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Most United States Adolescent Influenza A Is trH3N2
Recombinomics Commentary 05:30
November 23, 2011

The three children attended a small day-care together. They live in adjacent counties, Webster and Hamilton, in the centre of the state.
One became sick first and appears to have infected the other two. Quinlisk said it's not clear how the first child got infected.

Another child who is a contact of the first child was ill with what may have been influenza prior to the first child's infection, she said. But by the time laboratories had confirmed the cases, that other child had recovered.
Even if that child was the source of the infections, there is no easy explanation for how he or she got infected. That child did not have exposure to pigs, Quinlisk said.

In fact, none of the three confirmed cases contacts had exposure to swine or other animals that could have been a source of the virus, Quinlisk said. And nor did family members or other close contacts.

The reporting of a trH3N2 cluster with no swine exposure is long overdue.  trH3N2 has been circulating in the US since July, but the spread has largely gone unnoticed due to an absence of testing.  Dozens of influenza A positive samples in Georgia and South Carolina have never been sub-typed. 

In Maine, only two positives were identified, and both were trH3N2.  In Indiana, only three positives were identified and two were trH3N2.  In Pennsylvania only three adolescents were tested, and all three were trH3N2.

Since July, the CDC has only sequenced 14 H3N2 positives samples from adolescents, and 9 have been trH3N2 - 3 in Pennsylvania (A/Pennsylvania/09/2011, A/Pennsylvania/10/2011, A/Pennsylvania/11/2011), 3 in Iowa (sequences to be released by CDC), 2 in Maine (A/Maine/06/2011, A/Maine/07/2011), 1 in Indiana (A/Indiana/08/2011).

Increased surveillance of adolescent samples is long overdue.

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