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Commentary
Indiana DoH
Reports Second trH3N2 Case As Inconclusive
Recombinomics Commentary 22:15
November 3, 2011
ƾ The Indiana State Department of Health Laboratory identified a suspect swine-origin influenza A virus on October 28, 2011. The specimen was forwarded to the CDC where genome sequencing confirmed the specimen to be positive for the presence of a triple reassortant H3N2 (SOtrH3N2) influenza virus.
The above data from the Indiana DoH week 43 influenza report confirms that the latest trH3N2 case (59M – A/Indiana/11/2011) registered as “inconclusive” or “unable to sub-type” in the state sub-typing test. Since state labs cannot directly test for trH3N2, the sample was sent to the CDC where it was confirmed on October 28 (sample was collected on October 22 and sequence was released by the CDC on October 31 at GISAID).
The “inconclusive” sub-typing result was also obtained for the Maine case, A/Maine/07/2011, which was collected October 24, two days after the Indiana sample. These sequences were closely related to each other and the other October sample, A/Maine/06/2011, and had the same constellation as the four prior cases from Indiana and Pennsylvania.
Thus, the current H3 does not subtype with the human reagents at state labs, but only two of the first five cases (A/Pennsylvania/09/2011 and either A/Pennsylvania/10/2011 or A/Pennsylvania/11/2011) have been listed as unsubtypables (in collections from week 33 and 34 listed as "unable to sub-type").
The absence of the other confirmed trH3N2 cases from the sub-typing figures and tables increases concerns that the CDC is running a shell game on subtypables and a charade on the swine exposure, by limiting those case reported as “unable to sub-type” and only reporting trH3N2 cases with swine contact (as others are withheld because they are under epidemiological investigation seaching for a swine connection that doesn't exist).
Information on unreported suspect trH3N2 cases is long overdue.
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