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Curious H3N2 Cluster In Tri-State (KY/WV/OH) Area
Recombinomics Commentary 20:30
August 23, 2012

"We've had six confirmed cases." says Kristy Bolen. "Usually flu isn't something we even think about until September or October.

Flu has been making news in recent weeks, but it's the swine flu, that's being picked up at county fairs around the region, and not seasonal flu.
The health department says that may be the foundation for why doctors are testing early.

"I think that's why clinicians, when children and adults are coming in with flu like symptoms, are testing them. They're concerned it could be pig exposure, but it wasn't; it was a seasonal flu.

The above comments describe the first six H3 cases in Ashland/Boyd County in Kentucky.  The cases were about 40 miles from the Gallia Junior County Fair, where more than 200 attendees had flu symptoms.  69 were influenza A positive by rapid test and 11 have been H3N2v confirmed by the Ohio Department of Health and the CDC (and none were reported as seasonal H3N2).  This large outbreak precipitated the local testing in Kentucky of symptomatic children under the age of five who had no swine exposure but were influenza A positive, and the H3 seasonal diagnosis was made using the CDC RT-PCR test.

However, since many of prior H3N2v initially tested as seasonal H3, confirmation of the seasonal H3N2 diagnosis required sequencing by the CDC.  Recombinomics has sent multiple e-mails and made many phone calls to the Kentucky Cabinet for Health and Family Services as well as the Influenza division of the CDC in the past week and has failed to get an answer on CDC testing of these samples.

In addition to the H3N2v confirmations in Gallia County, Ohio, West Virginia has also reported three H3N2v confirmed cases in Mason County, which is adjacent to Gallia County.  West Virginia has also detected “seasonal H3” using the CDC RT-PCR kit and these “seasonal” samples have not been forwarded to the CDC, in spite of the CDC statement that they would suggest testing of ILI patients with no swine contact.

The failure of the CDC to test the West Virginia samples or respond to repeated inquiries regarding the Kentucky samples raises serious pandemic concerns.

The USDA sequences of H3N2pM including those which match the 2011 and 2012 human H3N2v cases does not support the CDC position that the sub-clade linked to the explosion of cases in July is widespread in “many states”.  Only two of the USDA public sequences match the human 2012 H3N2 cases, while 17 match the sub-clade found in the first 10 H3N2v cases in 2011.  The absence of this sub-clade in any of the 18 2012 cases, including those in Ohio and Indiana, indicates swine to human transmission is rare.

The failure of the CDC to seriously test ILI patients in the area surrounding a massive H3N2v outbreak continues to be hazardous to the world’s health.

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