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Most Recent US Adolecent H3N2 Sequences Are trH3N2
Recombinomics Commentary 01:20
October 25, 2011

The recently released sequences from the Maine case, A/Maine/06/2011, extend the compelling data for human transmission of trH3N2.  This case was the fifth in 2011 and all five isolates had gene segments with the same lineage.  The M gene segment was from H1N1pdm09, five gene segments (PB2, PA, HA, NP, NS) from the dominant 2010 human trH3N2 (A/Pennsylvania/40/2010, A/Wisconsin/12/2010, A/Minnesota/11/2010), NA from the second Pennsylvania isolate, A/Pennsylvania/14/2010, and PB1 closely related to the two Ohio isolates from the Huron outbreak (A/Ohio/01/2007 and A/Ohio/02/2007). Although the same trH3N2 was in all five human isolates (from three states collected over a two month time frame), the gene constellation has not been reported in any swine isolate.

In spite of the solid sequence data, the CDC continues to cite a swine linkage for human trH3N2 cases, even though no symptomatic swine or trH3N2 virus has been reported for any of the swine loosely linked to the five human trH3N2 cases.

In the final 10 weeks of the 2010/2011 season (weeks 30-39) most (67) of the 107 influenza A positive cases were not sub-typed and most H3N2 sequences from adolescents collected since July, 2011 have been trH3N2 cases.  The CDC has released H3N2 sequences from 15 cases infected since July.  The age was given for 13 cases, and 4 were adults.  For the 9 sets of sequences from adolescents, 5 were the trH3N2 cases (see list below).

Thus, the CDC has failed to provide evidence that the human trH3N2 cases in 2011 originated in swine, or that the trH3N2 cases in adolescents were rare.

The CDC should be testing all influenza A positive samples for swine H3 using the sensitive PCR test, which should also be distributed to all state testing labs.

Adult Seasonal H3N2 Sequences (since July, 2011)

PA/12 63M
LA/05 73F
IA/06 90F
FL/22 52F

Seasonal H3N2 (no age given)


Adolescent Seasonal H3N2

LA/06 13F
HI/02 9M
FL/20 8M
MD/17 11M

Adolescent trH3N2

IN/08 2M
PA/09 2F
PA/10 9F
PA/11 9F
ME/06 8M

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