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Commentary

WHO Issues Warning On Novel Influenza
Recombinomics Commentary 13:30
December 20, 2011

Recently, several human infections with variant influenza viruses currently thought to be circulating in swine populations have been reported. To date, epidemiological investigations have not revealed any onward transmission of these viruses outside of small clusters.

WHO also strongly recommends that all un-subtypable influenza A specimens should be immediately sent for diagnosis and further characterization to specialized laboratories or one of the six WHO Collaborating Centres for Reference & Research on Influenza (influenza/resources), This is important for early identification of emerging viruses with the potential to threaten global public health.

The above comments are from a WHO warning on novel influenza, including H5N1 and the recent novel US cases (H3N2pdm11, trH3N1, trH1N2).  Although the warning continues to cite swine linkages as seen in the recent PAHO and WHO influenza updates, the warning does remind countries of the IHR regulations for reporting novel influenza, and includes the above recommendation, which acknowledges difficulties in the detection of the novel cases in the US.

The latest US cases have no reported swine exposure and represent three distinct constellations (H3N2pdm11 as represented by A/Iowa/07/2011, A/Iowa/08/2011, A/Iowa/09/2011; trH3N2 – A/West Virginia/06/2011; trH1N2 – A/Minnesota/19/2011.  All of these cases are linked to confirmed or suspect clusters, including a new West Virginia isolate which will be announced this week.

The current situation in the US is alarming, because the detection of three clusters of distinct novel influenza (all of which have a PB1 with H1N1pdm09 E618D or H1N1pdm09 M gene) is without precedent. 

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