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Recent Indiana and Maine trH3N2 Cases Not In Week 43 MMWR
Recombinomics Commentary 15:20
November 3, 2011

Novel influenza A infection virus *** - 7 0 4 43,774 2 4 NN  

The above data from the provision MMWR notifiable disease page for week 43 does not include the two cases confirmed with samples collected in week 43.  The CDC released sequences from Indiana (59M sample collected on October 22 – A/Indiana/11/2011) and Maine (8M collected on October 24 – A/Maine/07/2011) on October 31, well in advance of today’s publication.
Moreover, the Maine DoH acknowledge the recent case in its week 43 report, although the week 43 report from Indiana was not posted yesterday, when new weekly reports are scheduled.  The week 42 report from Indiana denies circulation of novel influenza like the two trH3N2 confirmed cases in 2011.

These case are reportable under IHR regulations which require WHO notification within 48 hours of lab confirmation, so the absence of these two cases from the notifiable disease page for week 43 MMWR is odd.
Similarly, yesterday’s ProMED commentary associated with the first confirmed case in Maine is also odd.  That case (also 8M), was confirmed with a sequence, A/Maine/06/2011, released on October 17 from an October 10 (week 41) collection (but not reported by US CDC as an unsubtypable).  Maine CDC issued an advisory based on that case, which was the source of the media report which drew the recent ProMED commentary.  Once again ProMED failed to comment on the Maine CDC error claiming that all 2011 case has a swine exposure, when the first Indiana case had no such exposure.  The CDC has acknowledged that the case represented limited human to human transmission.

In the recent ProMED commentary, the earlier error was expanded by ProMED claims of no onward transmission, which is at odds with the US CDC statement.  The CDC stated that there was no sustained human transmission (which is based on negative data using the same approaches which have failed to identify a source for any of the 2011 trH3N2 cases).

Moreover, the ProMED commentary discussed an unsourced and unlinked rumor of trH3N2 in swine from New Hampshire, which is said to be due to the earlier media report.

Posting reports which make no reference to trH3N2 in New Hampshire swine as a source for some rumor that is not referenced, adds to the rather bizarre reports linked to the evolution and emergence of this novel trH3N2 in humans, which has increased to seven reported cases in humans and none in swine.

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