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Paradigm Shift Intervention Monitoring
Matches Clark County Ohio
The H3 sequence from Kentucky clusters with the Ohio sequences from Clark County, A/Ohio/23/2012, as well as two early isolates from Indiana (A/Indiana/59/2012 and A/Indiana/60/2012). This clustering provides further support for the human expansion.
Neither Kentucky nor the CDC has acknowledged H3N2v cases in Kentucky. Kentucky denies H3N2v in its August 16 press release and health alert, which describe the detection of seasonal H3N2 in children in Ashland, Kentucky, which is in Boyd County. These cases were initially tested by local practitioners because of the massive outbreak at the Gallia Junior County fair in southeastern Ohio. In addition to the 200 cases in Ohio, the three H3N2v cases in Mason County, West Virginia were from cases who also attended Gallia fair, and sequences from one of these cases, A/West Virginia/15/2012, were also released by the CDC, and these sequences matched the first case from Jackson County, Indiana, A/Indiana/12/2012 or A/Indiana/13/2012 (as well as additional sequences from Indiana), which were distinct from the Kentucky sub-clade, suggesting the Kentucky case was not linked to Gallia fair.
The Kentucky sequence raises concerns that many of the 188 seasonal H3N2 cases in weeks 31-33 reported in the week 34 FluView represent multiple H3N2v isolates with no swine contact, representing widespread community transmission.
Kentucky and the CDC have failed to respond to repeated inquiries regarding the sequence confirmation of the “seasonal” H3N2 cases reported on August 16.
Answers to that question, as well as detail on the case linked to the Kentucky/11/2012 sequence, would be useful.