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This child became ill in early October 2011 with symptoms similar to seasonal influenza including fever, cough, headache, sore throat and myalgia. Prior to illness, the child had exposure to swine including time spent in a closed setting at an agricultural fair. Maine CDC and the Department of Agriculture are currently investigating exposures.
The above comments are from an October 19, 2011 Health Advisory issued by the Maine Center for Disease Control and Prevention. The case matches the information on the GISAID characterization sheet for the full set of sequences for A/Maine/06/2011, which was from a sample collected on October 10, and made public by the federal CDC on October 17, 2011. Similarly, the date cited in the advisory suggests the linkage is to the Cumberland Fair, which was open from September 23-29.
However, like the earlier cases, there has been no data indicating that the swine at the exhibits were infect with SOIV, trH3N2, or trH3N2 with a pandemic H1N1 M gene, the constellation of flu genes identified in all five trH3N2 human cases and no swine cases reported to date. Like the cases in Pennsylvania, the case is reported to have attended an agricultural fair which exhibited swine, and this association facilitated the trH3N2 testing of the symptomatic children (all 2011 cases are between 2-9 years of age).
The testing of the Maine trH3N2 sample was “inconclusive” and was confirmed by the CDC in Atlanta, which again raises concerns that most of the trH3N2 in the United States cannot be confirmed by state labs.
PCR test kits for swine H3 should be distributed to state labs immediately.