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Maryland reports 6 confirmed cases of H3N2v

sharon sanders

Editor-in-Chief & President
hat tip Michael Coston


Swine Flu Detected in Humans who had Direct Contact with Pigs
by <nobr>System Account
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</nobr> on 8/17/2012 3:24 PM
BALTIMORE (August 17, 2012) ?

The Maryland Department of Health and Mental Hygiene has identified the influenza virus strain influenza A (H3N2v), in six Queen Anne?s County residents (five children and one adult) who had direct contact with pigs. In addition, the Maryland Department of Agriculture identified influenza A with a similar testing pattern in pigs from four Queen Anne?s County farms with which the sick people had contact. The pig testing is preliminary and will be confirmed by additional testing. H3N2v is the same virus strain that has been found recently in a number of other states.


None of the infected individuals has developed serious illness or been hospitalized. Symptoms are the same as seasonal flu and include fever and respiratory symptoms, such as sore throat and cough.

Human cases of this influenza strain have been identified in eight other states, including West Virginia and Pennsylvania. The virus was first detected in humans in 2011. Since July 2012, CDC has reported 224 cases of H3N2v. Nationally, there have been eight hospitalizations and no deaths. Most cases have occurred in children, and almost all cases have had contact with swine. In some rare cases, the virus seems to have spread from person-to-person. So far, spread has not continued beyond one or two people.


As a result of the positive tests, the Maryland Department of Agriculture?s Animal Health inspectors are on heightened surveillance, monitoring pigs at agricultural fairs around the state more closely for flu-like symptoms. Pigs with any suspicious symptoms or characteristics will be tested on site, with samples sent to the MDA Animal Health Diagnostic Laboratory in Salisbury, which was recently approved by the USDA National Veterinary Services Laboratory for the testing of swine flu. Fairs are currently underway in Montgomery and Worcester Counties. MDA has also sent outreach and education materials, as well as made personal contact, with fair sponsors, extension agents, veterinarians and fair liaisons, to educate them about swine flu and precautions that should be taken. Private veterinarians who encounter swine with suspected influenza like illness should contact the State Veterinarian at 410-841-5810 or (after hours at: 410-841-5971.)
Influenza is an infection caused by the influenza virus. It can affect people and other animals, including pigs and birds. There are vaccines against some strains. There is also medication that can be used to treat an influenza infection. Most people recover from illness without receiving medication; however certain people are at higher risk for complications of influenza. Those at higher risk are children under five, the elderly, pregnant women, and those with chronic heart, lung, liver, kidney and neurologic conditions or immunosuppression.


The spread of influenza, including the possible spread of H3N2v, between humans can be prevented by:

  • Covering your nose and mouth with a tissue when you cough or sneeze.
  • Washing your hands often with soap and water, especially after you cough or sneeze. If soap and water are not available, an alcohol-based hand rub may be used.
  • Avoiding touching your eyes, nose or mouth.
  • Trying to avoid close contact with sick people.
  • If you are sick, staying home from work or school.
  • Getting the seasonal influenza vaccine when it becomes available. Although it is not effective against H3N2v, it is protective against other common strains of influenza.
The spread of influenza between pigs and humans can be prevented by:

  • Washing your hands frequently with soap and running water before and after exposure to animals.
  • Never eating, drinking or putting things in your mouth in animal areas.
  • Considering avoiding exposure to pigs and swine barns this summer, especially if sick pigs have been identified and if you are high risk of complications from influenza.
  • Watching your farm animals, including pigs, for signs of illness and calling a veterinarian if you suspect they might be sick.
  • Avoiding close contact with animals that look or act ill, and
  • Avoiding contact with pigs if you are experiencing flu-like symptoms.
DHMH recommends that people with influenza-like illness who have risk factors for complications or with serious illness contact their healthcare provider and inform them if they have had pig contact within the past seven days.


?Information on Swine Influenza/Variant Influenza Viruses? is available at http://www.cdc.gov/flu/swineflu/
###
 
Re: Maryland reports 6 confirmed cases of H3N2v

http://www.baltimoresun.com/health/blog/bs-hs-swine-flu-maryland-20120817,0,7998893.story

Swine flu cases found in Maryland
Strain traveling the country comes to Maryland
By Meredith Cohn, The Baltimore Sun

6:49 p.m. EDT, August 17, 2012
Six Queen Anne's County residents have been diagnosed with a strain of swine flu that has been infecting people across the country, including many who have been attending state and local agricultural fairs, according to state health officials.

There have been 224 cases identified nationally by the U.S. Centers for Disease Control and Prevention, and state agricultural officials confirmed that the five children and one adult in Maryland from different families all came in contact with pigs at the Queen Anne's County fair as well as other locations. Officials say only rarely has the virus been transmitted from person to person.

The findings are preliminary and the H3N2v strain will be confirmed by additional testing, said officials at the state Department of Health and Mental Hygiene. Those infected have not become seriously ill or hospitalized, but they do have common influenza symptoms, including fever, sore throat and cough.

[snip]
 
Re: Maryland reports 6 confirmed cases of H3N2v

There isn't sufficient data, in my opinion, for them to make the statement in red. This is a presumption based on the lack of cases identified in persons who had no swine contact. However, the testing has been biased because they have primarily been testing persons with flu-like symptoms who have also had swine contact, in accordance with CDC guidance. It should be obvious that if you only test cases that have had swine contact, you won't identify cases with no swine contact (i.e. H2H).

I might add that officials are assuming that the majority of H3N2v cases in persons having had swine contact are the result of swine to human transmission. This might be true, but the data collected does not indicate the direction that the virus has transmitted. It only indicates coincidental cases of H3N2v in swine and persons that were in contact with one another. Given the number of cases detected and confirmed, the geographic distribution of cases, and the lack of H3N2v cases detected in swine prior to the fair season, it would seem that H2H transmission is not rare. For all we know, people could be infecting the swine. There was little to no surveillance to detect H3N2v in people prior to the fairs in Indiana and Ohio. If this outbreak is the result of swine to human transmission, then that tranmission route is clearly very efficient. When have hundreds to thousands of people been infected by a swine-origin virus transmitted from the swine and not H2H? Also, this in itself should be a huge red flag and could be easily controlled by keeping people away from swine.

http://www.baltimoresun.com/health/blog/bs-hs-swine-flu-maryland-20120817,0,7998893.story

Swine flu cases found in Maryland
Strain traveling the country comes to Maryland
By Meredith Cohn, The Baltimore Sun

6:49 p.m. EDT, August 17, 2012
Six Queen Anne's County residents have been diagnosed with a strain of swine flu that has been infecting people across the country, including many who have been attending state and local agricultural fairs, according to state health officials.

There have been 224 cases identified nationally by the U.S. Centers for Disease Control and Prevention, and state agricultural officials confirmed that the five children and one adult in Maryland from different families all came in contact with pigs at the Queen Anne's County fair as well as other locations. Officials say only rarely has the virus been transmitted from person to person.

The findings are preliminary and the H3N2v strain will be confirmed by additional testing, said officials at the state Department of Health and Mental Hygiene. Those infected have not become seriously ill or hospitalized, but they do have common influenza symptoms, including fever, sore throat and cough.

[snip]
 
Re: Maryland reports 6 confirmed cases of H3N2v

I might add that officials are assuming that the majority of H3N2v cases in persons having had swine contact are the result of swine to human transmission. This might be true, but the data collected does not indicate the direction that the virus has transmitted. It only indicates coincidental cases of H3N2v in swine and persons that were in contact with one another. Given the number of cases detected and confirmed, the geographic distribution of cases, and the lack of H3N2v cases detected in swine prior to the fair season, it would seem that H2H transmission is not rare.
JimO is pointing out the circularity of the logic that all human cases of H3N2v are caused by swine exposure. The argument is circular because only influenza cases associated with swine exposure are tested or assume to be probable H3N2v while other current influenza cases are either not tested or a priori assumed to be another flu variant than H3N2v.

The scope of testing needs to be expanded to all influenza cases followed up by questionnaires and contact tracing if necessary. Only then will we know if this only spread from swine to human or if it could also be H2H.

Only confirming H3N2v infections among people who have had swine contact is an example of the fallacy of affirming the consequent.

If a confirmed individual had contact with pigs, then the individual contracted H3N2v from the pigs.

The CDC is failing in its role as watchdog here.
 
Re: Maryland reports 6 confirmed cases of H3N2v

http://www.myeasternshoremd.com/new...cle_64460fae-ec7c-11e1-9a7b-0019bb2963f4.html

Caroline Co. child may have swine flu

Posted: Wednesday, August 22, 2012 1:06 pm

Caroline Co. child may have swine flu By ABBY ANDREWS Staff Writer My Eastern Shore, Maryland

DENTON ? A Caroline County child who attended the Queen Anne?s County fair could have swine flu as a result of exposure to the virus at the fair, but there have been no suspected cases reported related to the Caroline/Dorchester County Fair that took place a week earlier.

Dr. Leland Spencer, Caroline County health officer, said the child became ill and was seen by her family physician, who suspected swine flu. Tests results are not yet known, Spencer said.

Spencer said the child at some point attended the Queen Anne?s County Fair, which ran from Aug. 6 to 11.

Since that fair, six cases of swine flu have been reported in Queen Anne?s County, believed to be related to infected pigs at the fair, which came from four Queen Anne?s County farms. Those affected include five children and one adult.

The Caroline/Dorchester fair ran the week before, wrapping up Aug. 5. Spencer said at this point, it has been too long since it ended for any new swine flu cases to be attributed to the Caroline/Dorchester fair.

[snip]
 
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