Rhiza Labs FluTracker Forum

Why does the above suggest a separation in time????????????????
If seperated in time, there is no reason to include the Illinois case and exclude the Iowa case, which was reported in early 2010. The Iowa case was clearly an H3N2 triple reassortant.

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I think you are confused. The above report from Azerbiajan is the same report carried 100's of times in Russia, Ukraine, and Georgia. It has no dates for the 7 month old from IL or 46M from PA.

However, the 46M from PA is in tomorrow's MMWR which has the PA case listed as CURRENT (week 44). The PA case brings the 2010 novel H3N2 cases to two. The earlier case first appeared in MMWR in June, but it was NOT current in June. It was just quitely added. There were no media reports on novel H3N2 in June (in Illinois or anywhere else). However, there was a January 2010 report on novel H3N2 in an asymptomatic adult in IOWA (which was actually in late 2009 but not acknowledged until Jan, 2010). That case is almost certainly the case that was quitely added in June.

Thus, there is no evidence that the 7 mo old in Illinois is in the 2010 MMWR, indicating that like the PA case, it is VERY recent (which is why it would be included in a PAGER alert - if the ALERT included older H3N2 cases it should have also included the adult H3N2 case in Iowa).
The Iowa case was described by the CDC in week 1 of 2010 in its weekly flu report

http://www.recombinomics.com/News/01151 ... _Iowa.html

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It's too early to know when the Illinois case emerged. Many articles suggest "the first case is the Illinois one", and the second and current from PA. Dates are not mentioned, but very suggestive.
Illinois case doesn't appear in tomorrow's MMWR suggesting it's not current.

It will take some hours or days to clarified the potential situation. But, I can't say a pandemic has begun or it's very likely, without more information than a Russian articles.

We must wait until sequences and official data from The WHO and CDC comes out.

Novel H3N2 in humans in the US is both rare and newsworthy. Tomorrow's MMWR cites two cases in 2010 in the US. One was reported in the week 1 CDC report in January 2010 (and the first notation of novel H3N2 in the 2010 MMWR was in June, 2010). The second case was in week 44 in PA (as in the 46M in the WHO alert). It is likely that the 7 mo old in Illinois is not yet cited in the 2010 MMWR.

Media reports have described 3 novel H3N2 cases in 2010. The adult asymptomatic case in Iowa was reported in January 2010. The adult case (46M) in Pennsylvania is in week 44 based on tomorrow's MMWR. The 7 mo old in Illinois is not yet acknowledged by the CDC, but is acknowledged along with the Pennsylvania case in yesterday's WHO page, which has been reported by 100's of newspapers in Russia, Ukraine, Georgia, and Azerbaijan.

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Delays in MMWR reports are common. The case in Iowa was actually identified in Sept, 2009, confirmed in Nov 2009 and reported in January 2010. The first mention of novel H3N2 in the 2010 MMWR was in June.

Pandemic H1N1 reports in the US and Mexico were also delayed in April 2009 (the first US sample was colllected in March 2009).

Sending out a PAGER alert that cites an earlier H3N2 Illinois case while ignoring an earlier H3N2 Iowa case really doesn't make sense. It is likely that both IL and PA are in the same recent time frame and signal an H3N2 pandemic.

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Iowa H3N2 case (reported in January, 2010):

One case of human infection with a novel influenza A virus was reported by the Iowa Department of Public Health, according to FluView, a report from the Centers for Disease Control and Prevention for the week ending Jan. 9.

The case patient had onset of symptoms in September 2009, but did not require hospitalization and has fully recovered. The virus was identified as swine influenza A (H3N2) and investigated in November 2009.

No clear exposure to swine was identified, but no evidence of sustained human-to-human transmission with this virus was found. Early identification and investigation of novel influenza A cases is critical to evaluate the extent of the outbreak and possible human-to-human transmission, the CDC said. Surveillance for human infections with novel influenza A viruses is conducted year-round.

“I think if there was other transmission going on associated with this case we would have picked it up and we haven't," CDC spokesman Tom Skinner said.

http://vaccinenewsdaily.com/news/211694 ... a-cdc-says

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There will have to be a lot more cases in different regions for a pandemic definition.

Do you think we will have a pandemic in the next month, what is the probability, like a ball park figure, 20%?

If the IL and PA cases are current and not tightly linked, the probability is VERY close to 100%. Novel H3N2 cases in humans are VERY rare, and IL and PA are over 500 miles apart (with millions of people in between - detection of novel H3N2 is challenging).

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Actually, the only good reason for including the IL case with the PA case (while ignoring the IA case), would be close sequence identity between the PA and IL cases, which would signal an H3N2 pandemic, even if separated in time. Detection of novel swine H3N2 is difficult because novel H3N2 has human H3 and human N2, so it looks like seasonal H3N2 in most assays used in surveillance.

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2010.11.11 15:17
Russians are the new H3N2 virus does not threaten
Independent News Agency - Khakassia

In the U.S., found a new version of "swine flu". H3N2 virus was detected in 7 months child in Illinois and 46-year resident of Pennsylvania. This strain has been known since 1998.
Chief sanitary doctor Gennady Onishchenko said that the virus is recorded in the U.S., the Russians are not in danger, - transmits RBC.
Speaking to reporters, Gennady Onishchenko, said that the Federal Service closely monitors all the information about the new disease. He urged Russians to remain calm and not panic. "We've got it (the virus), fortunately, no, but we are watching him," - he said.

http://www.19rus.ru/more.php?UID=28830

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