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Kentucky H3N2v Case Raises Serious Pandemic Concerns
Recombinomics Commentary 23:55
September 1, 2012

The CDC has released another series of July / August H3N2v sequences (collected between July 29 - August 10) from isolates in Michigan (A/Michigan/14/2012), West Virginia (A/West Virginia/15/2012), Illinois (A/Illnois/09/2012), Ohio (A/Ohio/52/2012), Indiana (A/Indiana/20/2012 and A/Indiana/65/2012) and Kentucky (A/Kentucky/11/2012).  All sets of sequences were closely related to each other and the 34 prior sets of sequences from Hawaii, Indiana, Ohio, Maryland, Minnesota, Pennsylvania, and Wisconsin indicating the novel sub-clade had clonally spread across the United States via sustained human transmisison.   These sequences were closely related to the prior 2012 isolate, A/Utah/10/2012, as well as the two sequences from a 2011 West Virginia day care cluster A/West Virginia/06/2011 and A/West Virginia/07/2011, where 23 contacts of the index case had ILI and there was no swine contact or exposure.

All of the above sequences were from outbreaks which have been described by the CDC in various publications such as FluView, MMWR, Have You Heard, or various H3N2v website including the state case count that is updated each Friday, with the exception of the Kentucky isolate.  That sample was collected on August 5, 2012 and was deposited at GISAID on August 24, but not released until today. 

Thus, the CDC was well aware of the Kentucky case prior to updates on August 24 and 31, but this case was not cited.

However, on August 16, 2012 Ashton-Boyd County issued a press release and the Kentucky Health and Family Services Cabinet issued a health alert on the detection of seasonal H3N2 and claimed that “No cases of the H3N2 variant influenza that contain genetic material from swine influenza have been reported in Kentucky to date".

Recombinomics made many inquiries to Kentucky and the CDC regarding the sequence confirmation that these cases were seasonal H3N2, but multiple calls and e-mails were not answered.  The “seasonal” H3N2 cases are children who live in Boyd County, which is adjacent to Gallia County where hundreds of ILI cases had been reported at the Gallia Junior County Fair, and the symptomatic children in Kentucky, who had not been to the fair or had swine contact, were influenza A positive.

The seasonal H3N2 in 5-6 children in August in Kentucky adjacent to a massive H3N2v outbreak in Ohio and West Virginia’s Mason County, which was also adjacent to Boyd County, was highly suspect.  H3N2v would represent community transmission, which the CDC has denied.

However, the August 24 deposit of H3N2v sequences from an August 5 collection, raises serious pandemic concerns and transparency issues, as do the 188 "seasonal" H3N2 cases reported by the CDC for weeks 31-33 in week 34 FluView.

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