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Confirmed Influenza Cases In ME IN PA Are trH3N2
The above comments from a ProMED report are based on media reports. There has been no data presented to indicate that these cases were from jumps from pigs to people and no indication that these cases are sporadic. The linkage to swine is largely based on testing bias. The three states mentioned above have reported 10 influenza cases since July 24, 2011. All ten cases have been H3N2 and 7 of the 10 cases have been trH3N2 with an M gene from H1N1pdm09.
The week 44 report from Maine indicates there have been two influenza A positive cases. Both were sent to the CDC because the sub-typing was inconclusive and both (each was 8M) were trH3N2 cases with an M gene from H1N1pdm09. Samples were collected on October 10 and October 22. The isolates were named A/Maine/06/2011 and A/Maine/07/2011.
Similarly, the week 43 report from Indiana shows two confirmed cases for the 2011/2012 season. The first case (1M) was seasonal H3N2, as confirmed by the sequence from A/Indiana/09/2011, collected on October 3, 2011. The second case gave an inconclusive sub-typing result and was sent to the CDC for characterization. Sequencing confirmed the case was trH3N2 from isolate A/Indiana/10/2011 (originally reported as A/Indiana/11/2011). The only other reported case from Indiana was the first trH3N2 case in 2011, A/Indiana/08/2011, collected on July 27, 2011.
Pennsylvania has not filed a weekly influenza report since September. However, five sequences from Pennsylvania have been released by the CDC, and all 5 are H3N2. The first case (63M) was represented by an isolate, A/Pennsylvania/12/2011 collected on August 11, 2011 and was seasonal H3N2. The next three cases, A/Pennsylvania/09/2011, A/Pennsylvania/10/2011, A/Pennsylvania/11/2011 (2F, 9F, 9F, respectively) were collected on August 20, 25, 26 respectively and all three were trH3N2. The most recent case (56F) was isolate A/Pennsylvania/13/2011 and collected on September 23, 2011.
Thus, all PCR confirmed cases in Maine, Indiana, and Pennsylvania were H3N2 and 7 of the 10 case were trH3N2 with the same constellation of flu genes, which has never been reported in swine.
There is no scientific data indicating the cases represented sporadic jumps of this emerging human contagion from swine to humans.
The limited number of confirmed cases from these three states raises serious questions about influenza surveillance in these states, which increases pandemic concerns.