HUNTERDON COUNTY
DIVISION OF PUBLIC HEALTH
PO Box 2900, Flemington, New Jersey 08822 Notification
NJLINCS Health Alert Network
Public Health Update
Distributed by the New Jersey Department of Health
Subject: First case of variant influenza A H3N2 ("H3N2v") identified in New Jersey
Date: 1/7/2016; 14:09:09
Message#: 103028-1-7-2016-PHUP
Contact Info: Lisa McHugh, NJDOH
Phone: 609-826-5964; Email:
lm2@njlincs.net
Attachments: clinical_surv_critieria_H3N2v_010716_comb.pdf
On January 5, 2015, CDC confirmed that a specimen collected from a New Jersey resident
tested positive for variant influenza A H3N2 virus ("H3N2v"). The specimen was collected as
part of routine influenza surveillance from a child who resides in Mercer County. A public health
investigation was conducted and it was determined that the child was in a location where pigs
were present located in Middlesex County in the days prior to illness onset. The child had a mild
illness and has fully recovered. This is the first case of H3N2v to be identified in a New Jersey
resident. A public health investigation is ongoing but at this time no additional illnesses have
been identified.
Given the identification of this recent H3N2v case, NJDOH would like to provide information
regarding H3N2v and remind clinicians and public health authorities about case identification,
reporting, testing and treatment. A list of highlights is provided below. The NJDOH H3N2v
Surveillance and Testing Criteria are attached to this email and can be used to identify and
report any suspect cases.
. H3N2v is a flu virus that normally infects swine (pigs). While rare, this influenza virus can be
spread from pigs to people through close contact, such as petting the animal.
. A number of human infections with H3N2v have been detected in the United States since
August, 2011. The H3N2v virus is not a new virus: however it is different from seasonal
influenza. CDC has performed testing which indicates the virus identified in NJ closely matches
viruses circulating in swine.
. During the 2012-2013 influenza season, a high number of H3N2v viruses were identified. In 2012, there were 309 H2N2v infections in the US. Of these cases, 16 people were hospitalized and one died (
http://www.cdc.gov/flu/swineflu/h3n2v-case-count.htm). Most of the people who were hospitalized or died had more than one health or age factor that put them at high risk for flu complications. Most of the cases of H3N2v had direct contact with pigs which occurred at agricultural fairs, petting zoos and animal markets.
. The symptoms of H3N2v flu in people are similar to the symptoms of regular human seasonal flu. These symptoms include fever, lethargy (extreme tiredness), lack of appetite and coughing. Some people also report runny nose, sore throat, nausea, vomiting and diarrhea.
. H3N2v has been no more severe than seasonal flu. While this virus rarely spreads person to person, flu viruses are known to frequently mutate. The possibility of a mutation would allow this virus to more easily spread person-to-person. In the event that this occurs, prompt reporting and close observation of the case and their contacts is warranted.
. Individuals who had contact with a live pig and have flu symptoms should be evaluated by a health care provider and reported to public health authorities. NJDOH can recommend whether specimens should be collected and arrange for novel virus testing, including H3N2v, at the state public health laboratory.
. H3N2v viruses tested to date are susceptible to the neuraminidase inhibitor drugs oseltamivir and zanamivir. These drugs can be prescribed to treat H3N2v infections. However, H3N2v viruses are resistant to the antiviral drugs amantadine and rimantadine: therefore, amandtadine and rimantadine should not be prescribed. Antiviral treatment recommendations for H3N2v virus infection are similar to those for seasonal influenza (
http://www.cdc.gov/flu/swineflu/h3n2vclinician.htm).
. NJDOH recommends that individuals take precautions when they may come in contact with live pigs. Precautions include frequent handwashing, avoid eating/drinking in pig areas, and avoid close contact with pigs that look or act ill. Individuals at high risk of serious flu complications should consider avoiding pig exposure. The National Association of Public Health Veterinarians have created several documents focusing on minimizing the risk of influenza transmission in animal setting. These document can be found at the following:
http://www.nasphv.org/documentsCompendiaZoonoticInfluenza.html
Resources
http://nj.gov/health/flu/surveillance.shtml
http://www.cdc.gov/flu/swineflu/h3n2v-cases.htm
http://www.cdc.gov/flu/swineflu/h3n2v-clinician.htm
http://www.btschools.org/cms/lib04/...iscellaneous/First Case Variant Influenza.pdf
