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Wisconsin and Pennsylvania H3N2v Match WV Sub-Clade
Recombinomics Commentary 04:45
August 25, 2012

The CDC has released 8 more sets of H3N2v sequences (at GISAID).  Six of the sequences are from Indiana samples collected in late July (A/Indiana/14/2012 and A/Indiana/16/2012) or early August (A/Indiana/43/23012, A/Indiana/46/23012, A/Indiana/49/23012, A/Indiana/52/23012).  One sample is from Wisconsin (A/Wisconsin/22/2012 collected August 13) and one from Pennsylvania (A/Pennsylvania/13/2012 collected August 15).  All are closely related to each other and match the sub-clade first reported in the West Virginia day care cluster, which had no swine exposure or contact and 23 of the contacts of the index case had ILI.

This sub-clade has only been reported in 2 swine isolates.  In contrast, the H3N2v sub-clade identified in the first 10 cases in 2011 is widespread in 2012 swine isolates, but has caused no reported human cases since the Iowa cluster in November, 2011, casting serious doubt on swine to human transmission as a common mechanism for the reported human infections.

Instead, the finding that all 26 2012 isolates from 6 states (Utah, Hawaii, Indiana, Ohio, Wisconsin, Pennsylvania) match the 2011 West Virginia sub-clade, signals human to human transmission, which is detected by the CDC in their heavily biased testing of cases with swine exposure.
Although this approach has identified a large number of human cases, it has failed to identify the true extent of spread in the US population, such as the “seasonal” H3 cases in Kentucky and West Virginia in counties adjacent to the large cluster in Gallia County.

The CDC’s refusal to answer direct questions about this cluster suggests they are well aware of H3N2v community transmission.

Disclosure of the sequences from these “seasonal” H3 cases is long overdue, as is a critical evaluation of the CDC RT-PCR kit’s rate of misdiagnosing H3N2v cases as seasonal H3N2.

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