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Commentary
Maryland H3N2
Death
Cluster Due To CDC Low Reactor
Recombinomics Commentary 14:15
April 10, 2012
CDC has confirmed that the influenza viruses isolated from the cluster of severe respiratory illness in one family in Maryland are seasonal influenza A H3N2 viruses. Genetic sequencing has confirmed that this is a typical human seasonal H3N2 virus that is more than 99% similar to other H3N2 influenza viruses submitted by the state of Maryland this season. While full antigenic testing is pending, based on genetic sequencing of some of the samples, these viruses are close to the H3N2 component of the 2011-2012 seasonal vaccine such that vaccination should offer protection against these viruses.
The CDC has released two more series of 2012 H3N2 sequences from cases in the United States. Most of these sequences were designated as low reactors, A/Perth/16/2009-like(H3N2)LOW GP, including a January 25, 2012 isolate, A/California/17/2012, which was an exact match (1701/1701 BP) with isolates from the Maryland death cluster (see list here).
The CDC designation of the California isolate as a low reactor contradicts the above CDC statement in blue as well as the CDC rumor in red. California/17/2012 and the sequences from Maryland represent a drift variant that does not react well with the current H3N2 vaccine target, A/Perth/16/2009, and the CDC is well aware of this fact, as demonstrated by their selection of A/Brisbane/299/2011 as a potential H3N2 vaccine target. Like the Maryland and California sequences, it has S199A, and is a drift variant.
A/Brisbane/16/2009 was isolated in April of 2009, when the 2009 pandemic began. H1N1pdm09 became increasingly dominant, and by the start of the 2009/2010 flu season, virtually all influenza A isolates were the pandemic strain. Thus, H1N1pdm09 crowded out seasonal H1N1, as well as seasonal H3N2 (essentially eliminating Perth/16/2009).
In the summer of 2010 the CDC issued an alert because H3N2 had re-emerged. However, the H3N2 that emerged in the United States in the summer of 2010 had S199A and was related to the clade described above.
However, the CDC used its antigen characterization test to claim that the vaccine targeting A/Brisbane/16 was a “match” and not only used the vaccine target Perth/16 for the 2010/2011 season, but used it again in the current season (2011/2012) even though pneumonia and influenza (P&I) deaths in the 2010/2011 season were at record levels (all three components in the current vaccine are identical to the vaccine used in 2010/2011).
The recently released CDC H3N2 sequences confirm that virtually all 2012 US isolates fall into two major sub-clades, matching the 2012/2013 vaccine target, A/Victoria/361/2011 (with A198S and V223I), or A/Brisbane/299/2011 (with S199A).
However, even though the recent low reactors and phylogenetic analysis indicates these two drift variants dominant, the CDC continues to claim that only 20% of H3N2 isolates (see current FluView) from the current season are low reactors.
The CDC’s dual use of antigen characterization tests continues to be hazardous to the world’s health.
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