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Paradigm Shift Intervention Monitoring
Cases Increase to 20
The above comments from the Wisconsin Department of Human Services increase the total number of H3N2v beyond the number of confirmed and suspect cases reported previously. These initial cases were linked to four fairs, including the linkage of the first two cases to the Wisconsin State. However, one of the cases was an employee who reported no swine contact. The fair ended August 12 and the CDC has now released three sets of sequences, A/Wisconsin/22/2012 collected August 13, A/Wisconsin/23/2012 collected August 15, and A/Wisconsin/27/2012 collected August 17. The collection date of the third case is outside of the typical incubation period of 2-4 days.
However, all three HA sequences from these cases are identical, signaling clonal expansion suggesting human to human (H2H) transmission.
A recent CDC presenation cited 10 examples of human transmission of H3N2v suggesting these additional Wisconsin cases represent H2H tarnsmisison. This is also supported by match failures between swine H3N2v sequences (which largely match human 2011 cases) and human 2012 H3N2v cases, as well as the virtual identity between sequences from the same region, such as the Wisconsin sequences from eastern Wisconsin.