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Commentary Tale of Two CDC
trH3N2 Reports Raises Pandemic Concerns Both of the most recent patients confirmed with swine–origin influenza A (H3N2) infection had been in close contact with live pigs during the week prior to their illness onset. The above comments are from two CDC reports dated November 4, 2011, which describe the two most recent trH3N2 cases (from Maine and Indiana). The two comments above provide information on the second case from Maine (8M, A/Maine/07/2011), who had multiple swine exposures. He attended the Fryeburg fair (where symptomatic pigs were identified) and participated in one of the two pig scrambles at the fair. In addition, he also had exposure to asymptomatic swine after the fair. These exposures however, do not provide credible evidence for the source of the trH3N2 infection because the Fryeburg fair ended Oct 9, and disease onset for the second Maine case was Oct 22, which significantly exceeded the influenza incubation time of 1-4 days. Moreover, the post-fair exposure was to asymptomatic swine, and the symptomatic swine at the Fryeburg fair tested negative for SOIV. Thus, in spite of no credible evidence linking the swine exposures to the trH3N2 infections, the CDC carefully parsed out the details in the two reports to create an illusion that the case was exposed to symptomatic swine during the week prior to illness onset. The first description quoted above is from the detailed CDC report for health care professionals and excludes the date of exposure because health care professionals would be skeptical of an exposure two weeks prior to disease onset, but would readily accept a human infection linked to exposure to symptomatic swine. The second description is in the CDC’s “Have You Heard?” which is directed toward the media and is linked to the CDC media page. This report focuses on the close contact with asymptomatic pigs (by the second cases in Maine and Indiana) and does not cite “sick pigs” and instead cites “live pigs” because the CDC is well aware of the fact that these pigs were asymptomatic (as confirmed by Recombinomics discussions with the Maine Department of Agriculture or the Indiana State Board of Animal Health). Thus, the CDC carefully parses out the facts that discount the role of the swine exposures in the human cases, and tailors the reports to be factually correct, but highly misleading. The selection of the swine exposure facts are customized for the audiences for the two November 4 documents. This heavily biased release of swine exposure data compliments the heavily biased testing, which prioritizes cases with swine exposure for more sophisticated trH3N2 testing. This bias was also clear in the early release MMWR on the first two trH3N2 cases in 2011, which requested samples from cases with a swine exposure (instead of out of season flu cases in August / September). The heavily biased reporting by the CDC leads to mis-statements in the Maine CDC advisory, which claimed that all prior trH3N2 cases in 2011 had a swine exposure, when there was no such exposure for the first case from Indiana. Similarly, media reports and ProMED commentary make false claims on the origin of the infections, stating that the trH3N2 cases in Maine and Indiana are due to trH3N2 “jumping from “pigs to people” when both cases were only exposed to “live pigs” as stated in the “Have You Heard?” report, and not “sick pigs” as stated in the report for health professionals, for exposure In the week prior to symptoms. Thus, the CDC reports are little more than propaganda pieces supporting the CDC narrative on swine exposure as a source of the 2011 trH3N2 cases, and this propaganda is them dutifully spread by the media and ProMED. These parsed reports focused on the CDC narrative of trH3N2 linkage to swine exposures significantly increases pandemic concerns. Recombinomics
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