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Paradigm Shift Intervention Monitoring
Maryland H3N2v Match WV Sub-Clade
The Minnesota NA was identical to the Butler County, Ohio and LaPorte County, Indiana, which have N234D. This change abolishes the glycosylation site and has not been identified in prior swine isolates related to the human cases, once again signaling an important change that appears in human isolates prior to swine.
The closely related sequences have been found in all July and August isolates across the entire county with matching cases in Hawaii, Indiana, Ohio, Pennsylvania, Wisconsin, Minnesota, and Maryland. All match each other in all 8 gene segments, which also match earlier cases from Utah and West Virginia. This constellation has only been identified in 2 swine isolates prior to the recent outbreak, in spite of enhance surveillance which has identified 17 matches with the first 10 H3N2v cases from 2011. Although this related sub-clade is circulating in 2012 swine, matching human cases have been not identified since the Iowa cluster in November, 2011.
This novel 2012 sub-clade has achieved sustained human transmission, CDC testing focused on swine related cases notwithstanding.