Human Swine Flu Infection - California & Texas First Report April 21, 2009

[HenryN]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

Map updated to reflect 100 miles between cases

http://maps.google.com/maps/ms?ie=U...2.650649,-116.139221&spn=2.062781,3.99353&z=8

 

[HenryN]

Re: Human Swine Flu Infection - California

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.

 

[sharon sanders]

Re: Human Swine Flu Infection - California

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.

http://www.medicalnewstoday.com/articles/135613.php

 

[HenryN]

Re: Human Swine Flu Infection - California

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.

http://www.medicalnewstoday.com/articles/135613.php

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.
I suspect it came from Mexico.

 

[sharon sanders]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

from a study in 2005 -

[FONT=Arial, Helvetica, sans-serif]Serologic Evidence of Human and Swine Influenza in Mayan Persons[/FONT]

Guadalupe Ayora-Talavera,* Juan Manuel Cadavieco-Burgos,* and Alejandro Bernardino Canul-Armas*
*Universidad Autónoma de Yucatán, Mérida, Yucatan
[FONT=Arial, Helvetica, sans-serif]Suggested citation for this article[/FONT]
<hr>

[FONT=Arial, Helvetica, sans-serif]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.[/FONT]
​

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.

[FONT=Arial, Helvetica, sans-serif]The Study[/FONT]

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.
[FONT=Arial, Helvetica, sans-serif]
Conclusions[/FONT]

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.

[FONT=Arial, Helvetica, sans-serif]Acknowledgements[/FONT]

[FONT=Arial, Helvetica, sans-serif]We thank Chris Olsen for technical assistance and reviewing the manuscript and L. ´t Mannetje for his helpful advice on the manuscript.[/FONT]
[FONT=Arial, Helvetica, sans-serif]This research was supported by CONACYT-SISIERRA CIR-BIO980203 and Universidad Autónoma de Yucatán.[/FONT]
[FONT=Arial, Helvetica, sans-serif]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.[/FONT]
​

[FONT=Arial, Helvetica, sans-serif]References[/FONT]

1. Webster RG, Bean WJ, Gorman OT, Chambers TM, Kawaoka Y. Evolution and ecology of influenza A viruses. Microbiol Rev. 1992;56:152–79.
2. 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.
3. 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.
4. Kendal AP, Pereira MS, Shekel J. Concepts and procedures for laboratory-based influenza surveillance. Geneva: World Health Organization; 1982.
5. 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.
6. 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.
7. Kluska V, Macku M, Mensik J. Evidence of swine influenza antibodies in human. Cesk Pediat. 1961;116:408–14.
8. 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.
9. Schnurrenberger PR, Woods GT, Martin RJ. Serologic evidence of human infection with swine influenza virus. Am Rev Respir Dis. 1970;102:356–61.
10. 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.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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
(H1N1)​

</td> <td valign="bottom">

A/Sw/Wis/238/97
(H1N1)​

</td> <td valign="bottom">

A/Sw/Mn/593/99
(H3N2)​

</td> <td valign="bottom">

A/Sydney/5/97
(H3N2)​

</td> </tr> <tr> <td colspan="7"> <hr noshade="noshade" size="1"> </td> </tr> <tr> <td valign="top"> 73
</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
(H1N1)​

</td> <td valign="bottom">

A/Sw/Wis/238/97
(H1N1)​

</td> <td valign="bottom">

A/Sw/Mn/593/99
(H3N2)​

</td> <td valign="bottom">

A/Sydney/5/97
(H3N2)​

</td> </tr> <tr> <td colspan="6"> <hr noshade="noshade" size="1"> </td> </tr> <tr> <td valign="top"> 8–14
</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>

[FONT=Arial, Helvetica, sans-serif]Suggested citation for this article:[/FONT]
[FONT=Arial, Helvetica, sans-serif]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[/FONT]


http://www.cdc.gov/ncidod/EID/vol11no01/04-0554.htm

 

[HenryN]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

<a rel="nofollow" href="http://www.recombinomics.com/News/04220902/H1N1_CA_Swine_H2H.html">Commentary</a>

 

[gsgs]

Re: Human Swine Flu Infection - California

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 ?

 

[camster]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

Map updated to reflect 100 miles between cases

http://maps.google.com/maps/ms?ie=U...2.650649,-116.139221&spn=2.062781,3.99353&z=8

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.

--camster

 

[AlaskaDenise]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

<a rel="nofollow" href="http://www.recombinomics.com/News/04220901/H1N1_CA_Swine.html">Commentary</a>

Commentary

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.

.

 

[AlaskaDenise]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

<a rel="nofollow" href="http://www.recombinomics.com/News/04220902/H1N1_CA_Swine_H2H.html">Commentary</a>

Commentary

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.

.

 

[Giuseppe]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

The Canadian Press: Unrelated cases of swine flu in Calif. children have U.S. officials on alert

Unrelated cases of swine flu in Calif. children have U.S. officials on alert

U.S. public health authorities are investigating two cases of swine flu in unrelated children in California, a development that has officials in Canada and elsewhere on alert.


Discovery of the two cases, in children who apparently had no contact with pigs or with each other, suggests there probably has been some person-to-person spread of swine flu viruses, officials of the U.S. Centers for Disease Control said Tuesday.

Whether the viruses continue to spread isn't currently known.

"The investigation is not finished. It's ongoing. But of course not having that direct swine link does raise additional questions and does suggest that there may have been human-to-human transmission. And so it basically ratchets it (concern) up a bit," said Dr. Nancy Cox, head of the CDC's influenza division.

"I think this is one of those situations where everyone will want to stay tuned."

U.S. officials notified the World Health Organization of the cases last Friday, as required under the International Health Regulations. That treaty stipulates that countries must notify the WHO when they see cases of infectious diseases that pose an international threat, such as novel subtypes of influenza with pandemic potential.

Dr. Keiji Fukuda, a senior official of the WHO, said there is no need at this point to raise the global pandemic alert level.

The world is currently in phase 3 of a six phase alert scale because of ongoing sporadic cases of H5N1 avian influenza. Phase 3 means there are occasional human cases of influenza with a subtype with pandemic potential, but that there is no ongoing transmission.

"All things considered, based on what we already know about H1 (swine) infections and that they occur, I'm pretty comfortable that the right steps are being taken," said Fukuda, an influenza expert who is the WHO's acting assistant director general for health security and the environment.

Canada became aware of the situation when WHO was notified, said Dr. Arlene King, director general of the Public Health Agency of Canada's centre for immunization and respiratory infectious diseases.

King said no cases of infection with this particular swine flu virus have been spotted in Canada, but the public health network across the country has been put on the lookout.

"The labs are on alert and have been asked to send any non-subtypable influenza viruses ... to the National Microbiology Laboratory for testing and review," King said, adding they have also been asked to report if they can't identify a pathogen found in samples taken from a patient with flu-like symptoms, or have surveillance information indicating unexpected increases in illness.

The cases involved a boy, 10, from San Diego County and a nine-year-old girl from Imperial County, both of whom have recovered from their illnesses.

The two, who live over 150 kilometres apart, became ill at the end of March and sought care from clinics involved in an influenza surveillance program. Those clinics tested for flu; when they found viruses that didn't match known human viruses, they alerted authorities.

Given that most people with flu aren't tested, the CDC's Dr. Lyn Finella called the discovery of the swine flu infections "a very fortunate lightning strike."

Human infections with swine flu viruses are not unprecedented. A scientific paper published in 2007 recorded 50 known cases of human swine flu infections, in the U.S., Canada, the Netherlands and several other countries.

And most famously, a cluster of swine flu cases at Fort Dix, N.J., in 1976 triggered concerns a pandemic might be emerging. Vaccine was made and 47 million people were vaccinated against a pandemic that did not materialize.

Canada sees about one human case of swine flu a year, King said. And the CDC officials said until a couple of years ago, the U.S. averaged one case every year or two. But since December 2005, there have been 14 cases, including these children.In most of the recent cases, direct exposure to pigs could be established. And when cases were caused by H1N1 viruses, those viruses were relatively closely related. Not so in the viruses responsible for the infection in these children.

The viruses, which were described as very similar to one another, have unusual properties never seen before in swine flu viruses, the CDC said.

Two of the genes of the viruses were from swine viruses that normally circulate in Eurasia, a finding that has added to the level of interest and concern. And the hemagglutinin - the H in a flu virus's name - has a lot of mutations when compared to other swine H1N1 viruses, Cox said.

"It's different enough so that we're going to be looking very carefully at properties like receptor binding properties, growth kinetics. We'll be doing some animal model experiments and so on," she noted.

In California, health officials are investigating with help from the CDC, checking the children's contacts and looking for others who may have also been infected.

The CDC said in both cases, two family members were also sick around the time of the confirmed infections, but none of those four people was tested at the time for influenza.

Blood samples have been taken from those four and other people who have been in contact with the children; the blood samples will be tested for antibodies to these swine flu viruses, though results may not be available for some time, Finelli said.

The investigation has also spread to Texas, because the 10-year-old boy travelled by plane on April 3, while he was still ill. He and a brother who travelled with him remain in Texas, the CDC said.

Experts say it is not clear whether a swine flu virus of the H1N1 subtype could trigger a human pandemic at this point in time.

Human H1N1 viruses have been circulating around the world for decades, so there is a lot of immunity to those viruses in the population. But it's not yet known how much protection previous exposure to human H1N1 viruses - or to vaccine made to protect against them - would offer against these novel swine viruses.

"I think that the 100 per cent accurate answer is that nobody knows," Fukuda said from Geneva.

"But I think the other part of that answer is that if there's great enough antigenic distance between the current circulating H1 (human) viruses and for example a swine H1 virus, then there's no reason why it wouldn't behave in a pandemic fashion."

The term "antigenic distance" means how closely related viruses are to each other from the point of view of whether antibodies to one offer cross protection to another. If viruses are antigenically similar, there should be good cross protection.

But if there is great antigenic distance between human H1N1s and these swine flu viruses, the swine viruses would have greater potential to cause human illness.

Cox said that the CDC will be testing blood samples from people of a variety of age groups to try to get a sense of how much of the population might be vulnerable to these viruses. That work, which will take some time, should give a clearer picture of how much of a threat the viruses might pose if they are still circulating.
-
​

<cite cite="http://www.google.com/hostednews/canadianpress/article/ALeqM5gkfP4auwE6t3ik_obgTg9PH2t6mg">The Canadian Press: Unrelated cases of swine flu in Calif. children have U.S. officials on alert</cite>

 

[vinny]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

could this be a major problem if it spreads further..........?

 

[Giuseppe]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

could this be a major problem if it spreads further..........?

Everytime a novel influenza virus subtype infects humans, health authorities has the obligation to perform several activities in order to evaluate the risk for the general population.

This incident sees the isolation of a novel swine influenza virus subtype (namely A/H1N1), with the two surface proteins (hemagglutinin (HA) and neurmminidase (NA)) from different origins: the HA is from classical north America swine influenza virus known isolates, whereas NA is from European-like swine isolates; further, M protein is also from European-like lineages.

Human populations have a large immune protection against A/H1N1 seasonal human influenza viruses, but it is unclear whether these antibodies react with this novel subtype, and if yes, the strenght of the response.

In other words, human populations could be susceptible to this novel subtype, paving the way for an outbreak, localized, or more widespread, sparking a possible pandemic.

Until now, no data is available to state that this novel A/H1N1 swine influenza virus will start a pandemic.

For this purpose, US health agencies are testing people for antibodies and tracing contacts for localizing possible clusters of cases and the ''index case''.

At the end of this process, we will be able to know if the virus is readily transmissible and if a pandemic could start at brief or not.

The World Health Organization has been alerted by US authorities according the International Health Regulations rules.

 

[HenryN]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

could this be a major problem if it spreads further..........?

I don't think there is any doubt that it has spread further. The two confirmed cases were 100 miles apart and each cluster had multiple symptomatic family members. How far and wide is not known, but spread is virtually guaranteed.
Updated map

http://maps.google.com/maps/ms?ie=U....413102,-116.235352&spn=1.779042,2.856445&z=8

 

[HenryN]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

2 swine flu cases seen in region

New strain infects children in S.D., Imperial counties

By Keith Darcé (Contact) Union-Tribune Staff Writer
2:00 a.m. April 22, 2009

SWINE FLU

The respiratory disease regularly causes outbreaks among pigs.

Sporadic human infections of swine flu have occurred, mostly through direct exposure to pigs.

About one human case is reported every one to two years in the United States, but the count has risen to 14 cases since December 2005.

Symptoms resemble those of regular human influenza, including fever, lethargy, coughing and nausea.

There is no human vaccine for swine flu.
Source: Centers for Disease Control and Prevention

Federal health officials are asking doctors in San Diego and Imperial counties to take specimens from patients with flulike symptoms after one child in each county recently contracted a new strain of swine flu.
Both children recovered from the illness without hospitalization and no other cases have been identified, but medical experts are concerned because it remains unclear how the children contracted the disease.
Public health officials said the San Diego County case appears to be the first instance of swine flu ever reported in this region. The virus regularly causes outbreaks in pigs but rarely affects humans.
While the federal Centers for Disease Control and Prevention issued a special alert yesterday detailing the latest infections, it said the two cases didn't appear to pose a danger to the public.
“We are not making the assumption that there are widespread infections out there, and there is not any action that the public should take right now,” said Dr. Lyn Finelli, chief of influenza surveillance at the CDC.
The new cases also don't appear to be linked.
“The information we have so far is that (the children) are not related, don't know each other and had no direct association with pigs,” said Dr. Wilma Wooten, San Diego County's public health officer.
Like other types of influenza, swine flu typically creates a mild infection. But its rarity among humans and the lack of a vaccine to protect people from the disease mean that few individuals have antibodies in their blood to fight off the virus.
The strain found in the two children from San Diego and Imperial counties belongs to the same family as one of the seasonal flu viruses that affect humans, but it is genetically similar to a type found in pigs, the CDC said.
Most swine flu cases can be traced to contact between humans and pigs, usually at livestock events or on farms. Of the 14 cases reported in the United States since December 2005, including the two new patients, 11 involved contact with pigs.
In the first new case, a 10-year-old boy in San Diego County started running a fever, coughing and vomiting on March 30, according to the CDC alert. He was taken to a local outpatient clinic where a nasal swab was taken. His symptoms persisted for about a week.
On April 3, the boy flew to Texas with a sibling to visit relatives, CDC spokesman Tom Skinner said. He hasn't returned from the trip.
Federal health officials are monitoring two youngsters who sat near the infected boy on the flight for flu symptoms, and they are tracking down airline crew members who had close contact with the sick child.
The 9-year-old girl in Imperial County became sick March 28 and was taken to an outpatient clinic with a cough and 104-degree fever.
Specimens from both children were forwarded to the CDC last week after local laboratories were unable to match them with common strains of human influenza.
San Diego County's Health and Human Services Agency has deployed a team of epidemiologists, public health nurses and communicable-disease specialists to investigate the source of the infections.
In some cases, the virus is traced to indirect contact with pigs through other people. In other instances, the source is never identified.
“We want to do everything we can to make sure there isn't any person-to-person spread,” Wooten said. “We want to know if there is more virus.”
The Associated Press contributed to this report.

Keith Darce: (619) 293-1020; keith.darce@uniontrib.com
Keith Darcé: (619) 293-1020; (Contact)


http://www3.signonsandiego.com/stories/2009/apr/22/1m22flu231912-2-swine-flu-cases-seen-region/

 

[HenryN]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

Swine Flu Detected in 2 Children; Human-to-Human Spread Possible

Emma Hitt, PhD
Authors and Disclosures

<!-- astyle=html default a id 9002 --><!-- /Adspace --><!-- /ads -->
<!-- Right Column TOC --><!-- TOC --><!-- article content goes here -->April 22, 2009 — H1N1 swine influenza A infection has been reported in 2 children living in southern California. No direct contact with swine was reported in either case, suggesting that the virus may have spread directly among humans.
The cases were reported online April 21 in a special dispatch of the Morbidity and Mortality Weekly Report (MMWR), issued by the US Centers for Disease Control and Prevention (CDC). The swine viruses detected contain combinations of DNA segments not previously observed in influenza virus, and the seasonal influenza vaccine H1N1 strain is unlikely to provide protection, according to the report. The viruses also demonstrated antiviral resistance to amantadine and rimantadine.
According to CDC spokesperson Tom Skinner, it is not yet known whether this swine flu is susceptible to zanamivir (Relenza, GlaxoSmithKline) or oseltamivir (Tamiflu, Roche). "Results of testing should be available within a day or 2," he told Medscape Infectious Diseases in a telephone interview. He added that interim recommendations from the CDC suggest that clinicians should use either oseltamivir or zanamivir if they suspect that a patient has swine flu.
Two Patients Infected
The MMWR report describes 2 patients with swine influenza. One patient was a 10-year-old boy living in San Diego County, California, who traveled by airplane from San Diego to Dallas while sick with flu-like symptoms. These symptoms resolved uneventfully within a week. The patient, who continues to reside in Dallas, tested positive for influ¬enza A virus, but the test was negative for human influenza subtypes H1N1, H3N2, and H5N1. The CDC subsequently determined that the virus was swine influenza A (H1N1).
The second patient was a 9-year-old girl who lives in Imperial County, California, which is adjacent to San Diego County. She had a cough and fever, was treated with amoxicillin/clavulanate potassium and an antihistamine, and made a full recovery.
"Two is a very small sample size, but I think it is unlikely that this swine flu is associated with severe flu symptoms," Stephen Munday, MD, MPH, the public health officer for Imperial County, told Medscape Infectious Diseases. "Both of these cases would have completely recovered without medical intervention, and at least so far, there seems to be no propensity for severe influenza."
Dr. Munday added that of the 50 severe cases of pediatric influenza in California this flu season that would have been thoroughly evaluated because of their severity, no cases of swine influenza were detected.
"Other cases of swine flu may have occurred but remained undetected because they were mild and/or were not evaluated," he said and added that several close contacts of the patients with influenza-like symptoms are currently being evaluated to determine any relationship with the case patient viruses.
Need for Influenza Surveillance
These cases highlight the need for proper testing for suspected influenza virus, "not just in California, but around the country," Dr. Munday said.
The MMWR report advises clinicians who suspect swine influenza virus infection in humans to obtain a "nasopharyngeal swab from the patient, place the swab in a viral transport medium, and contact their state or local health department to facilitate transport and timely diagnosis at a state public health laboratory."
The CDC also requests that state public health laboratories send all influenza A specimens that cannot be subtyped to the CDC, Influenza Division, Virus Surveillance and Diagnostics Branch Laboratory.
Swine Flu on the Rise
According to the editorial note in the MMWR report, a total of 14 cases of swine influenza in humans, including the 2 current cases, have been reported since December 2005. This number represents an increase compared with previous years. This may be partly a result of an increase in influenza testing capabilities in public health labo¬ratories, although "genetic changes in swine influenza viruses and other factors also might be a factor," the authors note.
"The lack of known exposure to pigs in the two cases described in this report increases the possibility that human-to-human transmission of this new influenza virus has occurred," they add.
According to the CDC's Tom Skinner, with the increased level of influenza surveillance now taking place in Southern California, "it would not be a surprise to detect more suspected cases that warrant further investigation. As the CDC learns more about these cases we will update information regarding these cases," he said.
Morb Mortal Wkly Rep. Published online April 21, 2009.

http://www.medscape.com/viewarticle/701738

 

[HenryN]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

<TABLE border=0 cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR><TD class=ContentArea>Local Child Infected With Rare Swine Flu

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</TD></TR></TBODY></TABLE></TD></TR><TR><TD class=ContentArea colSpan=2 align=left><NEWS_TOPIC_DESCRIPTION> April 21, 2009<!-- ADDTHIS BUTTON BEGIN --><SCRIPT type=text/javascript>addthis_pub = 'teganglasheen'; addthis_brand = 'http://www.sdcounty.ca.gov'; addthis_options = 'email, favorites, digg, delicious, myspace, facebook, twitter, linkedin, google, live, more'; </SCRIPT>http://www.addthis.com/bookmark.php<SCRIPT type=text/javascript src="http://s7.addthis.com/js/152/addthis_widget.js"></SCRIPT> <!-- ADDTHIS BUTTON END -->


Two cases of human infection with swine influenza A (H1N1) have been detected in Imperial and San Diego Counties, according to the Imperial County Public Health Department and San Diego County Health & Human Services Agency.

In Imperial County, the case is a 9-year-old while the case in San Diego County is a 10-year-old. Confirmation for the San Diego case was received from the Centers for Disease Control and Prevention (CDC) on April 15th and Imperial County received confirmation on April 17th.

Neither of the patients were hospitalized and both have recovered.

Although swine influenza viruses normally infect and cause illness in pigs, sporadic human infections with swine flu do occasionally occur.

Both the Imperial County Public Health Department and San Diego County Health & Human Services Agency are working closely with state and federal officials on the investigation.
Preliminary study of the virus indicates that this particular genetic combination of swine influenza is novel and has not been seen before in the United States.

Neither of the two patients reported being near pigs and both cases were detected through seasonal influenza surveillance with local providers. Health officials in both counties are investigating the source and transmission of the two infections by speaking with family members and others who had close contact with the cases.
The first human swine influenza virus, H1N1, was reported in the United States in 1930. Swine flu is a cause of respiratory disease in pigs throughout the world and can occasionally cause human disease.

In the past, CDC received reports of approximately one human swine influenza virus infection every one to two years in the United States, but since 2005, 12 cases of human infection with swine influenza have been reported.

The increase could be a result of increased influenza testing capabilities and capacities in public health laboratories.
Most commonly, human cases of swine influenza happen when people are in close proximity to infected pigs, such as in pig production barns and livestock exhibits at fairs.

The symptoms of swine influenza in people are similar to the symptoms of regular seasonal influenza infection and include fever, lethargy, coughing and lack of appetite.
To diagnose swine influenza A infection, a respiratory specimen is collected within the first 4 to 5 days of infection.

The seasonal influenza vaccine (i.e., flu shot) does not protect against swine H1N1 viruses.

Although the current influenza season has been mild in both counties, individuals are encouraged to take the following steps to stop the spread of influenza and other respiratory illnesses:
· Stay home when you are sick to avoid spreading illness to friends and co-workers or students.
· 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.
For further information about swine influenza, visit the CDC Web site.


http://www.sdcounty.ca.gov/Portal/News/042109swineflu.html

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[HenryN]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

For Immediate Release: Tuesday April 21, 2009
Two Individuals in Imperial and San Diego Counties have
Been Confirmed with Swine Flu
An investigation is being conducted with State and Federal officials.
IMPERIAL / SAN DIEGO COUNTIES ? The Imperial County Public Health Department
and San Diego County Health & Human Services Agency announced today that two cases of
human infection with swine influenza A (H1N1) have been detected in Imperial and San Diego
Counties. In Imperial County the human case is a nine-year old while the case in San Diego
County is a 10-year-old. Confirmation for the San Diego case was received from the Centers
for Disease Control and Prevention (CDC) on April 14th and Imperial County received
confirmation on April 17th. Neither of the patients were hospitalized and both have recovered.
Although swine influenza viruses normally infect and cause illness in pigs, sporadic human
infections with swine flu do occasionally occur. Both the Imperial County Public Health
Department and San Diego County Health & Human Services Agency are working very closely
with state and federal officials on the case investigation.
Preliminary study of the virus indicates that this particular genetic combination of swine
influenza is novel and has not been seen before in the United States. Neither of the two
patients reported being near pigs and both cases were detected through seasonal influenza
surveillance with local providers. Health officials in both counties are investigating the source
and transmission of the two infections by speaking with family members and others
that had close contact with the cases.
The first swine influenza virus, H1N1, was reported in the United States in 1930. Swine flu
-- more --
is a cause of respiratory disease in pigs throughout the world and can occasionally cause human disease. In the past, CDC received reports of approximately one human swine influenza virus infection every one to two years in the United States, but since 2005, 12 cases of human infection with swine influenza have been reported. The increase could be a result of increased influenza testing capabilities and capacities in public health laboratories.
Most commonly, human cases of swine influenza happen when people are in close proximity to infected pigs, such as in pig production barns and livestock exhibits at fairs. The symptoms of swine influenza in people are similar to the symptoms of regular seasonal influenza infection and include fever, lethargy, coughing and lack of appetite. To diagnose swine influenza A infection, a respiratory specimen is collected within the first 4 to 5 days of infection. The seasonal influenza vaccine (i.e., flu shot) does not protect against swine H1N1 viruses. Although the current influenza season has been mild in both counties, individuals are encouraged to take the following steps to stop the spread of influenza and other respiratory illnesses: 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.
For further information about swine influenza, visit www.cdc.gov/flu/swine/index.htm.
If you are a member of the media seeking further information, please contact any of the following contacts: Imperial County Public Health Department, Public Health Information Officer
(760) 482-4461; mariapeinado@co.imperial.ca.us
San Diego County Health & Human Services Agency, Media and Public Relations Specialist: (619) 515-6535; thomas.christensen@sdcounty.ca.gov

http://www.icphd.org/menu_file/Human_Cases_of_Swine_Flu_April_21_2009.pdf?u_id=1

 

[Giuseppe]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

[From ProMedMail.org, commentary by moderator dr Craig Pringle. msIOH]

(...)

[Infection with swine influenza virus has been detected sporadically in humans since the 1950s and the human disease is usually clinically similar to disease caused by infections with human influenza viruses. However, complications that include pneumonia and death have occasionally been reported in the literature in otherwise healthy adults without underlying
disease. On the whole, human infections with swine influenza virus, to date, have been different and much milder than those seen with avian influenza A (H5N1) and more similar to infections with low pathogenic avian influenza viruses (see Eurosurveillance edition 2009; 14(7) at <http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19124>).

The significant features of this report are that although this is not a new subtype of influenza A in humans, concerns exist that this new strain of swine influenza A (H1N1) is substantially different from human influenza A (H1N1) viruses, that a large proportion of the population might be susceptible to infection, and that the seasonal influenza vaccine H1N1 strain might not provide protection. The lack of known exposure to pigs in the 2 cases increases the possibility that human-to-human transmission of this new influenza virus has occurred.

The viruses isolated from the 2 children are similar and carry a unique combination of genes not previously encountered. No information currently is available regarding the efficiency of their transmission in swine or in humans - Mod.CP

San Diego and Imperial are the southernmost counties in California and can be located on the map at <http://www.californiacountymaps.com/>. The state of California can be seen on the HealthMap/ProMED-mail interactive map at <http://healthmap.org/r/009X>. - CopyEd.MJ]
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[HenryN]

Re: Human Swine Flu Infection - California

Re: Human Swine Flu Infection - California

<a rel="nofollow" href="http://www.recombinomics.com/News/04220903/H1N1_CA_Swine_H2H_SS.html">Commentary</a>