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H3N2v Case In Washtenaw County Michigan
Recombinomics Commentary 23:30
August 15, 2012

The Michigan Department of Community Health (MDCH) says it has identified its first H3N2v influenza infection in a child from Washtenaw County. The child was reportedly around swine at the Ingham County Fair on August 1, 2012. The illness was mild and did not require hospitalization.
The above comments from Kent County Health Department news release describe the first confirmed H3N2v case in Michigan.  It is unclear if  diagnosis was made with the CDC RT-PCR test which is used by state labs.  This case has not been CDC confirmed.

Although the link to the agricultural fair will undoubtedly lead to media reports on H3N2v jumping from pigs to people, all sequences released to date from H3N2v cases in 2012 (A/Utah/10/2012, A/Hawaii/03/2011, A/Indiana/06/2012, A/Indiana/07/2012, A/Indiana/08/2012, A/Indiana/09/2012, A/Indiana/12/2012, A/Ohio/13/2012) have been a novel sub-clade first identified at a West Virginia day care center in November, 2011, which is distinct from the first 10 H3N2v cases in 2011.

The novel H3N2v was only reported in two swine isolates prior to the July explosion of human cases, while there were 26 swine examples of the sub-clade matching the earlier cases in 2011.  Neither sub-clade has been reported in swine in Michigan.

Release of sequence data from this child would be useful.  It will likely match the novel sub-clade isolated from WV, UT, HI, IN, and OH.  In Indiana H3N2v has been confirmed in at least 18 counties, while in Ohio confirmation has been made in 17 counties.  Moreover, West Virginia has confirmed three H3N2v cases in Mason County, which is adjacent to the Gallia Junior County Fair in southeast Ohio, where 200 symptomatic attendees were tested and 69 were influenza A positive.

The rapid spread further supports human to human transmission.

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