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Commentary

Vietnam H3N2v Swine Flu Case Raises Transparency Concerns
Recombinomics Commentary 13:15
February 15, 2012

The national flu monitoring system detected this case in April 2011. A two-year-old female baby in Long An province contracted the disease and was treated successfully at the Children’s Hospital No 1. in HCM City. The A/H3N2 flu virus she had originated from pigs.

The test results of the HCMC Pasteur Institute were confirmed on January 10, 2012, by the WHO laboratory at the US Centres for Disease Control and Prevention (CDC).

The above comments provide additional clarity on the dates surrounding the confirmed H3N2v case in Vietnam, but still leave many questions unanswered.  It is likely that this case was initially classified as seasonal H3N2 in 2011.  The H3N2v cluster in Iowa in November led to an alert issued by WHO, largely because the three confirmed cases had no swine exposure.  That alert was followed by a media report in Vietnam that described the US cases and increased surveillance in Vietnam.  Those reports incorrectly described the US H3N2v cases as H3N1.
Last week media reports in Vietnam again issued a warning about H3N2v cases, but only provided detail on the cases in the United States and again described the cases as H3N1, and a follow-up report claimed no H3N2v cases in Vietnam in 2012 (carefully parsed to avoid acknowledgement of the 2011 case).

Today, reports from Vietnam described the above case (age, gender, and location) and the English language reports clearly indicated this was a 2011 case that was confirmed over a month ago by the US CDC.

This raises several important questions, which have not been answered. None of the reports have cited a swine exposure by the confirmed case.  Similarly, the CDC has not released the sequences at GISAID, as was done for the 2011 variant cases in the United States (H3N2v, H1N2v, H1N1v).  Moreover, WHO has not announced the confirmed case, in spite of lab confirmation by a WHO regional center, although it is unclear if the WHO has announced this case at its password protected site.
Thus, a month after confirmation, all of the above questions remain unanswered by public data, although the sequence would clearly distinguish between a linkage to Asian or North American swine lineages.

The lack of transparency by WHO and the CDC continues to increase pandemic concerns.

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