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Paradigm Shift Intervention Monitoring
California Issues H3N2v
The above comments are from the Marin county Public Health Alert issued December 21, 2011, which followed a December 15 alert issued the California Department of Public Health due to a CDC request citing the West Virginia cluster involving 23/70 contacts with ILI. The request for segregation of patients and use of masks is similar to guidelines for suspected H1N1pdm11 cases in 2009.
In addition to the CDC request for increased surveillance, an early release MMWR was issued on December 23, 2011, and reissued today. The MMWR describes the West Virginia cluster as a case report, which indicates the virus was transmitting for a month at the Mineral county daycare facility. Symptomatic contacts were cited, but the attack rate suggested by 23/70 cases of ILI in contacts of the index case.
Two sets of sequences from the cluster were released (A/West Virginia/06/2011 and A/West Virginia/07/2011), which had a novel N2 sequence, which had acquired tandem polymorphisms (L370S and S372L) from seasonal H3N2, signaling further human adaptation.
The large cluster suggests more cases and clusters will be reported this month.