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Paradigm Shift Intervention Monitoring
CDC Unsubtypable For Week 33 Raises trH3N2 Pandemic Concerns
The above figure was published by the CDC in its week 34 FluView, which shows a low level of influenza detection. The underlying data for this figure is released on each Friday, but is updated as new data is generated. This weekend the data was updated to report an unsubtypable (unable to sub-type) for week 33 (see fiftth column below which lists the data for the past 5 weeks). This chart also shows an increase in detection of H3N2 (three cases in each of the past three weeks), which was the dominant serotype for each of the last three weeks.
The increase in H3N2 cases, as well as the unable to sub-type (unsubtypable) case in week 33, may represent a low level of detection of trH3N2, which has a human H3 and N2 from the 1990’s. Thus, the human linage may be detected by serotyping reagents and reported as seasonal H3N2. However, since the trH3N2 has been evolving in swine since the 1990’s, the H3 and N2 may have evolved far enough away from the human to sequence to produce an “unsubtypable” designation. The “unsubtypable” from week 33 was not listed in the underlying data for the week 33 report and was not represent in the above figure from Friday’s week 34 report.
The last reported unsubtypable by the CDC was pandemic H1N1, reported in the 2009/2010 season.
More detail on the unsubtypable added this weekend, as well as the increase in H3N2 cases, would be useful.