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Paradigm Shift Intervention Monitoring
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Pennsylvania Department of Health (PADOH) has noted increasing
influenza activity in several parts of the commonwealth, including
influenza A (H3N2) in the Southwest region and 2009 influenza A (H1N1)
virus in the Lehigh Valley area. As a result, severe illness and one
death have occurred in the Lehigh Valley.
Patients with severe illness in hospitalized patients or fatalities where influenza is suspected should have respiratory specimens submitted to the state Bureau of Laboratories for testing. For information or for assistance to facilitate specimen submission to the Bureau of Laboratories, clinicians should call 1-877-PA HEALTH.
The above comments are from a “Health Advisory” issued by the PADOH on Monday, increasing the likelihood that the two deaths in the week 46 report were the two H1N1 infected patients on ventilators which appear to have died within a few days of each other.
This type of clustering and high case fatality rate raise concerns that a more virulent version of H1N1 is emerging, which is common when levels decline due to immunity against wild type H1N1. Variant sequences were described in Australia and New Zealand where H1N1 cases were reported in vaccinated subjects.
Initial sequences from Australia had D225G and D225N, so sequence data from the PA cluster would be useful.
As seen above, the advisory notes that lab confirmed influenza is a reportable disease and requests laboratory specimens from hospitalized patients.
The most recent reported trH3N2 isolate was also from Pennsylvania, and detection of such variants would require detailed laboratory analysis.
Therefore the collection of samples and release of sequences would be useful.