USA - Indiana: 4 humans, many pigs confirmed with H3N2v - suspected additional human cases mentioned presenting with similar symptoms

[Shiloh]

Source: http://www.wsbtv.com/news/ap/health/4-laporte-c-flu-like-illnesses-linked-to-swine/nP3M4/


Updated: 5:45 p.m. Tuesday, July 24, 2012 | Posted: 5:45 p.m. Tuesday, July 24, 2012
4 LaPorte C. flu-like illnesses linked to swine

The Associated Press
INDIANAPOLIS ?

Health officials say four people who've developed flu-like illnesses all had direct contact with swine at the LaPorte County Fair in northwestern Indiana.

The Indiana State Department of Health said Tuesday that confirmed test results on patient specimens indicate the cause as a variant influenza A virus...

 

[alert]

Re: IN: 4 LaPorte Co. flu-like illnesses linked to swine- cariant Flu A

Re: IN: 4 LaPorte Co. flu-like illnesses linked to swine- cariant Flu A

The article contains the line:

The department says six of the 17 human cases of variant influenza A virus identified nationwide have been in Indiana.

[Since 13 prior trH3N2 cases have been reported in the US, I suspect that makes these four cases trH3N2. - alert]

 

[alert]

Re: IN: 4 LaPorte Co. flu-like illnesses linked to swine Flu A - trH3N2?

Re: IN: 4 LaPorte Co. flu-like illnesses linked to swine Flu A - trH3N2?

http://www.wsbt.com/news/wsbt-healt...-ill-from-same-virus-20120724,0,6722524.story

snip

The Indiana State Department of Health, Centers for Disease Control and the USDA National Veterinary Services laboratory in Iowa found 4 people and all 12 randomly selected pigs from the LaPorte County Fair swine barn had what’s called influenza A (H3N2)v – a strain of influenza in the same family as swine flu.

snip

Once they arrived at the ER with Emma, who’d been taking care of her pigs in the swine barn, Hunt said she became even more alarmed by the reaction from doctors and nurses.

“We told them we were in the swine barn and they immediately all put masks on, they started IVs in Emma and took blood cultures to be sent off. It was just nerve wracking not knowing what was going on,” Hunt continued.

She wasn’t alone. WSBT spoke with at least three other parents whose children also became ill at the fair with similar upper respiratory symptoms. When members of the LaPorte County Fair Swine Committee checked the temperatures of all the pigs in the barn on July 13, 41 of the pigs had fevers so high that guidelines issued by the State Board of Animal Health kept them from being sold at the auction.

But fair organizers didn’t quarantine the barn.

“They really didn’t tell us anything,” Hunt said. “They didn’t want anybody to know what was going on.”

Also on July 13, neither the LaPorte County Health Department nor the State Board of Animal Health knew humans were sick until WSBT called them. They later launched a joint investigation into the human and swine illnesses.

“I’m angry now,” Hunt said, because she recently found out her daughter, at least two other children and one adult were officially diagnosed with influenza A (H3N2)v – the same virus all the tested pigs had.

“I got a $2,700 emergency room bill where they tested [Emma] for everything from a pregnancy test down to a cocaine test. Yeah, I have insurance but why should I have to pay for something that's not my fault? Our pigs weren't sick, the kids' pigs were sold fine, they never ran a fever,” she explained.

The state and LaPorte County Health Departments said they are still investigating, trying to find out if more people were sick. State Health Department Epidemiologist Pam Pontones declined to tell WSBT how many humans had been tested for the H3N2v virus.

WSBT spoke with several parents off camera who said at least a dozen children who had similar symptoms as the pigs and other sick children were treated at local hospitals and doctor’s offices.



[snip]

 

[alert]

Re: IN: 4 humans, many pigs confirmed with H3N2v - additional symptomatic human cases reported

Re: IN: 4 humans, many pigs confirmed with H3N2v - additional symptomatic human cases reported

http://articles.wsbt.com/2012-07-13/sick-pigs_32667783

Are sick pigs and sick kids at the LaPorte County Fair connected?
July 13, 2012|By Kelli Stopczynski | WSBT TV Reporter

snip

One father who did not want to be identified because he was afraid speaking out would adversely affect his family’s farming business became emotional when he told WSBT three of his pigs and his three daughters were all sick. He said an ambulance rushed his 11-year-old daughter from the fairgrounds to a local hospital after she passed out Thursday. There, he said an emergency room doctor wore a face mask while he examined the girl before sending her home with prescribed antibiotics. The man said he was upset he wasn’t getting more answers.

snip

 

[alert]

Re: IN: 4 humans, many pigs confirmed with H3N2v - additional symptomatic human cases reported

Re: IN: 4 humans, many pigs confirmed with H3N2v - additional symptomatic human cases reported

Well, this definitely looks like direct contact with ill, infected swine, but this looks like a fairly large human outbreak. Note also the conflicting reports as to whether all four or just three of the confirmed cases are children, which might suggest more than four cases have already been confirmed.

 

[Emily]

Re: IN: 4 humans, many pigs confirmed with H3N2v - additional symptomatic human cases reported

Re: IN: 4 humans, many pigs confirmed with H3N2v - additional symptomatic human cases reported

I think you are right that swine contact is causing most of the cases, but they are playing with fire by not quarantining the barn, I think. (I could be wrong since I don't have a swine husbandry background. Maybe these fair outbreaks happen more commonly than we know without them evolving into something worse.)

But fair organizers didn?t quarantine the barn.

?They really didn?t tell us anything,? Hunt said. ?They didn?t want anybody to know what was going on.?

 

[sharon sanders]

Re: USA - Indiana: 4 humans, many pigs confirmed with H3N2v - suspected additional human cases mentioned presenting with similar symptoms

hat tip Michael Coston

Wednesday, July 25, 2012

Reports Of H3N2v In Indiana

# 6449

Over the past year we’ve been carefully watching the evolution and spread of a novel swine flu variant called H3N2v (formerly trH3N2), which is a reassortment of the swine H3N2 virus with the Matrix (M) gene segment from the 2009 H1N1 virus.

So far, the number of cases has been small, and while some human-to-human transmission appears to have occurred, the CDC has not seen evidence of sustained and efficient transmission in humans.
​

The last reported human detection goes back to March of this year (see CDC Update On Utah H3N2v Infection), but overnight local media outlets and the Associated Press are reporting on a small cluster of H3N2v that occurred recently, apparently in connection with infected swine at the LaPorte County Fair (held July 8th-14th).

First, a quick look at a couple of these reports, then I’ll return with more on variant influenza. From the AP:

4 LaPorte C. flu-like illnesses linked to swine

Jul 24, 2012 5:45pm
INDIANAPOLIS (AP) — Health officials say four people who've developed flu-like illnesses all had direct contact with swine at the LaPorte County Fair in northwestern Indiana.
(Continue . . .)
​

This short report goes on to say that the ISDH has confirmed a `variant influenza A virus’ in these four people, and that the same virus has been isolated in local swine.

While H3N2v is not directly identified in the AP report, it does appear prominently in other reports, including this lengthy one from the local CBS network affiliate WSBT (includes a 3 minute video newscast).

Health officials: Kids, pigs at LaPorte County Fair ill from same virus

(excerpt)
The Indiana State Department of Health, Centers for Disease Control and the USDA National Veterinary Services laboratory in Iowa found 4 people and all 12 randomly selected pigs from the LaPorte County Fair swine barn had what’s called influenza A (H3N2)v – a strain of influenza in the same family as swine flu.
(Continue . . .)

​

While only 4 new human cases have tested positive for the virus, WSBT reports talking to the parents of a number of children who also fell ill with flu-like symptoms after visiting the pig barn.

According to this report, some local citizens have expressed deep concerns over the handling of this outbreak at the fair, stating that organizers did not quarantine the pigs even after 41 were found to have high fevers.
​

In the past, we have seen reluctance on the part of some hog farmers to test their herds after the bad publicity their industry suffered during the 2009 H1N1 (`Swine Flu’) pandemic (see Swine Flu: Don’t Test, Don’t Tell).

As to the exact strain in this outbreak, the reports are calling it H3N2v and suggest that it is the same strain that has previously been detected in 13 people over the past 12 months.

We’ll obviously be interested in a more precise description from the CDC in the coming days.
​

Swine are highly susceptible to the influenza virus, and are capable of serving as `mixing vessels’, allowing them to reassort into new hybrid strains. When that happens, once in a great while a swine virus can emerge that is capable of spreading in humans.

While the number of confirmed H3N2v infections remain small, the CDC is obviously concerned and has ordered enhanced surveillance, testing, and reporting around the country as to better gauge the prevalence of this virus.

In January we learned that the CDC was working on a vaccine candidate (see H3N2v Vaccine Trials), in the event this virus ever develops `legs’. And earlier this year the CDC Released Updated H3N2v Interim Guidance documents.

For the most part, these documents provide background information, context, and a bit of advice for specific groups on the emergence of this new variant virus.
​

Seventeen cases over a year’s time (even assuming a substantial number of undetected cases) does not a pandemic make - and so far at least - we are not aware of this virus causing any serious illness or death.

This virus has, thus far, mostly affected children.

In April of 2012 we saw a study (see MMWR: Antibodies Cross-Reactive to Influenza A (H3N2) Variant Virus) that found that children under the age of 10 had few or no cross-reactive antibodies to the H3N2v strain, suggesting they would be the most vulnerable age group to the virus.

However, another study I blogged about in Eurosurveillance: Older People May Be Susceptible To The H3N2v Virus suggests that acquired immunity to this virus may wane over time.

​

Although this swine flu variant could one day evolve into a greater public health concern, it could also up in the evolutionary dustbin of failed organisms; little more than an interesting footnote in the history of influenza in the 21st century.

For now, the threat to the public appears low, and we remain in a watchful waiting mode. But anytime a virus jumps species – as this one has - we are particularly attentive.
​

For more on the H3N2v virus, you may wish to revisit some of these older blogs.

Eurosurveillance: Cross Reactive Antibodies to H3N2v In Norway
H3N2v: Three’s A Crowd
MMWR: H3N2v Transmission and Guidelines
WHO/FAO/OIE: Call It A(H3N2)v
​

And for more background on variant flu viruses, you may wish to visit the following CDC webpage:

Key Facts about Human Infections with Variant Viruses (Swine Origin Influenza Viruses in Humans)

Questions & Answers
On this Page

• What is swine influenza?
• What is a variant influenza virus?
• Can humans be infected with swine influenza viruses?
• How common is it for humans to be infected with influenza viruses that normally spread in swine?
• Why are human infections with variant viruses of concern?
• What symptoms do people have when they are infected with variant viruses?

• Can people catch swine flu/variant flu from eating pork?
• How are variant influenza viruses spread?
• How can human infections with variant influenza viruses be diagnosed?
• What medications are available to treat variant flu infections in humans?
• What other examples of outbreaks with influenza viruses that normally circulate in swine are there?
• Was the “2009 H1N1” pandemic virus the same as previously circulating human H1N1 viruses?

Posted by Michael Coston at http://afludiary.blogspot.com/2012/07/reports-of-h3n2v-in-indiana.html 2012-07-25T06:10:00-04:00 6:10 AM

 

[Treyfish]

Re: USA - Indiana: 4 humans, many pigs confirmed with H3N2v - suspected additional human cases mentioned presenting with similar symptoms

Health Officials are Investigating Flu Illness From LaPorte County Fair
Start Date: 7/25/2012 Start Time: 12:00 AM
End Date: 7/25/2012 End Time: 11:59 PM


INDIANAPOLIS—The Indiana State Department of Health, the Indiana Board of Animal Health, and the LaPorte County Health Department are actively investigating an outbreak of four human illnesses associated with the LaPorte County Fair, held July 8-14. All four individuals had direct contact with swine and all four cases are now recovered.



The State Health Department continues to collect information to determine the extent of the illnesses. Symptoms reported include cough, fever and sore throat. Confirmed test results on patient specimens indicate the cause as a variant influenza A virus. Swine specimens also tested positive for this virus.



Influenza viruses can be directly transmitted from swine to people and from people to swine. Human infections are most likely to occur when people are in close proximity to live infected swine, such as in barns and livestock exhibits at fairs. Influenza viruses are not transmitted by eating pork and pork products.



Since 2011, 17 human cases of variant influenza A virus have been identified nationwide. Six of these cases have been identified in Indiana.



Individuals should always wash hands with soap and water before and after petting or touching any animal. Never eat, drink, or put anything in your mouth in animal areas. Older adults, pregnant women, young children, and people with weakened immune systems should be extra careful around animals.



Hoosiers who have direct, routine contact with swine, such as working in swine barns or showing swine at fairs, and have experienced cough or influenza-like illness should contact their health care provider or local health department. Symptoms include cough, sore throat, fever, body aches, and possibly other symptoms, such as nausea, vomiting, or diarrhea.



While influenza is not an uncommon diagnosis in pigs, the State Board of Animal Health encourages swine owners to contact a veterinarian if their animals show signs consistent with flu, including coughing, respiratory illness, off-feed and fever. Most county fairs have a private veterinary practitioner on call for on-site assistance.



Additional information regarding influenza can be found at the Indiana State Department of Health website at www.in.gov/isdh/25462.htm.



###


Contact Information:
Name: Ken Severson
Phone: 317.233.7104
Email: kseverson@isdh.in.gov

 

[Treyfish]

Re: USA - Indiana: 4 humans, many pigs confirmed with H3N2v - suspected additional human cases mentioned presenting with similar symptoms

Pigs, humans had same virus


<CENTER></CENTER>



By Matt Fritz


Published: Wednesday, July 25, 2012 5:03 PM CDT
La PORTE — Sick humans and pigs at the La Porte County Fair had one thing in common — the H3N2 virus.

Yesterday the Indiana Board of Animal Health and the Indiana State Department of Health determined that the same virus was responsible for both animal and human sickness at the annual event, which drew more than 20,000 people to the La Porte fairgrounds earlier this month.

According to a health department press release, four people associated with the fair were diagnosed with the illness after having direct contact with the animals. They have all since recovered.

Janelle Thompson, public information officer for the Indiana Board of Animal Health, said samples were collected from sick people and animals on July 16 after several respiratory illness complaints in both pigs and the children were reported.


Thompson classified the type A influenza as a zoonotic disease, meaning it can be transmitted from animals to humans or vice versa.

The health department release said human infections are more likely to occur when people are in close proximity to live infected swine, such as in barns and livestock exhibits at fairs. Influenza viruses are not transmitted by eating pork and pork products.

Thompson agreed.

"All the people who were diagnosed in this situation had direct contact with the swine," she said. "They were all in the barn working with the animals. At this time we have not heard of any fairgoers becoming ill. So pork is still completely safe to eat."

One parent associated with the swine program (who asked to go unnamed for fear of retaliation) said he had two kids sent to the emergency room, one with a temperature of 102 degrees and the other with a temperature of 104 degrees.

He explained that participants started noticing the problem on July 12.

He said he knew of 41 sick pigs. He owned one of them.

According to the health department, the reported symptoms included coughing, fevers and sore throats. It's continuing to collect information on the extent of the illnesses.

The department release said 17 human cases of this virus have been identified nationwide. Six of these cases have been identified in Indiana.

It recommended individuals to wash hands with soap and water before and after petting or touching any animal, and to never eat, drink, or put anything in their mouths in animal areas. And older adults, pregnant women, young children and people with weakened immune systems should be extra careful around animals.:tiphat:
http://heraldargus.com/articles/2012/07/25/news/local/doc500f38aaaf87f288598925.txt

 

[Treyfish]

Re: USA - Indiana: 4 humans, many pigs confirmed with H3N2v - suspected additional human cases mentioned presenting with similar symptoms

Swine Flu at an Indiana County Fair


Jul 25, 2012
Comments
0






By Anna Tomasulo



Photo credit: pidoubleg, August 2010 via flickr

The Indiana State Department of Health is investigating the potential outbreak of variant influenza A virus, or swine flu.
Shortly after the LaPorte County Fair, held from July 8 to July 14, four individuals reported symptoms of cough, fever and sore throat. Test results from the patients were positive for variant influenza A. To determine the source of the outbreak, swine from the fair are also being tested.
The State Department of Health is working with the Indiana Board of Animal Health and the LaPorte Country Health Department to collect information and determine the spread of the outbreak.
According to the Department of Health, each of the individuals had direct contact with swine, and each has since fully recovered.
Variant influenza viruses are called so because they do not occur seasonally, nor do they normally affect humans. Influenza A viruses regularly cause outbreaks in pigs.

Symptoms of influenza A in infected pigs include, sneezing, respiratory distress, fever, depression or lack of appetite. When infected pigs and humans are in close proximity or direct contact, influenza can be transmitted. The symptoms of human infection with a variant influenza A virus are similar to seasonal flu symptoms (fever, coughing, nausea, lack of appetite, etc.). In rare and limited cases, variant influenza has spread from person-to-person.

Swine flu, or variant influenza A virus, infections are concerning because pigs are susceptible to avian, human and swine influenza viruses. If a pig is infected with influenza viruses from different species at the same time, the creation of a new virus is possible. This process, in which genes from different viruses mix to create a new virus, is called antigenic shift. The 2009 H1N1 pandemic was the result of human infection with a genetically different influenza virus, against which humans had no protection. Now, flu vaccines include protection against the H1N1 virus.
The Indiana State Department of Health recommends frequent washing of hands when working with animals. Additionally, the department cautions against eating around animals, particularly if you have a weakened immune system. Swine owners are also encouraged to contact a veterinarian if their animals show any signs of swine flu. :tiphat:http://www.healthmap.org/news/swine-flu-indiana-county-fair-72512