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H3N2 Triple Reassortants in Pennsylvania and Illinois Patients
Recombinomics Commentary 21:40
November 10, 2010

"We have received disturbing information on the WHO alert system that the U.S. two people the virus H3N2: a seven-month child in Illinois and 46-year-old man in Pennsylvania, "- told Interfax Rospotrebnadzor head Gennady Onishchenko.

The above translation describes the detection of two novel H3N2 triple reassortants.  Friday’s MMWR indicates one novel H3N2 from Pennsylvania was reported in week 44.  The MMWR notes a second novel H3N2 isolate which first appeared in the June 18 report (week 23).  There was no detail in the June report, but a novel H3N2 was reported at the beginning of 2010.  That case was first identified in late 2009 and was in a patient from Iowa, who was asymptomatic.  Thus, the earlier MMWR report may be in reference to the Iowa case, which would suggest that the child in Illinois is not yet in the latest MMWR.

Two novel H3N2 cases would be cause for concern, especially if there was no linkage.  An increase in H3N2 novel reassortants this season is more likely because of the increase in seasonal H3N2 as well as pH1N1, which is now widespread in swine worldwide.  The level of pH1N1 in swine has been frequently reported in the United States and reassortment in swine is common (H3N2 triple reassortants have three human flu genes, including H3 and N2).

More information on the two cases, including sequence data would be useful.

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