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of trH3N2 Across the United States
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.
The above comments on the trH3N2 cluster in Iowa leaves little doubt that the novel virus has spread across the United States, yet the CDC continues to deny the extent of the spread and is increasing surveillance in “bordering states”.
The trH3N2 has already been confirmed in children in Indiana, Pennsylvania, Maine, and now Iowa, in addition to a pig in New York. Surveillance remains abysmal in spite of rates of 100% in confirmed cases in children in Maine and Pennsylvania, and 50% in Indiana. All seven of the prior isolates match in all 8 gene segments, which also match the swine isolate in New York, signaling a jump from human back to swine.
The CDC has maintained a “swine exposure” narrative, leading to a request for samples with “swine exposure” when the first two cases were announced in the early release MMWR. The denial of human transmission was maintained in the Maine CDC advisory claiming that all prior 2011 cases had a swine exposure, which was not true for the case in Indiana, and the cases in Pennsylvania had limited exposure to asymptomatic swine at a state fair (and only one had direct contact). Moreover, the Maine state epidemiologist claim “no thought” of human transmission, and these agency claims were propagated by media and ProMED reports, and remarkably, this narrative on swine exposure is still be propagated by CIDRAP in its report in the Iowa cluster.
The upcoming MMWR on the cluster in Iowa should demand an increased surveillance throughout the country to get a true estimate of the extent of spread and the number of hospitalized cases.
The silent spread of a trH3N2 pandemic two years after the trH1N1 pandemic raises serious concerns about influenza surveillance in the United States and worldwide.