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Commentary

Release of Illinois H3N2v Sequences Overdue
Recombinomics Commentary 14:30
August 15, 2012

The Illinois Department of Public Health (IDPH) laboratory has confirmed one case of what is known as the H3N2v influenza virus, which has now been reported in four states this year – Hawaii, Illinois, Indiana and Ohio. IDPH is working with local, state and federal health officials, including the Centers for Disease Control and Prevention (CDC), the U.S. Department of Agriculture, the Illinois Department of Agriculture and the Coles County Health Department, to identify how a child, who attended the Coles County Fair, contracted the virus last week.

The above comments from an August 9, 2012 press release from the Illinois Department of Public Health describe the first H3N2v case in Illinois.  The case was noted in the CDC August 9 telebriefing as well as the CDC H3N2v page which includes a table with 2011 and 2012 H3N2v cases, which is updated each Friday.

Sequences from recent cases in Hawaii (A/Hawaii/03/2012), Indiana (A/Indiana/06/2012, A/Indiana/07/2012, A/Indiana/08/2012, A/Indiana/09/2012, A/Indiana/12/2012), and Ohio (A/Ohio/13/2012), were released by the CDC (at GISAID) in late July and early August. 

All of the above isolates were closely related to each other and represented a novel sub-clade, which was first identified at a West Virginia day care center, where two H3N2 cases were confirmed (
A/
West Virginia/06/2011 and A/West Virginia/07/2011).  The confirmed case had no swine contact or exposure, and 23 contacts of the index case had influenza-like illness (ILI).  This novel sub-clade was also identified in the first 2012 H3N2v case, A/Utah/10/2012.

The identification of this novel sub-clade in the human cases, even though four June, 2012 swine isolates (as well as an earlier 2012 isolate from Ohio matched the sub-clade found in the first 10 cases from 2011, which was also true for four of the five Indiana isolates (including four from 2012 isolates) and 24/26 isolates matched the earlier sub-clade, while only two swine matches (in North Carolina and Indiana).
 
The presence of the novel sub-clade in all public human H3N2v cases from 2012 suggests that the Illinois case will also be due to this sub-clade (even though all five Illinois swine matches are with the 2011 human cases).

The CDC has not released any H3N2v sequences since early August, even though the confirmed 2012 cases, including the above Illinois case, is now above 200, and 154 of these recent cases were cited in last week’s telebriefing.

The release of the Illinois sequences, as well as the explosion of July H3N2v cases would be useful.

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