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Symptomatic H3N2v Cases At LaPorte County Fair
Recombinomics
Commentary 11:15
July 27, 2012
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.
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.
“Me and my husband took [our 13-year-old daughter] to the emergency room and on the way from the campground to the hospital, she was almost unconscious,” Hunt recounted. “I was slapping her face, asking her questions, trying to get her to stay awake.”
“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.
The above comments from media reports indicate the number of symptomatic people who were associated with the LaPorte County fair was significantly higher than the four confirmed cases, which appears to involve three children and one adult.
One family had three symptomatic siblings, while another family had two symptomatic siblings, which were in addition to a confirmed adult and reports of a dozen children with symptoms. The LaPorte County outbreak in Indiana appears to be similar to the 2007 Huron County fair in Ohio, where H1N1v was confirmed in a presenter and her father (A/Ohio/1/2007 and A/Ohio/2/2007), in addition to symptomatic swine (A/swine/Ohio/24366/07 and A/swine/OH/511445/2007). In that outbreak there were 26 symptomatic attendees who were not tested.
In the Indiana outbreak however, the number of symptomatic or infected swine was well above the 41 with temperatures on July 13, since the 12 confirmed swine cases involved symptomatic and asymptomatic swine.
Although the CDC has put out an MMWR report as well as a “Have You Heard”, neither report gives detail on the number of symptomatic attendees or swine. The absence of these numbers in public reports is similar to the outbreak at the Imperial County daycare center in West Virginia, were two students were H3N2v confirmed, but 23 contacts were symptomatic.
The West Virginia cluster, as well as the prior 2012 case (in Utah), involved an H3N2v sub-clade with a N2 common in H3N2 swine, in contrast to the earlier cases which involved an N2 common in H1N2 swine.
Recently released sequences from May, 2012 collections from Indiana swine included both H3N2v sub-clades, so the sub-clade involved in the LaPorte cluster remains unclear.
Release of the sequences from the human and swine cases would be useful.
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