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Paradigm Shift Intervention Monitoring
Comments On Minnesota trH1N2 Infant
The above comments from a WHO update on influenza in the world, like the PAHO update on influenza in the Americas, Is false and misleading. The two most recent novel cases in the United States are closely related to the prior human 2010 and 2011 trH3N2 isolates in the US. The isolate from West Virginia (A/West Virginia/06/2011) is a reassortant which matches the ten 2011 prior US cases (H3N2pdm11) except the NA gene is from another lineage in swine (trH3N2 but with linkage back to seasonal H3N2 from 2003). The trH1N2 from Minnesota (A/Minnesota/19/2011 has the same two parents as the first 10 H3N2pdm11 (A/swine/Ohio/FAH10-1/2010 and A/Pennsylvania/40/2010), except A/Minnesota/19/2011 has acquired the H1 and N2 from the Ohio parent. As a result, all 18 human triple reassortants in 2010 and 2011 either have a PB1 with H1N1pdm11 E618D, or an H1N1pdm09 M gene and the constellations from the two most recent human cases, described above, have not been reported in any swine in the United States, or anywhere in the world.
Thus, there are currently three different constellations circulating in humans at this time (H3N2pdm11, trH3N2, trH1N2) and include isolates from each sub-clade from patients with no swine exposure and part of a confirmed or suspect cluster. H3N2pdm11 was confirmed in A/Iowa/07/2011, A/Iowa/08/2011, A/Iowa/09/2011, and the index case was linked to two suspect cases (her brother and father). trH3N2 was confirmed (A/West Virginia/06/2011) and a suspect contact influenza A positive samples is under investigation at the CDC. trH1N2 (A/Minnesota/19/2011) and linked to a symptomatic suspect case, who was not tested.
In spite of this unprecedented situation involving three different novel sub-clades in three different states (Iowa, West Virginia, Minnesota), the WHO issues false and misleading statements which are hazardous to the world’s health.