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Second trH3N2 Case In Minnesota Raises Pandemic Concerns
Recombinomics
Commentary 16:45
December 17, 2010
The above comments in today’s week 49 CDC FluView describes another patient infected with an H3N2 triple reassortant (trH3N2). This announcement follows a November pager alert due to the detection of two other trH3N2 cases, one in September (10 month M), A/Wisconsin/12/2010, and one (54M) in Pennsylvania, A/Pennsylvania/14/2010. Like the above case in Minnesota, the Wisconsin case required hospitalization.
The sequences of the Wisconsin and Pennsylvania isolates were very closely related to each other, even though they were isolated 6 weeks apart and there was no know contact between the patients. These sequences were also related to the Minnesota case (1F) in May, A/Minnesota/09/2010. The current case raises the Minnesota total to two this year, and the number of trH3N2 cases reported in the United States to six. All six cases were reported after the start of the 2009 H1N1 pandemic and four of the five earlier PB1 sequences had E618D, a marker found in virtually all pandemic H1N1 sequences.
These similarities in sequences strongly suggest trH3N2 is transmitting human to human (H2H) and suggest that the recent Minnesota case will be closely related to the three earlier infections in 2010. The four examples in 2010, plus two more in 2009 also support H2H since the US had not reported any trH3N2 cases prior to the 2009 pandemic.
In addition, trH3N2 sequences have been identified in sequneces from Argentina and Cameroon.
Release of the sequences from the Minnesota case, as well as addition November and December cases under investigation, would be useful.
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