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Three October trH3N2 Maine and Indiana Cases Match
Recombinomics Commentary 16:45
November 1, 2011

The CDC has released two more sets of trH3N2 sequences from recent cases and once again the CDC is commended for the rapid release of sequences from these October cases.  The two cases (A/Indiana/11/2011 and A/Maine/07/2011) were collected two days apart (October 22 and October 24), but are closely related to each other, as well as the Maine case, A/Maine/06/2011, also collected in October (October 10, 2011).  The close relationship between all three October cases strongly supports human transmission, which is further supported by the close relationship between all seven of the 2011 cases, which are distinct from all swine isolates.

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.

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