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California H3N2v Health Alert - PCR Testing of All ILI Cases Recombinomics Commentary 02:30
August 15, 2012

Current recommendations
During the summer months, encourage influenza testing in the following:
o All persons with influenza-like illness (ILI)*, including severely ill/fatal cases and outpatients
o Acute respiratory outbreaks
o ILI in persons with recent swine exposures
o ILI in persons who can be epidemiologically linked to confirmed cases of novel or variant influenza.
* Influenza-like illness = fever (>100°F or 37.8°C) and cough and/or sore throat, in the absence of a known cause

The above recommendations are from and August 10, 2012 Health Alert Update by the California Department of Public Health CDPH).  Testing involves RT-PCR testing and the CDPH is applauded for its proactive position of testing of all ILI cases (including outpatients) during the summer months, when seasonal influenza levels are low, and probabilities for detection of H3N2v cases without swine exposure are high.

The Indiana and Ohio explosion of confirmed H3N2v human cases involving the novel sub-clade, which was first detected that the West Virginia day care center where confirmed cases had no swine contact or exposure, strongly suggests that the novel sub-clade is transmitting in human populations independent of swine exposure or contact.

In addition to the explosion of confirmed cases in Indiana and Ohio, a recent case from Maui, Hawaii, A/Hawaii/03/2012, was also due to infection involving the novel sub-clade, which also infected the first 2012 confirmed H3N2v case, A/Utah/10/2012.

CDPH example of RT-PCR testing of all summer ILI cases should be implemented by all fifty states.

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