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Indiana DoH Confirms Second trH3N2 Case
Recombinomics Commentary 17:45
November 3, 2011

The Indiana State Department of Health Laboratory identified a suspect swine-origin influenza A virus on October 28, 2011. The specimen was forwarded to the CDC where genome sequencing confirmed the specimen to be positive for the presence of a triple reassortant H3N2 (SOtrH3N2) influenza virus. The case has been investigated by ISDH Surveillance and Investigations Division, the Indiana State Department of Health Laboratory, and the CDC. The affected Local Health Department and BOAH have been notified and have been cooperative in the investigation. The case patient had very close contact with pigs in the week prior to illness onset. No illness has been reported in the case’s household or close contacts. This case is the 7th recognized case of human infection with S-OtrH3N2 with the M segment gene from the pH1N1virus (previously identified in Maine [2], Indiana [1], and Pennsylvania [3]) in 2011. This case from Indiana marks the second case in the past 3 months and the 15th human case of S-OtrH3N2 reported to CDC since 2005. No community transmission has been documented in this case.

The above comments are from the Indiana Department of Health week 43 report describing its second trH3N2 case, as indicated by the sequences released by the CDC on October 31.

Thus, both recent cases have now been confirmed (using samples collected two days apart) by the respective state agencies in week 43 reports, although neither was acknowledged in CDC’s week 43 MMWR.  It is likely that the CDC will comment in the week 43 FluView, but unclear if either case will be included in the sub-typing table since only two of the five prior 2011 trH3N2 cases have been acknowledged.

As expected, this case also had swine contact, extending the CDC "trend" of only reporting trH3N2 cases some sort of loose swine exposure.

All 7 confirmed cases have the same constellation of flu genes, including the M gene segment from H1N1pdm09 and this constellation has not been reported in swine in Indiana, Maine, Pennsylvania, or any location anywhere.

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