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Is trH3N2 Linked To Death Cluster In Manitoba Canada?
Recombinomics Commentary 04:05
December 4, 2010

Dr. Joel Kettner, Manitoba's chief public health officer, said later Friday that the second death had not yet been confirmed as a result of H3N2 although confirmation was expected.

But he said officials have been able to rule out the suggestion that this might be the start of a pandemic.

"We've looked at what this virus is. It's the virus that has been circulating."

The above comments suggest that the death cluster in Manitoba is due to the seasonal H3N2, that is widespread in Canada.  However, trH3N2 would test as seasonal H3N2 in a sero-typing test, which is the type of testing that would be done in Manitoba.  To rule out trH3N2, more extensive testing would be required, such as antigenic characterization or sequencing, which would be done at the National Labs in Winnipeg.

The week 47 report noted that 24 H3N2 samples had been antigenically characterized since September 1, 2010 and all had been Perth/16-like.  However, in week 47 alone there had been 111 samples positive for influenza and although 102 were influenza A, only 39 had been sero-typed as H3N2 (most were not sub-typed because they were identified with the rapid test).  Thus, most of the 24 characterized H3N2 would have been prior to the first fatality in Manitoba, which was the first fatality under 65 in Canada this season.

As noted in the characterization sheet for the trH3N2 sequences generated by the CDC, “Human case of H3N2 triple reassortant Swine-origin influenza virus, HA and NA from seasonal H3N2” the H3 and N2 are human seasonal flu sequences from the 1990’s, so the human sero-typing reagents would recognize the trH3N2.  Thus, the serotyping data for trH3n2 would look like seasonal H3N2, which is the main serotype circulating in Canada at this time.

Therefore, details of the testing done to conclude that the H3N2 in Manitoba is Perth/16-like H3N2 would be useful.

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