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Paradigm Shift Intervention Monitoring
Transmission At LaPorte County Fair
The above comments from the Indiana Department of Health confirm that the recent H3N2v cluster was at the LaPotre County fair. The four confirmed cases are the largest number of confirmed H3N2v cases from a single venue and comments in tomorrow’s MMWR indicates swine from the fair have also tested positive for H3N2v. Prior H3N2v cases have had swine exposure, but H3N2v had not been confirmed in any swine contacts.
The LaPorte County Fair has much in common with the 2007 H1N1v outbreak at the Huron County fair, where H1N1v was isolated from a presenter and her father (A/Ohio/1/2007 and A/Ohio/2/2007). Sequences from the confirmed cases matched each other as well as H1N1v from symptomatic swine at the fair (A/swine/Ohio/24366/07 and A/swine/OH/511445/2007). However over 2 dozen fair attendees also had symptoms signaling significant transmission.
The internal genes from the H1N1v isolates were closely related to the human H3N2v cases, which may have contributed to human adaptation. Moreover, all of the human H3N2v cases in 2011 and 2012 have acquired an H1N1pdm09 M gene and matching sequences have been reported in recently released June swine sequences from Ohio, as well as May sequences from Iowa and Indiana.
The Indiana swine isolates included those which matched the initial cases from 2011 as well as the version found in the most recent cases from 2011 as well as the only 2012 case other than the four cases described above.
Release of sequences from the cases and swine would be useful.