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Paradigm Shift Intervention Monitoring
trH3N2 Cluster Confirmed
The above chart confirms the second trH3N2 case in West Virginia (in week 49). The two week gap between the two cases raises concerns of additional cases due to the incubation time of 2-4 days. This case should be detailed in the week 50 FluView and “Haveyouheard?”, but it was sent to the CDC because of an epidemiological link. Therefore, like the week 47 case (1F), A/West Virginia/06/2011, the sequence of the week 49 case should also have a unique N2, representing a new confirmed cluster involving a new constellation with no swine linkage.
The cases from week 47 led to new guidance by the CDC for increased surveillance in all 50 states, as well as a warning from WHO. The co-circulation of of two distinct trH3N2 clades as clusters without swine linkage is without precedent and raises serious pandemic concerns.