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Commentary CDC In State of
Denial Regarding trH3N2 Human Transmission While we know the M gene plays a role in influenza virus infection, assembly and replication, the significance of this change in these swine–origin influenza A (H3N2) viruses is unknown at this time. CDC continues to investigate the implications of this genetic change. The above comments are from the latest “have you heard” put out by the CDC. The statements represent an agency in the state of denial with regard to the human transmission of trH3N2. They confuse reported trH3N2 with actual trH3N2 infections. The association with swine is directly linked to the CDC trH3N2 testing which is largely limited cases with some kind of pseudo-link to swine. The report acknowledges that the 5 trH3N2 in 2011 all involve the same trH3N2 virus which has an M gene from pandemic H1N1, but ignores the data indicating the M gene of pandemic H1N1 is critical for human transmission. The CDC has yet to provide any direct evidence for human trH3N2 infections from swine in 2011. The first case (from Indiana) has no known swine contact, and the CDC has acknowledged likely human to human transmission, which has also been acknowledged for the two most recent 2010 trH3N2 cases (father and daughter from Minnesota represent by A/Minnesota/11/2010 isolated from the father). For the four most recent trH3N2 cases (in Pennsylvania and Maine) no link has been established between SOIV infected swine and the four cases. The three Pennsylvania cases attended an agricultural fair (which is why they were tested for trH3N2), but no swine with symptoms or trH3N2 swine infections have been identified. The same is true for the Maine fair in Cumberland County. Moreover, no swine anywhere at any time have been identified with the human constellation, even though swine surveillance in 2010 and 2011 has been dramatically increased in the US. Similarly, the CDC has failed to demonstrate that trH3N2 is rare in recent human H3N2 cases. They have released sequences from 15 US H3N2 cases infected since July, and 5 of the 15 were trH3N2. Thus, the CDC is relying solely on its heavily biased testing to claim the swine linkage. Distribution of trH3N2 PCR kits to state labs is long overdue. Such state testing will determine the true extent and transmission of trH3N2 in humans in the US in the 2011/2012 season. Recombinomics
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