of houses. All pigs are wild or criollos. Some families have 1–18 pigs. For this study, serum samples from 115 persons were made available by the health official of Kochol in 2000. Serum samples were from Kochol residents who came to the health service for any medical condition and required laboratory tests.
Samples were treated with receptor-destroying enzyme from Vibrio cholera and heated at 56°C in a water bath to inactivate nonspecific inhibitors (4). The following 4 influenza strains were used to detect antibodies: A/Swine/Wisconsin/238/97 (classical swine H1N1), A/Bayern/7/95 (human H1N1), A/Sydney/5/97 (human H3N2), and A/Swine/Minnesota/593/99 (reassortant swine H3N2); all were grown in 10-day-old embryonated chicken eggs. The hemagglutination inhibition tests were performed by using chicken erythrocytes at a concentration of 0.5%. A sample was considered seropositive to H1 and H3 when the HA titer was >1:40. Each serum sample was tested against chicken receptor–destroying enzymes in the absence of virus to rule out induction of nonspecific hemagglutination.
Conclusions
As shown in Table 1, reactivity rates were uniformly high to H3 subtype influenza virus. These results agree with previous serologic tests of human serum samples from Yucatán (G. Ayora-Talavera, unpub. data). H1 viruses likely circulate at a lower frequency than H3 viruses. Overall, 31 (26.9%) of 115 samples were positive to H1, whereas 93 (80.8%) of 115 were seropositive to H3. The results indicate that influenza virus infection occurs in a large proportion of persons in this area. In general, Mexican persons are not vaccinated, so we can be sure that the antibodies detected reflect actual infection (5). Samples were divided into 5 age groups (Table 2). By analyzing the percentage of seropositive persons in different age groups, we observed that persons 15–24 years of age were most commonly seropositive. Through virus surveillance in Yucatán, we have also observed a very low circulation of influenza A H1. From ≈1,500 throat swabs collected in 5 years, no sample has been found to contain H1 influenza by immunofluorescence assay, and only 5 viruses have been detected with reverse transcription–polymerase chain reaction (G. Ayora-Talavera, unpub. data).
The highest seropositivity rates across all age groups were detected with the A/Sw/Minnesota virus as antigen. Although this strain was isolated from American pigs, the HA, NA, and PB1 genes are of human origin (6). Taking into consideration the cutoff values of this study, seropositivity to the swine H1 virus was only detected in 2 samples, from persons 43 and 59 years of age. However, lower titers were detected in 4 more persons 33–55 years of age. The weak reactivity to this virus could suggest a past exposure of adult persons to viruses of swine origin, a situation that has not occurred in persons >30 years of age.
The animal population owned by persons in this study consisted of pigs (68.7%), chickens (73%), and ducks (17.3%). Any combination of 2 or 3 species was kept by 54.7%. The range of the number of animals owned was 0–12 (mean 2.9) pigs, 0–60 (mean 7) chickens, and 0–23 (mean 0.93) ducks. Since we did not have avian antigens available, serum samples collected from humans, pigs, chickens, and ducks were not tested for exposure to avian influenza viruses.
The relative risk of being seropositive for H1 or H3 viruses from exposure to pigs was 1.93 with human H1 (95% confidence interval [CI] 1.2–3.0), 0.88 with human H3 (95% CI 0.55–1.4), 0.6 with swine H1 (95% CI 0.08–4.2), and 1.0 with swine H3 (95% CI 0.62–1.6).
Serologic evidence of swine antibodies in persons in contact with pigs has been reported in several studies (7–12). In Mexico, apart from this report, no information about the prevalence of antibodies to swine influenza virus in humans exists. The only information available comes from a study carried out on pig farms in central Mexico, where the subtype H1 is prevalent in 20% of pigs (13) and from a previous study from Yucatán, where the most prevalent subtype in pig farms is H3 (65%) and H1 (20%) (14).
As a result of the Mexican outbreak of HPAI H5N2, the Mexican Ministry of Agriculture (SAGARPA) implemented a national surveillance system in all chicken farms (NOM-044-ZOO-1995). Yucatán is considered a free state for avian influenza virus. Chicken farms are sampled 3 times a year for serologic surveillance, and 10% of the backyard flocks are sampled annually (15). On the other hand, swine influenza is not considered within the SAGARPA priorities, and no surveillance program exists for swine farms, although we found serologic evidence that in Yucatán influenza H3 subtype is highly prevalent (14).
Asia has been considered as an epicenter for the generation of pandemic influenza virus, and some factors are high densities of humans and animals in close contact (1). In Yucatán, the backyard system is a common practice, and human and animal encounters could lead to generation of novel reassortant viruses here as well.
AcknowledgementsWe thank Chris Olsen for technical assistance and reviewing the manuscript and L. ´t Mannetje for his helpful advice on the manuscript.References
This research was supported by CONACYT-SISIERRA CIR-BIO980203 and Universidad Autónoma de Yucatán.
Dr. Ayora-Talavera is an associate researcher and lecturer at the University of Yucatan. Her research interest is the molecular epidemiology of respiratory viruses, with emphasis on influenza virus.
- Webster RG, Bean WJ, Gorman OT, Chambers TM, Kawaoka Y. Evolution and ecology of influenza A viruses. Microbiol Rev. 1992;56:152–79.
- Olsen CW. Influenza in pigs and their role as the intermediate host. In: Nicholson KG, Cox N, Hay AJ, Webster RG, editors. Textbook of influenza. 2nd ed. London: Blackwell Science. In press 2004.
- Tabulados Básicos. Estados Unidos Mexicanos. XII Censo General de Población y Vivienda 2000. Tomo I. 552 pp. Instituto Nacional de Estadística, Geografía e Informática (INEGI). México, D.F. 2000.
- Kendal AP, Pereira MS, Shekel J. Concepts and procedures for laboratory-based influenza surveillance. Geneva: World Health Organization; 1982.
- Van Essen GA, Palache AM, Forleo E, Fedson DS. Influenza vaccination in 2000: recommendations and vaccine use in 50 developed and rapidly developing countries. Vaccine. 2003;21:1780–5.
- Zhou NN, Senne DA, Landgraf JS, Swenson SL, Erickson G, Rossow K, et al. Emergence of H3N2 reassortant influenza A viruses in North American pigs. Vet Microbiol. 2000;74:47–58.
- Kluska V, Macku M, Mensik J. Evidence of swine influenza antibodies in human. Cesk Pediat. 1961;116:408–14.
- Woods GT, Hanson LE, Hatch RD. Investigation of four outbreaks of acute respiratory disease in swine and isolation of swine influenza virus. Health Lab Sci. 1968;5:218–24.
- Schnurrenberger PR, Woods GT, Martin RJ. Serologic evidence of human infection with swine influenza virus. Am Rev Respir Dis. 1970;102:356–61.
- Shu LL, Zhou NN, Sharp GB, He SQ, Zhang TJ, Zou WW, et al. An epidemiological study of influenza viruses among Chinese farm families with household ducks and pigs. Epidemiol Infect. 1996;117:179–88.
- Zhou N, He S, Zhand T, Zou W, Shu L, Sharp GB, et al. Influenza infection in humans and pigs in southeastern China. Arch Virol. 1996;141:649–61.
- Olsen CW, Brammer L, Easterday BC, Arden N, Belay E, Baker I, et al. Serologic evidence of H1 swine influenza virus infection in swine farm residents and employees. Emerg Infect Dis. 2002;8:814–9.
- Rodríguez TJ, Ramírez MH, Carreón NR, Mercado GC. Muestreo serológico a nivel de rastro para detectar anticuerpos contra el virus de influenza porcina. Veterinaria de México. 1996;27:17–21.
- Álvarez FM, Rodríguez BJC, Ciprián CA, Rodríguez GL, Ayora TG, Segura CJC. Perfil serológico del virus de influenza porcinA, Micoplasma hyopneumoniae y Actinobacillus pleuropneumoniae en granjas del estado de Yucatan. Veterinaria de México. 2004;35:295–305.
- Dirección de Campañas Zoosanitarias y CPA. Servicio Nacional de Sanidad, Inocuidad y Calidad Agroalimentaria. Situación Zoosanitaria en los Estados de la República Mexicana (al 9 de Febrero de 2004). SENASICA 2003. México, D.F.
<table border="0" cellpadding="0" cellspacing="0" width="100%"> <tbody><tr> <td colspan="7" valign="bottom">Table 1. Hemagglutination inhibition antibodies to influenza virus, Kochol, Yucatán</td> </tr> <tr> <td colspan="7"> <hr noshade="noshade" size="1"> </td> </tr> <tr> <td rowspan="3" valign="bottom"> No. samples
</td> <td rowspan="3" valign="bottom">Titer</td> <td rowspan="3" valign="bottom">Month</td> <td colspan="4" valign="bottom">No. (%) positive samples</td> </tr> <tr> <td colspan="4"> <hr noshade="noshade" size="1"> </td> </tr> <tr> <td valign="bottom">A/Bayern/7/97</td> <td valign="bottom">
(H1N1)A/Sw/Wis/238/97</td> <td valign="bottom">
(H1N1)A/Sw/Mn/593/99</td> <td valign="bottom">
(H3N2)A/Sydney/5/97</td> </tr> <tr> <td colspan="7"> <hr noshade="noshade" size="1"> </td> </tr> <tr> <td valign="top"> 73
(H3N2)
</td> <td>
</td> <td valign="top">June</td> <td valign="top">22 (30)</td> <td valign="top">2 (2.7)</td> <td valign="top">59 (80.8)</td> <td valign="top">32 (43.8)</td> </tr> <tr> <td>
</td> <td valign="top">0</td> <td>
</td> <td valign="top">41</td> <td valign="top">67</td> <td valign="top">4</td> <td valign="top">10</td> </tr> <tr> <td>
</td> <td valign="top">10</td> <td>
</td> <td valign="top">6</td> <td valign="top">2</td> <td valign="top">2</td> <td valign="top">12</td> </tr> <tr> <td>
</td> <td valign="top">20</td> <td>
</td> <td valign="top">4</td> <td valign="top">2</td> <td valign="top">8</td> <td valign="top">19</td> </tr> <tr> <td>
</td> <td valign="top">40</td> <td>
</td> <td valign="top">5</td> <td valign="top">2</td> <td valign="top">9</td> <td valign="top">9</td> </tr> <tr> <td>
</td> <td valign="top">80</td> <td>
</td> <td valign="top">6</td> <td>
</td> <td valign="top">11</td> <td valign="top">17</td> </tr> <tr> <td>
</td> <td valign="top">160</td> <td>
</td> <td valign="top">7</td> <td>
</td> <td valign="top">18</td> <td valign="top">4</td> </tr> <tr> <td>
</td> <td valign="top">320</td> <td>
</td> <td>
</td> <td>
</td> <td>
</td> <td valign="top">2</td> </tr> <tr> <td>
</td> <td valign="top">640</td> <td>
</td> <td valign="top">4</td> <td>
</td> <td valign="top">18</td> <td>
</td> </tr> <tr> <td>
</td> <td valign="top">1,280</td> <td>
</td> <td>
</td> <td>
</td> <td valign="top">3</td> <td>
</td> </tr> <tr> <td colspan="7"> <hr noshade="noshade" size="1"> </td> </tr> <tr> <td valign="top"> 35
</td> <td>
</td> <td valign="top">July</td> <td valign="top">8 (23)</td> <td valign="top">0</td> <td valign="top">26 (74)</td> <td valign="top">14 (40)</td> </tr> <tr> <td>
</td> <td valign="top">0</td> <td>
</td> <td valign="top">18</td> <td>
</td> <td valign="top">5</td> <td valign="top">13</td> </tr> <tr> <td>
</td> <td valign="top">10</td> <td>
</td> <td valign="top">6</td> <td>
</td> <td valign="top">2</td> <td valign="top">2</td> </tr> <tr> <td>
</td> <td valign="top">20</td> <td>
</td> <td valign="top">3</td> <td>
</td> <td valign="top">2</td> <td valign="top">6</td> </tr> <tr> <td>
</td> <td valign="top">40</td> <td>
</td> <td valign="top">3</td> <td>
</td> <td valign="top">7</td> <td valign="top">8</td> </tr> <tr> <td>
</td> <td valign="top">80</td> <td>
</td> <td valign="top">3</td> <td>
</td> <td valign="top">10</td> <td valign="top">4</td> </tr> <tr> <td>
</td> <td valign="top">160</td> <td>
</td> <td valign="top">1</td> <td>
</td> <td valign="top">4</td> <td valign="top">2</td> </tr> <tr> <td>
</td> <td valign="top">640</td> <td>
</td> <td valign="top">1</td> <td>
</td> <td valign="top">4</td> <td>
</td> </tr> <tr> <td>
</td> <td valign="top">1,280</td> <td>
</td> <td>
</td> <td>
</td> <td valign="top">1</td> <td>
</td> </tr> <tr> <td colspan="7"> <hr noshade="noshade" size="1"> </td> </tr> <tr> <td valign="top"> 7
</td> <td>
</td> <td valign="top">August</td> <td valign="top">1 (14)</td> <td valign="top">0</td> <td valign="top">6 (85.7)</td> <td valign="top">1 (14)</td> </tr> <tr> <td>
</td> <td valign="top">0</td> <td>
</td> <td valign="top">4</td> <td>
</td> <td valign="top">1</td> <td valign="top">3</td> </tr> <tr> <td>
</td> <td valign="top">10</td> <td>
</td> <td valign="top">1</td> <td>
</td> <td>
</td> <td valign="top">1</td> </tr> <tr> <td>
</td> <td valign="top">20</td> <td>
</td> <td valign="top">1</td> <td>
</td> <td>
</td> <td valign="top">3</td> </tr> <tr> <td>
</td> <td valign="top">40</td> <td>
</td> <td valign="top">1</td> <td>
</td> <td valign="top">1</td> <td valign="top">1</td> </tr> <tr> <td>
</td> <td valign="top">160</td> <td>
</td> <td>
</td> <td>
</td> <td valign="top">4</td> <td>
</td> </tr> <tr> <td>
</td> <td valign="top">320</td> <td>
</td> <td>
</td> <td>
</td> <td valign="top">1</td> <td>
</td> </tr> <tr> <td colspan="7"> <hr noshade="noshade" size="1"> </td> </tr> </tbody></table>
<table border="0" cellpadding="0" cellspacing="0" width="100%"> <tbody><tr> <td colspan="6" valign="bottom">Table 2. Specific hemagglutination inhibition antibodies by age group, Kochol, Yucatán</td> </tr> <tr> <td colspan="6"> <hr noshade="noshade" size="1"> </td> </tr> <tr> <td rowspan="3" valign="bottom"> Age group
</td> <td rowspan="3" valign="bottom">N</td> <td colspan="4" valign="bottom">n (%)</td> </tr> <tr> <td colspan="4"> <hr noshade="noshade" size="1"> </td> </tr> <tr> <td valign="bottom">A/Bayern/7/97</td> <td valign="bottom">
(H1N1)A/Sw/Wis/238/97</td> <td valign="bottom">
(H1N1)A/Sw/Mn/593/99</td> <td valign="bottom">
(H3N2)A/Sydney/5/97</td> </tr> <tr> <td colspan="6"> <hr noshade="noshade" size="1"> </td> </tr> <tr> <td valign="top"> 8–14
(H3N2)
</td> <td valign="top">16</td> <td valign="top">4 (25)</td> <td valign="top">0</td> <td valign="top">14 (87)</td> <td valign="top">9 (56)</td> </tr> <tr> <td valign="top"> 15–24
</td> <td valign="top">33</td> <td valign="top">13 (39)</td> <td valign="top">0</td> <td valign="top">29 (88)</td> <td valign="top">14 (42)</td> </tr> <tr> <td valign="top"> 25–34
</td> <td valign="top">28</td> <td valign="top">5 (16)</td> <td valign="top">0</td> <td valign="top">22 (78)</td> <td valign="top">9 (32)</td> </tr> <tr> <td valign="top"> 35–44
</td> <td valign="top">24</td> <td valign="top">4 (16)</td> <td valign="top">1 (4)</td> <td valign="top">16 (66)</td> <td valign="top">9 (37)</td> </tr> <tr> <td valign="top"> 45–53
</td> <td valign="top">14</td> <td valign="top">4 (33)</td> <td valign="top">1 (8)</td> <td valign="top">10 (71)</td> <td valign="top">6 (43)</td> </tr> <tr> <td colspan="7"> <hr noshade="noshade" size="1"> </td> </tr> </tbody></table>
Suggested citation for this article:
Ayora-Talavera G, Cadavieco-Burgos JM, Canul-Armas AB. Serologic evidence of human and swine influenza in Mayan persons. Emerg Infect Dis [serial on the Internet]. 2005 Jan [date cited]. Available from http://www.cdc.gov/ncidod/EID/vol11no01/04-0554.htm
Comment
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Re: Human Swine Flu Infection - California
<a rel="nofollow" href="http://www.recombinomics.com/News/04220902/H1N1_CA_Swine_H2H.html">Commentary</a>Comment
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Re: Human Swine Flu Infection - California
how do European and American swine come into contact ?
husbandry,meat,imports of new races for mixing ,
imports of Ferkel for m?sten ?I'm interested in expert panflu damage estimates
my current links: http://bit.ly/hFI7H ILI-charts: http://bit.ly/CcRgTComment
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Re: Human Swine Flu Infection - California
This map is a little misleading as it put the San Diego case in Oceanside. It was collected from a clinic in San Ysidro, which is about 20 miles south of San Diego proper, close to the border. I'm sure this is something google did automatically and not intentional error, just thought I would point it out.Originally posted by niman View Post
--camsterNHRC-We found the swine in 2009!Comment
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Re: Human Swine Flu Infection - California
CommentaryOriginally posted by niman View Post
Swine H1N1 In Southern California Children Raise Concerns
Recombinomics Commentary 01:27
April 22, 2009
Patient A. On April 13, 2009, CDC was notified of a case of respiratory illness in a boy aged 10 years who lives in San Diego County, California. The patient had onset of fever, cough, and vomiting on March 30, 2009.
The patient's mother had respiratory symptoms without fever in the first few days of April 2009, and a brother aged 8 years had a respiratory illness 2 weeks before illness onset in the patient and had a second illness with cough, fever, and rhinorrhea on April 11, 2009.
patient B, is a girl aged 9 years who resides in Imperial County, California, adjacent to San Diego County. On March 28, 2009, she had onset of cough and fever (104.3°F [40.2°C]).
The patient's brother aged 13 years had influenza-like symptoms on April 1, 2009, and a male cousin aged 13 years living in the home had influenza-like symptoms on March 25, 2009, 3 days before onset of the patient's symptoms.
The above comments from today’s MMWR dispatch describe two children in southern California infected with H1N1 swine flu. The isolates are similar and have an unusual constellation of genes. Although all 8 are reported as being swine, the NA and MP sequences are European, while the other 6 gene segments are North American. The HA, NA, and MP sequences of A/California/04/2009 have been placed on deposit at GISAID.
The lack of contact between the two children, as well as a lack of contact with swine, suggests the virus is spreading human to human. Although both children recovered, the presence of swine H1N1 in humans raises concerns of recombination with H1N1 seasonal flu, including the acquisition of H274Y.
Moreover, the 1918 pandemic strain was a recombinant between human H1N1 and swine H1N1.
The likely ability of this swine H1N1 to transmit efficiently in humans is cause for concern.
."The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller FoundationComment
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Re: Human Swine Flu Infection - California
CommentaryOriginally posted by niman View Post
Human Transmission of Swine H1N1 in Southern California
Recombinomics Commentary 04:10
April 22, 2009
"This virus is different, very different from that circulating in pigs. That was a red flag," Finelli told WebMD and several other news organizations. "The other red flag is both cases appeared almost simultaneously, 100 miles apart.
The above comments leave little doubt that the H1N1 swine flu is being efficiently transmitted human to human in southern California. The unique constellation of swine genes has not been reported previously and the two cases do not have swine contacts. Moreover, family members had <a rel="nofollow" href="http://www.recombinomics.com/News/04220901/H1N1_CA_Swine.html">symptoms</a> before and after the confirmed cases, indicating the H1N1 spread efficiently within each family.
However, none of the family members were tested because the H1N1 was mild and they recovered without treatment. The two cases were identified through routine surveillance, but such identifications require sero-typing. The swine sequences will test positive for influenza A.
Therefore the virus can silently spread, which resulted in two independent detections 100 miles apart - see map for general locations. Specific locations within San Diego and Imperial countries have not been released, but upcoming testing of classmates should lead to the identification of location(s).
Although both cases recovered without hospitalization, the spread of the swine H1N1 in a human population is cause for concern. The virus can adapt and spread more efficiently. Moreover, co-infection of H1N1 swine flu and osletamivir resistant H1N1 season flu can lead to acquisition of H274Y by the swine flu via recombination or reassortment. Swine H1N1 with human H1 and N1 have been reported. Moreover, the swine flu can also infect swine and acquire more polymorphisms that could lead to increased virulence.
The 1918 pandemic strain has polymorphism from swine and human H1N1 in all eight gene segments. Similar swapping of polymorphism in human co-infected with season and swine H1N1 can lead to rapid evolution. Therefore, release of both sets of sequences, as well as new sequences, which will likely be detected in the near term in the United States and Mexico, would be useful.
."The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller FoundationComment
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