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Paradigm Shift Intervention Monitoring
H3N2v Child Matches 2012 Cases
Those three cases were followed by a cluster at a West Virginia Mineral County day care center (A/West Virginia/06/2011 and A/West Virginia/07/2011). Two cases were confirmed but 22 additional contacts of the index case were symptomatic, signaling sustained human transmission. These sequences had replaced the N2 with an H1N2 lineage, with an N2 that had been circulating in H3N2v swine. This N2 was subsequently found in all 2012 human H3N2v cases, wuth the exception of 3 cases from Michigan, which had the H1N2v swine N2 as well as a PB1 which had been found in all 6 human 2010 cases, which had E618D, which is in all H1N1pdm09 isolates.
The 2012 Iowa case is the first such case in Iowa in 2012, and it has the N2 from the swine H3N2v lineage. Prior to the spike in human cases in the summer, which were closely tied to agricultural fairs, the Iowa case had no swine exposure. Sequence sequence released by the USDA indicate this sub-clade is becoming increasingly widespread in swine. In addition to matches in North Carolina swine, October matches have been reported in Iowa, Illinois, and Indiana swine.