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First H3N2 Variant Virus Infection Reported For 2012
April 12, 2012 – The first human infection with an influenza A H3N2 variant (H3N2v) virus in 2012 has been reported in a child by the state of Utah. CDC has confirmed this virus is very similar to the 12 H3N2v viruses that infected 12 people in the United States in the latter half of 2011. The virus contains genes from human, swine and avian influenza viruses, and the M gene from the 2009 H1N1 virus. Swine exposure has been reported for this case. Animal and public health investigations are currently underway to determine the source of this infection and if there are additional human cases. The report will be officially reported in the April 13, 2012 FluView influenza surveillance report.

After seeking medical care for a fever in late March, the patient in Utah tested positive for influenza A and was treated with oseltamivir, which is one of two antiviral drugs known as “neuraminidase inhibitors” currently recommended by CDC for the treatment of influenza virus infections, including infections with variant influenza viruses. The child recovered at home.

The case in Utah was detected through routine surveillance, when the influenza-positive sample from the medical visit was forwarded to the state public health laboratory for further characterization. Testing at the state public health laboratory identified the sample as a possible variant influenza virus. Follow-up testing at CDC confirmed that this is an influenza A H3N2v virus.

When a virus that is known to circulate in swine but not in people is identified in a person, it is called a “variant influenza virus.” The case in Utah brings the number of human infections with H3N2v viruses detected in the United States to 21 since July 2009. Thirteen of those 21 H3N2v viruses have had the 2009 H1N1 M gene and have occurred since July 2011. Twelve of these 13 cases have occurred in children younger than 18 years old. All patients have recovered from their illness. The previously identified 12 human infections with viruses like this one occurred in Indiana (2), Pennsylvania (3), Maine (2), Iowa (3) and West Virginia (2) between July and November 2011. None of the 13 viruses studied have any genetic markers known to confer resistance to the neuraminidase inhibitors oseltamivir (Tamiflu®) or zanamivir (Relenza®).

About half of the 12 infections in 2011 with H3N2v viruses like this one involved the patients being exposed to swine before becoming ill. The prevalence of this virus in swine is unknown, but it has been detected in U.S. swine through the United States Department of Agriculture’s (USDA) swine influenza surveillance program. Limited human-to-human transmission with this virus is suspected to have occurred in Iowa and West Virginia in November 2011.

An article in the April 13, 2011 Morbidity and Mortality Report Weekly Report entitled “Antibodies Cross-Reactive to Influenza A (H3N2) Variant Virus and Impact of 2010-11 Seasonal Influenza Vaccination on Cross-Reactive Antibodies” looked at whether a seasonal flu shot might create antibodies that would be protective of infection with these H3N2v viruses. The study found that the seasonal flu shot would not be expected to protect against H3N2v in young children, and would only provide limited protection against H3N2v viruses in adults. The study results imply that if these H3N2v viruses were to begin to spread easily and widely in people, an H3N2v-specific influenza vaccine would be needed to provide the best protection against H3N2v viruses.

CDC produced an H3N2v vaccine candidate virus. A precautionary vaccine against H3N2v is in development and will likely be ready for clinical trials in the coming months.

The total number of variant influenza virus infections in humans reported in the United States since December 2005 now stands at 36. The remaining 15 infections were with other variant influenza viruses, including H1N2v and H1N1v.

Human infections with influenza viruses that commonly circulate in swine are still rare events, but the frequency with which they have been detected has increased recently. These cases should be carefully investigated jointly by public and animal health officials to determine the source of the infection and ensure that no additional human infections occur or that there is no ongoing human-to-human transmission.

The Weber-Morgan Health Department Press Release on this case is available at http://www.webermorganhealth.org/view_p ... id=23&id=1.
For CDC recommendations to the public about H3N2v see Fact Sheet: Protect Yourself Against H3N2v and Seasonal Influenza (Flu).
For more information about variant influenza viruses see Variant (Swine Origin) Influenza Viruses in Humans.
For more information about H3N2 variant viruses see Information on H3N2 Variant Influenza A Viruses.
For more information about swine influenza, see Swine Influenza (Influenza in Swine).

http://www.cdc.gov/flu/spotlights/h3n2v ... t-utah.htm

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Press Release
April 11, 2012

WMHD Announces Confirmed Case of Novel Influenza

(Ogden, UT) Weber-Morgan Health Department received confirmation from the Centers for Disease Control and the Utah Department of Health that a Weber County resident has tested positive for a novel flu virus that has been identified in several isolated cases in the United States.

The individual was not hospitalized and recovered at home. As a precaution, all known contacts have been advised to watch for fever, cough and other flu-like symptoms and to contact their physician if necessary.

While considered novel, the virus, A/H3N2v, is genetically similar to those which circulate in pigs. It is common practice for the CDC to monitor diseases that are capable of transmitting from animals to humans, says Gary House, director of the Weber-Morgan Health Department.

Fortunately, this individual is getting better,” House says. We know there have been 12 other cases with in the past year in the United States that have also fully recovered. We are working with the CDC, the Utah Department of Health and Utah Department of Agriculture and Food to determine how the individual was exposed to this particular flu virus.

As with all other flu viruses, House reminds the community to take preventive measures such as covering coughs and sneezes, staying at home while ill and washing hands frequently.

'We learned from the H1N1 experience of 2009 that the public's willingness to follow these simple precautions is the best line of defense.' House says.

http://www.webermorganhealth.org/view_p ... id=23&id=1

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On March 29 a child between the ages of 0-5 presented to a local ER with a high fever, sore throat, and intermittent headache. The child tested positive for influenza A and was sent home with Tamiflu. The child was never hospitalized and has since recovered without any adverse effects. Through routine surveillance, the specimen was forwarded to the Unified State Laboratories: Public Health for subtyping. Testing results suggested a variant influenza strain, which was confirmed today as swine-origin influenza A H3N2 by CDC.

The child had contact a week prior with swine at a family-owned slaughterhouse. At this time, no additional ill persons have been found. The Utah Department of Agriculture and Food will be leading an investigation to determine if any swine at the facility are still ill and if testing of the swine is possible.

At this time, public health in Utah considers the case an isolated incident and does not see any indication for risk in the general public. Seasonal influenza activity throughout the state remains high, however providers should be aware that incidental infection with animal influenza viruses in humans is possible.

http://canyonviewmedical.com/blog/?p=195

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Novel H3N2 flu case reported in Utah
Health officials in Utah today announced that a Weber County resident has tested positive for a novel reassortant H3N2 (H3N2v) influenza virus, the same strain that sickened 12 patients last summer and fall in five other states. A press release from the Weber-Morgan Health Department (WMHD), based in Ogden, said tests by the US Centers for Disease Control and Prevention (CDC) and the Utah Department of Health (UDH) confirmed the finding. The swine-origin H3N2v strain includes the M (matrix) gene from the pandemic 2009 H1N1 (pH1N1) virus. Gary House, MPH, director of the WMHD, said in the statement that the CDC and Utah officials are trying to determine how the individual was exposed to the virus. He said the patient was not hospitalized and has recovered at home. The patient's contacts have been asked to report any flu-like symptoms. He advised the community to take routine flu-prevention precautions such as covering coughs and sneezes, staying home when sick, and washing hands frequently.

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

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Commentary

http://www.recombinomics.com/News/04121 ... 2v_UT.html

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Updated: Thu Apr. 12 2012 11:49:19

The Canadian Press

TORONTO — After a lull of several months, U.S. officials are reporting a new case of human infection with a swine-origin H3N2 flu virus.

The case is in a child in Utah who had exposure to pigs.

It's the first case of the H3N2 variant flu reported this year and the 13th since this particular virus started sporadically causing human infections last summer.

All but one of those cases have been seen in children under the age of 18 and all have been spotted in the United States.

The child has recovered after having been treated with the flu drug Tamiflu.

Flu experts are keeping a close eye on this virus, which contains a gene from the 2009 pandemic virus that is believed to enhance its ability to infect people.

http://winnipeg.ctv.ca/servlet/an/local ... nnipegHome

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Published Date: 2012-04-12 10:30:23
Subject: PRO/AH/EDR> Influenza (28): USA (UT) H3N2v isolation
Archive Number: 20120412.1098447

INFLUENZA (28): USA (UTAH) H3N2V ISOLATION
******************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Wed 11 Apr 2012
Source: Weber-Morgan Health Department, press release [edited]
http://www.webermorganhealth.org/view_p ... id=23&id=1


Confirmed case of H3N2v infection in Weber County
-------------------------------------------------
Weber-Morgan Health Department [WMHD] received confirmation from the Centers for Disease Control and the Utah Department of Health that a Weber County resident has tested positive for a novel influenza virus [the swine-origin H3N2 reassortant now designated H3N2v] that has been identified in several isolated cases in the United States.

The individual was not hospitalized and recovered at home. As a precaution, all known contacts have been advised to watch for fever, cough, and other flu-like symptoms and to contact their physician if necessary.

While considered novel, the A/H3N2v, influenza virus is genetically similar to those which circulate in pigs. It is common practice for the CDC to monitor diseases that are capable of transmitting from animals to humans, says Gary House, director of the Weber-Morgan Health Department.

"Fortunately, this individual is getting better,"ù House said. "We know there have been 12 other cases with in the past year in the United States that have also fully recovered. We are working with the CDC, the Utah Department of Health, and Utah Department of Agriculture and Food to determine how the individual was exposed to this particular flu virus."

As with all other flu viruses, House reminds the community to take preventive measures such as covering coughs and sneezes, staying at home while ill, and washing hands frequently. "We learned from the H1N1 experience of 2009 that the public's willingness to follow these simple precautions is the best line of defense." House said.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Previously cases of human infection with this variant H3N2 virus (H3N2v) have been seen in Indiana, Pennsylvania, Iowa, Maine, and West Virginia. Most have been in children younger than 10 and none of the cases has died. 6 of the 12 had exposure to pigs but in the other 6, no contact with swine could be found. The CDC has said it believes some of these cases are the result of human-to-human spread, but suggests spread among people is probably still limited at this point.

Swine influenza virus (SIV) H3N2 with triple reassorted internal genes (TRIG) has been enzootic in US since 1998. Transmission of the 2009 pandemic H1N1 (pH1N1) virus to pigs in the US was followed by reassortment with endemic SIV, resulting in reassorted viruses that include the novel H3N2 genotypes (rH3N2p). The swine-origin H3N2v strain includes the M (matrix) gene from the pandemic 2009 H1N1 (pH1N1) virus.

The state of Utah can be seen on the HealthMap/ProMED-mail interactive map at http://healthmap.org/r/2aBt. A map showing the location of Weber county in the north of the state can be accessed at http://www.digital-topo-maps.com/county-map/utah.shtml. - Mod.CP]


See Also

Influenza (25): H3N2v, pathogenesis & transmission 20120407.1093271
Influenza (12): H3N2v pandemic potential 20120222.1049306
2011
----
Influenza (78): USA, swine-origin H3N2 reassortants update 20111224.3669
Influenza (76): USA, two novel influenza A viruses 20111210.3563
Influenza (74): swine-origin H3N2 reassortant, vaccine candidate 20111203.3526
Influenza (72): Europe, swine-origin H3N2 reassortant, risk assessment 20111130.3494
Influenza (71): USA (IA) swine-origin H3N2 reassortant, WHO 20111125.3448
Influenza (70): USA (IA) swine-origin H3N2 reassortant 20111124.3438
Influenza (69): USA (IA) swine-origin H3N2 reassortant 20111123.3430
Influenza (68): Hong Kong swine-origin H3N2 reassortant 20111119.3411
Influenza (66): USA swine-origin H3N2 reassortant, update 20111105.3298
Influenza (63): USA (ME, NOT NH) corr. 20111106.3307
Influenza (63): USA (ME, NOT NH) swine-origin H3N2 reassortant 20111102.3260
Influenza (60): USA (ME) swine-origin H3N2 reassortant 20111021.3134]
.................................................cp/mj/dk

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OGDEN — A Weber County resident has tested positive for a novel flu virus, similar to those that circulate in pigs.

The variant influenza A H3N2 virus has been confirmed in at least a dozen isolated cases in the United States, but Wednesday's announcement by the Weber-Morgan Health Department identified the first in Utah.

The virus was confirmed by the U.S. Centers for Disease Control and Prevention, which reports the virus presented itself in the U.S. during the second half of 2011.

"While there is no evidence that sustained human-to-human transmission is occurring, all influenza viruses may become widespread," according to the CDC. They liken the severity of the virus strain to similar seasonal flu virus infections.

Health departments are required to report the incidence of any flu variant. Information prompts prevention strategies throughout communities.

The affected person was not hospitalized for the illness, features of which include fever, cough and other flu-like symptoms. As a precaution, all known contacts have been advised to watch for symptoms and contact a doctor if necessary.

The department and the CDC will continue to monitor the illness in Utah, as it is common for both agencies to track diseases that are capable of transmitting from animals to humans, said health director Gary House. He said they are also working to determine how the patient was exposed to the flu.

“Fortunately, this individual is getting better,” House said. “We know there have been 12 other cases within the past year in the United States that have also fully recovered."

The 12 cases have been identified in Indiana, Iowa, Maine, Pennsylvania and West Virginia. At least half of those recently infected have had contact with pigs, but in some cases, the virus has spread from person to person. The variant strain is related to human flu viruses from the 1990s, so adults should have some immunity, but children likely do not, according to the CDC.

A vaccine against the strain is not yet being manufactured, but health officials are watching the illness closely at this time.

Residents are reminded to take preventive measures, such as covering coughs and sneezes, staying at home when ill, and frequently washing hands.

“We learned from the H1N1 experience of 2009 that the public’s willingness to follow these simple precautions is the best line of defense,” House said.

E-mail: wleonard@desnews.com Twitter: wendyleonards
http://www.deseretnews.com/article/7655 ... ounty.html

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Commentary

http://www.recombinomics.com/News/04121 ... Match.html

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Similarity between 2012 and 2011 sequences signal H2H.

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