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PostPosted: Wed Nov 23, 2011 1:34 pm 
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niman wrote:
Have You Heard?

Iowa Reports Novel Influenza Infections in Three Children

November 22, 2011

The Iowa Department of Public Health today reported that a “novel strain of the influenza virus has been detected in three children.” All three of the children were reportedly mildly ill and have recovered. Iowa has increased surveillance for influenza-like-illness to detect any additional cases of infection with this novel virus.

All three patients are young children who were in contact with one another. All cases were detected at the state public health laboratory through virologic surveillance. An investigation is ongoing but no additional cases have been identified.

Testing at CDC has confirmed that these viruses are similar to the swine-origin influenza A (H3N2) viruses identified in three other states. These viruses contain the “matrix (M) gene segment” from the pandemic 2009 H1N1 virus. This combination of genes was first identified in a person in July. Since then, several additional human infections with this virus have been detected, bringing the total number of human infections to 10 (Indiana 2, Pennsylvania 3, Maine 2, and Iowa 3). All 10 patients have recovered and the majority of cases had relatively mild illness, although 3 patients were hospitalized.

CDC has reported on the previous infections on its website, in the FluView activity report, and in the Morbidity and Mortality Weekly Report. Links to all previous reports related to this virus are available on the CDC swine influenza website at http://www.cdc.gov/flu/swineflu/index.htm.

These viruses are substantially different from human influenza A (H3N2) viruses, so the seasonal vaccine is expected to provide limited cross-protection among adults and no protection to children. However, laboratory testing so far indicates these viruses are susceptible to the antiviral drugs oseltamivir (Tamiflu®) and zanamivir (Relenza®). CDC recommends these drugs for treatment of seasonal and these swine-origin influenza viruses.

Iowa Reports Novel Influenza Infections in Three Children
November 22, 2011



The Iowa Department of Public Health today reported that a “novel strain of the influenza virus has been detected in three children.” All three of the children were reportedly mildly ill and have recovered. Iowa has increased surveillance for influenza-like-illness to detect any additional cases of infection with this novel virus.

All three patients are young children who were in contact with one another. All cases were detected at the state public health laboratory through virologic surveillance. An investigation is ongoing but no additional cases have been identified.

Testing at CDC has confirmed that these viruses are similar to the swine-origin influenza A (H3N2) viruses identified in three other states. These viruses contain the “matrix (M) gene segment” from the pandemic 2009 H1N1 virus. This combination of genes was first identified in a person in July. Since then, several additional human infections with this virus have been detected, bringing the total number of human infections to 10 (Indiana 2, Pennsylvania 3, Maine 2, and Iowa 3). All 10 patients have recovered and the majority of cases had relatively mild illness, although 3 patients were hospitalized.

CDC has reported on the previous infections on its website, in the FluView activity report, and in the Morbidity and Mortality Weekly Report. Links to all previous reports related to this virus are available on the CDC swine influenza website at http://www.cdc.gov/flu/swineflu/index.htm.

These viruses are substantially different from human influenza A (H3N2) viruses, so the seasonal vaccine is expected to provide limited cross-protection among adults and no protection to children. However, laboratory testing so far indicates these viruses are susceptible to the antiviral drugs oseltamivir (Tamiflu®) and zanamivir (Relenza®). CDC recommends these drugs for treatment of seasonal and these swine-origin influenza viruses.

Prior to the three cases in Iowa, most human infections with this virus were associated with exposure to swine. In Iowa, however, no swine exposure has been identified. At this time, it appears that unsustained human-to-human transmission may have occurred. These viruses have been reported in swine in several states in the United States. Swine influenza viruses do not spread through contact with pork or pork products. Eating properly handled and cooked pork is safe.

As part of routine preparedness measures to counter possible pandemic threats posed by novel influenza viruses in the event that they gain the ability to spread easily from person-to-person, CDC has developed a candidate vaccine virus and provided it to manufacturers.
These cases will be officially reported in the MMWR and FluView.
http://www.cdc.gov/media/haveyouheard/s ... uenza.html

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PostPosted: Wed Nov 23, 2011 1:45 pm 
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niman wrote:
niman wrote:
Have You Heard?

Iowa Reports Novel Influenza Infections in Three Children

November 22, 2011


Prior to the three cases in Iowa, most human infections with this virus were associated with exposure to swine. In Iowa, however, no swine exposure has been identified. At this time, it appears that unsustained human-to-human transmission may have occurred. These viruses have been reported in swine in several states in the United States.
http://www.cdc.gov/media/haveyouheard/s ... uenza.html

CDC remains in denial regarding nonsense on "swine exposure". There is ONE swine sequence that matches the 10 human sequences.

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PostPosted: Wed Nov 23, 2011 4:29 pm 
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niman wrote:
niman wrote:
niman wrote:
Have You Heard?

Iowa Reports Novel Influenza Infections in Three Children

November 22, 2011


Prior to the three cases in Iowa, most human infections with this virus were associated with exposure to swine. In Iowa, however, no swine exposure has been identified. At this time, it appears that unsustained human-to-human transmission may have occurred. These viruses have been reported in swine in several states in the United States.
http://www.cdc.gov/media/haveyouheard/s ... uenza.html

CDC remains in denial regarding nonsense on "swine exposure". There is ONE swine sequence that matches the 10 human sequences.

The CDC has released sequences from 14 influenza A positive adolescent US cases since late July. 9 of those cases (64.3%) were trH3N2. In Indiana, Pennsylvania, Maine, and Iowa, the rate is 90%.

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PostPosted: Wed Nov 23, 2011 5:04 pm 
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Here are all influenza A confirmed adolescent cases in the United States since 7/20/11 based on public sequences (trH3N2 w/ H1N1 M gene in bold)

A/Iowa/09/2011 11/14 2M
A/Iowa/08/2011 11/14 1M
A/Iowa/07/2011 11/14 3F
A/Maine/07/2011 10/24 8M
A/Maine/06/2011 10/10 8M
A/Indiana/09/2011 10/03 1M
A/Washington/17/2011 09/14 10F
A/Pennsylvania/10/2011 08/26 9F
A/Florida/24/2011 08/25 1M
A/Pennsylvania/11/2011 08/25 9F
A/Pennsylvania/09/2011 08/20 2F
A/Louisiana/06/2011 08/16 13F
A/Florida/20/2011 08/05 8M
A/Indiana/08/2011 07/27 2M

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PostPosted: Wed Nov 23, 2011 5:23 pm 
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niman wrote:
Here are all influenza A confirmed adolescent cases in the United States since 7/20/11 based on public sequences (trH3N2 w/ H1N1 M gene in bold)

A/Iowa/09/2011 11/14 2M
A/Iowa/08/2011 11/14 1M
A/Iowa/07/2011 11/14 3F
A/Maine/07/2011 10/24 8M
A/Maine/06/2011 10/10 8M
A/Indiana/09/2011 10/03 1M
A/Washington/17/2011 09/14 10F
A/Pennsylvania/10/2011 08/26 9F
A/Florida/24/2011 08/25 1M
A/Pennsylvania/11/2011 08/25 9F
A/Pennsylvania/09/2011 08/20 2F
A/Louisiana/06/2011 08/16 13F
A/Florida/20/2011 08/05 8M
A/Indiana/08/2011 07/27 2M

All trH3N2 cases above are between ages of 1-9. Thus, 75% of all sequenced US influenza A cases from cases under 10 are trH3N2 w/ M gene confirmed.

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PostPosted: Wed Nov 23, 2011 5:39 pm 
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New flu virus in three Iowa kids raises concern about wider spread
Image

A transmission electron micrograph shows some of the structural details of the H3N2 flu virus that infected patients in Indiana and Pennsylvania earlier this year. The virus was formed through the reassortment of two other flu viruses.

By JoNel Aleccia

Three children in Iowa have come down with a new type of flu virus previously linked to pigs, but this time the bug appears to have been spread by people.

The children, who live in rural Webster and Hamilton counties, did not become seriously ill, said Dr. Patricia Quinlisk, medical director for the Iowa Department of Public Health. But the detection of the virus known as swine-origin A/H3N2 in patients who hadn't had contact with animals raises concerns about potentially greater spread of a new type of flu.

"We have pretty good evidence of person-to-person spread," Quinlisk said. "None of the children or anyone around them had exposure to swine, turkeys or other sources."

Officials with the Centers for Disease Control and Prevention had previously detected seven cases of people with the new H3N2 virus that appears to have acquired a gene that may make it more transmissible from H1N1, the flu that sparked the so-called swine flu pandemic in 2009. Flu viruses often swap genetic parts. Officials say the new virus was probably formed when a pig became infected with the H3N2 virus and the H1N1 virus at the same time.

The new bug has components of human, avian, H1N1 and swine flu viruses, all mixed together in what scientists call a recombinant virus.

The first new H3N2 case was identified in a child in Indiana in July, and has been followed by cases in Pennsylvania, Maine and, now, Iowa.

In the previous cases, however, the patients either had direct exposure with pigs, or exposure to a person who'd been around pigs. In the new cases, it appears that one of the children transmitted the flu to the other two, and none of them had any animal exposure, Quinlisk said. She declined to identify the children or their ages, saying only they were younger than 18. No further cases have been identified in the past week, she said.

The Iowa cases are nothing to panic about, health officials emphasized. The H3N2 flu causes symptoms similar to the regular seasonal flu, including fever, cough, fatigue, body aches and loss of appetite.

"People need to be most concerned about the regular, everyday seasonal flu," Quinlisk said.

But Iowa health officials are now testing samples of people with flu-like illness to detect further spread of the new bug. And CDC officials have asked states across the country to be vigilant in looking for it, said Dr. Joe Bresee, the agency's influenza and epidemiology branch chief.

The current seasonal flu vaccine being offered by doctors and clinics was not developed to protect against the H3N2 virus. It contains some antigens similar to a flu virus that circulated in the 1990s, so some people who had the flu then or were vaccinated could have some immunity, but it's not clear how much, Quinlisk said. The Iowa children apparently had not been vaccinated, she added.

With the new cases, CDC officials have confirmed 31 cases in the U.S. of the new swine-origin virus since 2005, including 10 with the H3N2 virus that carries the M gene from the 2009 H1N1 virus.

The best prevention for the new flu, as with any flu, is to wash hands frequently, cover coughs and sneezes and limit spread of germs by staying home when you're sick, health officials said.
http://vitals.msnbc.msn.com/_news/2011/ ... der-spread

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PostPosted: Wed Nov 23, 2011 7:16 pm 
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Commentary

http://www.recombinomics.com/News/11231 ... 10_75.html

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PostPosted: Wed Nov 23, 2011 7:51 pm 
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Nov 23, 2011 (CIDRAP News) – Testing by the US Centers for Disease Control and Prevention (CDC) has confirmed that the novel H3N2 viruses that recently sickened three Iowa children are similar to swine-origin viruses containing a gene segment from the 2009 H1N1 virus that have been identified in three other states.

The CDC, in a statement late yesterday, said the gene combination was first identified in July and that the Iowa cases announced yesterday raise the total number of human infections to 10. The virus is a swine-origin triple-recombinant H3N2 that includes the matrix gene from the 2009 H1N1 virus.

Unlike the other seven cases, no swine exposure has been identified in the Iowa case-patients, all young children who were in contact with each other, the CDC said. "It appears that unsustained human-to-human transmission may have occurred," the agency said. So far there appears to be no sustained transmission, an event that would raise pandemic concerns.

Of the 10 patients who were infected with the novel H3N2 virus in recent months, 9 were children and one was a 58-year-old, according to Dr. Joe Bresee, chief of the epidemiology and prevention branch in the CDC's influenza division. Besides the three Iowa cases, the recent cases include 2 in Indiana, 3 in Pennsylvania, and 2 in Maine.

CDC officials said previously that the H3N2 reassortant is related to an H3N2 strain that circulated before 1990, so people younger than 20 may be more susceptible to the novel virus than older people are, which could explain why most of the cases have been in children.

But Bresee told CIDRAP News it's too early to reach any conclusions about the reason for the age pattern of the cases. "It's certainly true that adults may be more likely to have some protection against the virus because of previous exposure. But the age distribution with 10 cases could be a variety of things," he said.

Of the three patients who were hospitalized with their infections, at least two had underlying illnesses, Bresee said. He couldn't characterize how sick they were, but he said none needed mechanical ventilation.

Bresee also said the CDC had not identified any links between the case clusters in the different states.

The CDC said that because the virus is so different from human H3N2 viruses, the seasonal vaccine is expected to provide limited cross-protection in adults and no protection in children.

Dr. Patricia Quinlisk, medical director for the Iowa Department of Public Health (IDPH), told CIDRAP News that having been immunized against seasonal flu or sick with flu in the 1990s might have provided a priming effect to the immune system against the novel virus. If that's the case, this year's vaccine may provide a limited boosting effect that could provide some cross-protection, she added.

Health officials are concerned about the limited human-to-human spread, Quinlisk said, though clusters of novel swine-related influenza infections typically pop up, then die out. Over the past several years, Iowa has had three other similar events.

However, she said the IDPH is looking for more cases, and so far no more illnesses have been reported in people who had contact with the three children.

The main message for preventing novel flu is the same as for seasonal flu, especially as Americans prepare to gather to celebrate the Thanksgiving holiday, Quinlisk said. "The big push is to stay home when you're sick."

The CDC said several states have reported the novel virus in swine, but did not identify the states. It emphasized that swine influenza viruses do not spread through contact with pork or pork products and that eating properly handled and cooked pork is safe.

As a routine preparedness measure, the CDC has developed a candidate vaccine virus and provided it to manufacturers, in case the new virus becomes able to spread easily, posing a pandemic threat.

See also:

Nov 22 CDC statement

Nov 22 CIDRAP News story "Iowa reports three novel swine-origin H3N2 cases"

Previous CIDRAP News reports on novel H3N2 cases:
Nov 4
Oct 21
Sep 6
Sep 2
http://www.cidrap.umn.edu/cidrap/conten ... novel.html

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PostPosted: Wed Nov 23, 2011 7:56 pm 
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niman wrote:
Nov 23, 2011 (CIDRAP News) – Health officials are concerned about the limited human-to-human spread, Quinlisk said, though clusters of novel swine-related influenza infections typically pop up, then die out. Over the past several years, Iowa has had three other similar events.

http://www.cidrap.umn.edu/cidrap/conten ... novel.html

Reality check. The sequences have been published and all three are virtually identical to each other and match the 7 prior cases in Indiana, Pennsylvania, Maine.

Comparision to prior outbreaks ignores the sequences, which could not be clearer.

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PostPosted: Thu Nov 24, 2011 7:53 am 
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A new swine-flu variant infected three children in Iowa, spurring a search for more cases that may signal whether the virus is spreading easily among people.

The cases occurred over the past three weeks, causing a “mild” respiratory illness with fever, the Centers for Disease Control and Prevention said in a report today. All three children were in contact with one another, and none had a known recent exposure to pigs, the Atlanta-based agency said.

No more infections with the virus, dubbed S-OtrH3N2, have been found among Iowans and there is no evidence of sustained human-to-human transmission, the CDC said. Surveillance is ongoing, it said. Iowa is the biggest U.S. hog-raising state. Scientists around the world are searching for novel flu viruses to get a jump on ones with pandemic potential.

Doctors in the U.S. discovered a new strain of H1N1 swine influenza in patients in California and Texas in April 2009. That virus eventually spread globally, sparking the first flu pandemic in 41 years. The S-OtrH3N2 strain contains one gene from the H1N1 pandemic virus and genes from influenza viruses circulating among North American swine, the CDC said today.

At least seven other people have been infected with the new swine-flu variant this year -- with three cases in Pennsylvania, two in Maine and two in Indiana, the CDC said.

A sample of the S-OtrH3N2 virus suitable for use in human vaccine production has been developed and sent to drugmakers, CDC said. It’s “part of routine preparedness measures to counter possible pandemic threats posed by novel influenza viruses in the event that they gain the ability to spread easily from person to person,” the agency said.

To contact the reporter on this story: Jason Gale in Singapore at j.gale@bloomberg.net

To contact the editor responsible for this story: Jason Gale at j.gale@bloomberg.net

http://www.bloomberg.com/news/2011-11-2 ... pread.html

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