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Commentary

More Cited H3N2v LaPorte County Fair Cases
Recombinomics Commentary 13:45
July 28, 2012

BW****** at 12:57 PM July 14, 2012
My little sister was one of these sick kids. She was rushed to the ER last week with a 104 fever and now her pig has a 108 fever and has to be shot.

H****** K****** My children were in the hog barn all week. One of my sons did become ill. It was a nasty flu bug that lasted a day. People, and animals, get sick all the time.
July 24 at 11:44am

J***** K****** We were at fair all week. My daughter got the 24 hr infection going around. She had a fever and slept it off. I knew she was sick when she asked to go to bed at 5pm. Wasn't that big of a deal. :/
July 24 at 12:23pm via mobile
 
“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.

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

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.

The above comments from media reports and posted comments to the media stories describe 5 children who went to emergency rooms (representing at least 4 different cases in 3 different families) as well as two siblings of one of the ER cases, as well as two additional symptomatic attendees who recovered without medical attention.  These 8 or 9 children would be in addition to the confirmed case cited as an adult.


However, two of the milder cases were named in a short list of postings (using Facebook registered names, edited above), and likely represent a small fraction of mild cases which recovered in 24 hours without medical attention, suggesting that dozens who attended the fair, or had contact with the symptomatic swine, were H3N2v infected.


The CDC has released a full set of complete sequences from two of the cases (A/Indiana/07/2012 and A/Indiana/09/2012 – both collected on July 16, 2012) which were identical in all 8 gene segments.  These two sequences had the same constellation of genes reported for the two cases in West Virginia (A/West Virginia/06/2011 and A/West Virginia/07/2011) and one case in Utah (A/Utah/10/2012). 

The LaPorte sequences were most closely related to the West Virginia cluster which included 2 confirmed cases (day care center classmates) and 23 symptomatic contacts from the Mineral County day care center.


These two large clusters represent a high attack rate of an emerging H3N2v which is distinct from the first 10 cases in 2011.  The latest outbreak will increase the number of confirmed human cases to 7 and the number of confirmed swine to 14 assuming the unpublished LaPorte swine and human sequences match the two sequences released yesterday by the CDC.


More detail on the LaPorte investigation and the number of symptomatic fair attendees would be useful.

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