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Paradigm Shift Intervention Monitoring
trH3N2 Maine and Indiana Cases Match
Thus, the human cases form two branches, those collected in July and August (A/Indiana/08/2011, A/Pennsylvania/09/2011, A/Pennsylvania/10/2011, A/Pennsylvania/11/2011) forming one branch, and those collected in October (A/Maine/06/2011, A/Indiana/11/2011, A/Maine/07/2011) forming another.
The close relationship between isolates from different states also supports human transmission.
Similarly, the first Maine case was from Cumberland County and he had attended an agricultural fair prior to disease onset on October 7. This fair was likely the Cumberland County fair, which ended October 2 and therefore was an unlikely source for the more recent Maine case, whose trH3N2 came from a sample collected two weeks after the first Maine case. Moreover, the Indiana case is not likely to have been linked to the two cases in Maine.
The bizarre reporting of early unsubtypables suggested additional cases without swine “exposure” would be reported.
Detail on swine exposure for the two latest cases would be useful.