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Paradigm Shift Intervention Monitoring
Issues RFI To WHO and US CDC On H3N2pdm11
Dr Chow said the Government has taken various measures to prevent and control influenza outbreaks, and has developed "flu pandemic contingency planning framework", set out the Hong Kong influenza pandemic of command structure, preparation and control measures. These include a number of the new influenza pandemic influenza as well as the prevention and control measures, such as strengthening surveillance, rapid diagnosis.
The above translation describes an RFI (Request For Information) issued to WHO and US CDC on the recently described H3N2pdm11 and trH3N2 cases. These cases as well as the recent trH1N2 case(s) in Minnesota have no swine exposure linkage and raise serious concerns regarding sustained human transmission.
Although the CDC has claimed “limited human to human” transmission, they have not explained why the first 10 cases in 2011 would have the same constellation and lineages for all 8 gene segments, which would either indicate widespread swine infections and efficient transmission to humans, or efficient and sustained human transmission.
The failure of the USDA to identify H3N2pdm11 in swine prior to the July and August spread in humans, as well as the limited detection (one isolate from New York, A/swine/NY/A01104005/2011) after the spread strongly suggests sustained human to human spread.
The last five human cases involving novel influenza have had no swine exposure, which strongly suggests that the earlier linkage in the first 7 cases was due to the CDC enhanced surveillance program during the off season, which targets ILI cases with swine exposure.
Thus, the CDC has failed to explain the lack of exposure in the five most recent cases, other than to claim limited transmission, while failing to identify the source for any of the 12 novel cases in 2011, other than human contact / relatives in the Iowa cluster.
The obvious sustained transmission has raised concerns, as has the deafening silence from the WHO on the two most recent cases, including the delayed reporting of the trH1N2 case(s).