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Case Raises Concerns
Confirmatory testing at CDC identified H1N1v with the matrix (M) gene from the 2009 H1N1 influenza virus in specimens collected from this patient.
The above comments from the CDC’s week 36 FluView describe a Missouri patient infected with H1N1v with an H1N1pdm09 M gene. This result is similar to reports at the end of 2011 of a Wisconsin case, A/Wisconsin/28/2011, which also was infected with H1N1v with an H1N1pdm09 M gene. These are the only cases since the 2009 H1N1pdm09 pandemic.
This case follows recent reports of 4 H1N2v cases in Minnesota, which also saw an H1N2v case, A?Minnesota/19/2011, at the end of 2011. However, the 2012 cases have the H1N1pdm09 M gene.
The detection of three different serotypes with the H1N1pdm09 gene (other than H1N1pdm09 cases) is without precedent, and raises concerns that the spread of H1N1pdm09 in swine populations has led to a number of constellations with an H1N1pdm09 M gene.
However, it is worth noting that all 2012 H3N2v case have a novel constellation which was first detected in West Virginia at the end of 2011. The constellation seen in the first 10 H3N2v cases in 2011 has not been reported in 2012.
Release of the sequences from the Missouri H1N1v case would be useful.