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Commentary
Taiwan CDC
Warns of Travel To United States Due To trH3N2
Recombinomics Commentary 14:00
November 10, 2011
The United States ─ H3N2 swine flu
Source: WHO Event Information Site for IHR National Focal Point, 2011/11/2
U.S. 11 / 1 reported two cases of swine-derived H3N2 influenza cases, prior to the onset had a history of contact with pigs. 1 case of 8-year-old boy, the incidence of 10/22, 10/24 medical treatment; the other 1 case of 58-year-old male veterinarian, the incidence of 10/20, 10/21-10/24 hospital. The United States this year, total 7 cases swine-derived H3N2 influenza cases so far in 2005 total of 15 cases.
Relevant countries and regions:
The above translation is from the Taiwan CDC website which warns of travel to all 50 US states and District of Columbia due to the two most recent trH3N2 cases described at the WHO password protected site (IHR National Focal Point) for the reporting of diseases covered by International Health Regulations.
As seen above, like the WHO update on pandemic vaccine target, the 15 trH3N2 confirmed cases are reports as beginning in 2005, although the first US case was reported in August. 2009. Thus, the concentration of cases is far higher than indicated on the WHO website designed for submission and reporting of a variety of cases including those infected by a novel influenza, such as trH3N2.
Although media and ProMED are reporting these cases as “sporadic” jumps from pigs to people, all 7 cases from the US, including the two cases cited above, have the identical constellation of flu genes which has never been reported in swine.
The finding of the 3 or more identical constellation of genes in triple reassortant cases, other than those infected with H1N1pdm09, is without precedent and clearly signals human transmission. Thus far reported 2011 trH3N2 cases have been limited to Indiana, Pennsylvania, and Maine, the 7 cases represent 70% of influenza cases reported by these states since July, 2011.
There has been limited and biased testing in the US, due in part to the CDC request for samples in the early release MMWR describing the first two 2011 cases, which limited samples to cases with a swine exposure.
The CDC should announce a modified request for pediatric samples from cases with flu-like symptoms and/or those that are influenza A positive. These cases cannot be tested for trH3N2 by state agencies and samples must be tested by the CDC at this time, but an expanded testing of samples without swine exposure, such as the atypical pneumonia cases in Shelby County Indiana, is long overdue.
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