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H3N2v Cases In Washington County Indiana
Lindsey Brough, public health nurse for Washington County, said so far, transmission of the virus has been from pig to human and human to pig, there has been no transmission between people.
The above comments note 23 confirmed H3N2v cases in Washington County, Indiana as of Monday. Earlier media reports had described influenza A positive cases who had been treated with Tamiflu (oseltamivir). These cases contributed to the increase in the number of confirmed H3N2v cases in Indiana from 120 to 138. However, an ISDP update was expected this morning, and the press release has been delayed, suggesting another significant jump in the Indiana case count. Yesterday, Ohio reported 47 confirmed cases in 11 counties. The number of counties with confirmed H3N2v cases in Indiana is at least 18.
The above comments also cite human to pig transmission, which is clearly support by the H3N2v sequence data from humans and swine. The state and county fairs provide a vehicle for the expansion of human adapted H3N2v into swine, which causes the discordance between reported swine and human sequences.
Prior to the July outbreaks, the swine matches were dominated by the H3N2v constellation in the first 10 H3N2v confirmed cases in 2011, yet all 2012 human case match the large cluster at the West Virginia day care center, which is readily distinguished from the earlier human H3N2v cases in 2011.
The sequence data, coupled with the explosion of human clusters of H3N2v cases in Ohio and Indiana, clearly signal sustained and efficient community transmission of H3N2v.