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Commentary

CDC Have You Heard On trH3N2 Cluster In Iowa
Recombinomics Commentary 03:00
November 23, 2011

All three patients are young children who were in contact with one another. All cases were detected at the state public health laboratory through virologic surveillance. An investigation is ongoing but no additional cases have been identified.

Testing at CDC has confirmed that these viruses are similar to the swine-origin influenza A (H3N2) viruses identified in three other states. These viruses contain the “matrix (M) gene segment” from the pandemic 2009 H1N1 virus.
 
The above comments are from the CDC Novemebr 22  “Have You Heard?” on the three trH3N2 cases in Iowa.  These three cases were in contact with each other, but had no exposure to swine.  In addition, Ann Garvey, Deputy State Epidemiologist, noted that two additional contacts had ILI (influenza-like-illness) but had recovered prior to sample collection. 

This cluster has striking similarities with the 2009 H1N1 pandemic involving the same novel influenza in patients with no swine contact and no contact with each other.  This cluster is larger than the initial cases in California in 2009 (which had 1 confirmed case and ILI contacts), and matches the seven prior trH3N2 cases, who had a loose association with swine, but no confirmation that any of the swine were infected.

An upcoming MMWR on these cases is in progress, and sequences should be released tomorrow.

To date there has been one example of this isolate in swine in New York, A/swine/NY/A01104005/2011,which appear after the novel trH3N2 spread in humans.

This cluster clearly signals the expansion of the trH3N2 pandemic.

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