Rhiza Labs FluTracker Forum

http://www.cdc.gov/media/subtopic/heard.htm

there is a bit more at the original link than I have posted here.

the CDC's version:

November 12, 2010

Reports of Human Infections with Swine Origin Influenza A (H3N2)

The November 12, 2010 FluView reports two human infections with swine origin influenza A (H3N2) viruses in the United States. Test samples from two patients submitted by Wisconsin and Pennsylvania have been confirmed at CDC as positive for swine origin triple-reassortant (tr) H3N2 influenza viruses—viruses that normally infect pigs. While human infection with swine influenza viruses is rare, it can occur. This is most likely to occur when people are in close proximity to infected pigs, such as in pig barns and livestock exhibits housing pigs at fairs. Both of the patients with confirmed trH3N2 infection reported in FluView were in the vicinity of live pigs. Dates of illness onset in the two patients are more than six weeks apart and the viruses from the two patients have some genetic differences, confirming that these two cases are not linked. Ongoing investigations in both states have not shown any evidence of community transmission of these viruses. The most likely scenario at this point is that these are two isolated cases of human infection with swine influenza viruses that, while very rare, do occur from time to time. Both patients have fully recovered from their illnesses; however, these two cases do underscore the importance of human and animal surveillance for influenza.

These two cases reported in FluView bring the total number of human infections with swine origin influenza viruses reported to CDC since 2005 to 18. Previously, three of these reports had been swine origin A (H3N2) viruses. The Pennsylvania and Wisconsin cases bring the number of reports swine origin A (H3N2) infections in humans in the United States to five. The viruses identified in Pennsylvania and Wisconsin are similar to viruses that infected a patient in Iowa in September 2009, a patient in Kansas in August 2009 and a patient in Minnesota in May 2010.

Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that regularly causes outbreaks of influenza in pigs. Swine flu viruses cause high levels of illness and low death rates in pigs. Swine influenza viruses may circulate among swine throughout the year, but most outbreaks occur during the late fall and winter months similar to outbreaks in humans. There are four main influenza type A virus subtypes that have been isolated in pigs: H1N1, H1N2, H3N2, and H3N1. Most flu viruses circulating in pigs are referred to as "triple-reassortant" viruses because these flu viruses contain genes from human, swine and avian influenza viruses.

Most commonly, cases of human infection with swine-origin influenza viruses occur in people with direct exposure to pigs. The patient in Pennsylvania lives in an area where live pigs are farmed and the patient in Wisconsin became sick two days after attending a state fair where pigs were exhibited. It's important to note that swine influenza viruses are not transmitted to humans by food. You can not get swine influenza from eating pork or pork products. Eating properly handled and cooked pork and pork products is safe.

=========

These viruses are different from the swine classical H1N1 or swine trH1N1 influenza viruses that also circulate in pigs in North America because they have H3N2 surface antigens. Tr H3N2 viruses first emerged in North American swine herds in the late 1990s. The H3 and N2 genes which first emerged in swine flu viruses originated from human seasonal H3N2 influenza viruses that circulated globally among humans in the late 1990s.

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

CDC reports two swine-related H3N2 infections

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Praemonitus, Praemunitus..Forewarned is Forearmed.

Commentary

http://www.recombinomics.com/News/11121 ... e_CDC.html

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Commentary

http://www.recombinomics.com/News/11121 ... ences.html

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INFLUENZA (14): SWINE ORIGIN (TRIPLE REASSORTANT) H3N2 VIRUSES
**************************************************************
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: Fri 12 Nov 2010
Source: CDC Online Newsroom [edited]
<http://www.cdc.gov/media/subtopic/heard.htm#h3n2>


Reports of human infections with swine origin influenza A (H3N2)
----------------------------------------------------------------
The 12 Nov 2010 FluView reports 2 human infections with swine origin
influenza A (H3N2) viruses in the United States. Test samples from 2
patients submitted by Wisconsin and Pennsylvania have been confirmed at the
CDC [Centers for Disease Control and Prevention] as positive for swine
origin triple-reassortant (tr) H3N2 influenza viruses -- viruses that
normally infect pigs. While human infection with swine influenza viruses is
rare, it can occur. This is most likely to occur when people are in close
proximity to infected pigs, such as in pig barns and livestock exhibits
housing pigs at fairs.

Both of the patients with confirmed trH3N2 infection reported in FluView
were in the vicinity of live pigs. Dates of illness onset in the 2 patients
are more than 6 weeks apart and the viruses from the 2 patients have some
genetic differences, confirming that these 2 cases are not linked. Ongoing
investigations in both states have not shown any evidence of community
transmission of these viruses. The most likely scenario at this point is
that these are 2 isolated cases of human infection with swine influenza
viruses that, while very rare, do occur from time to time. Both patients
have fully recovered from their illnesses; however, these 2 cases do
underscore the importance of human and animal surveillance for influenza.

These 2 cases reported in FluView bring the total number of human
infections with swine origin influenza viruses reported to CDC since 2005
to 18. Previously, 3 of these reports had been swine origin A (H3N2)
viruses. The Pennsylvania and Wisconsin cases bring the number of reports
swine origin A (H3N2) infections in humans in the United States to 5. The
viruses identified in Pennsylvania and Wisconsin are similar to viruses
that infected a patient in Iowa in September 2009, a patient in Kansas in
August 2009 and a patient in Minnesota in May 2010.

Swine Influenza (swine flu) is a respiratory disease of pigs caused by type
A influenza viruses that regularly causes outbreaks of influenza in pigs.
Swine flu viruses cause high levels of illness and low death rates in pigs.
Swine influenza viruses may circulate among swine throughout the year, but
most outbreaks occur during the late fall and winter months similar to
outbreaks in humans. There are 4 main influenza type A virus subtypes that
have been isolated in pigs: H1N1, H1N2, H3N2, and H3N1. Most flu viruses
circulating in pigs are referred to as "triple-reassortant" viruses because
these flu viruses contain genes from human, swine and avian influenza viruses.

Most commonly, cases of human infection with swine-origin influenza viruses
occur in people with direct exposure to pigs. The patient in Pennsylvania
lives in an area where live pigs are farmed and the patient in Wisconsin
became sick 2 days after attending a state fair where pigs were exhibited.
It's important to note that swine influenza viruses are not transmitted to
humans by food. You can not get swine influenza from eating pork or pork
products. Eating properly handled and cooked pork and pork products is safe.

In the past, CDC received reports of approximately one human infection with
a swine influenza virus every one to 2 years, but in the past few years,
about 3 cases have been reported per year. Increased reporting of human
infections with swine influenza could be the result of increased influenza
testing capacity and capabilities in public health laboratories.

These trH3N2 viruses are different from the 2009 H1N1 virus that has been
circulating in the United States since late April 2009. They are also
different from human seasonal influenza A (H3N2) viruses that typically
circulate among people during the flu season. Swine trH3N2 viruses commonly
circulate in pigs in North America, but rarely infect humans. These viruses
are different from the swine classical H1N1 or swine trH1N1 influenza
viruses that also circulate in pigs in North America because they have H3N2
surface antigens. Tr H3N2 viruses first emerged in North American swine
herds in the late 1990s. The H3 and N2 genes which 1st emerged in swine flu
viruses originated from human seasonal H3N2 influenza viruses that
circulated globally among humans in the late 1990s.

Although the vast majority of instances of human infection with animal
influenza viruses do not result in human to human transmission, each case
should be fully investigated to be sure that such viruses are not spreading
among humans and to limit further exposure of humans to infected animals if
infected animals are identified. Surveillance for both seasonal and novel
influenza viruses is conducted by the CDC and its state and local health
partners year round.

For more information about swine influenza, see:
<http://www.cdc.gov/flu/swineflu/>.
Weekly US surveillance updates are published in FluView and posted at:
<http://www.cdc.gov/flu/weekly/fluactivitysurv.htm>.

--
communicated by:
ProMED-mail Rapporteur Mary Marshall

[There are 4 main influenza type A virus subtypes that have been isolated
in pigs: H1N1, H1N2, H3N2, and H3N1. Most flu viruses circulating in pigs
are referred to as "triple-reassortant" viruses because these flu viruses
contain genes from human, swine, and avian influenza viruses.

Swine triple-reassortant H3N2 influenza viruses commonly circulate in pigs
in North America, but rarely infect humans. The total number of human
infections with swine origin influenza viruses reported to the CDC since
2005 had been 16, and 3 of these reports had been swine origin A (H3N2)
viruses. The Pennsylvania and Wisconsin cases described above bring the
number of reports swine origin A (H3N2) infections in humans in the United
States to 5, and the total of swine origin A influenza A viruses to 18.

The dates of illness onset in the 2 patients are more than 6 weeks apart
and the viruses from the 2 patients have some genetic differences,
confirming that these 2 cases are not linked.

Swine flu viruses cause high levels of illness and low death rates in pigs.
Swine influenza viruses may circulate among swine throughout the year, but
most outbreaks occur during the late fall and winter months similar to
outbreaks in humans.

Transmission of swine (tr) influenza a viruses to humans has been rare,
even in individuals occupationally exposed to pigs. With the exception of
the swine-origin A (H1N1) 2009 pandemic virus human-to-human transmission
has occurred rarely, if at all.

The HealthMap/ProMED-mail interactive map of the United States, showing the
locations of the states of Pennsylvania and Wisconsin, can be accessed at
<http://healthmap.org/r/01bQ>. - Mod.CP]

[see also:
Influenza (13): WHO update 20101111.4092]

...................cp/ejp/sh

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www.twitter.com/hniman

We report the clinical features of the first 11 sporadic cases of infection of humans with triple-reassortant swine influenza A (H1) viruses reported to the Centers for Disease Control and Prevention, occurring from December 2005 through February 2009, until just before the current epidemic of swine-origin influenza A (H1N1) among humans.

The median age of the 11 patients was 10 years (range, 16 months to 48 years), and 4 had underlying health conditions. Nine of the patients had had exposure to pigs, five through direct contact and four through visits to a location where pigs were present but without contact. In another patient, human-to-human transmission was suspected. The range of the incubation period, from the last known exposure to the onset of symptoms, was 3 to 9 days. Among the 10 patients with known clinical symptoms, symptoms included fever (in 90%), cough (in 100%), headache (in 60%), and diarrhea (in 30%). Complete blood counts were available for four patients, revealing leukopenia in two, lymphopenia in one, and thrombocytopenia in another. Four patients were hospitalized, two of whom underwent invasive mechanical ventilation. Four patients received oseltamivir, and all 11 recovered from their illness.

http://www.nejm.org/doi/full/10.1056/NEJMoa0903812

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A reassortant influenza A(H1N1) virus of swine origin distinct from the pandemic H1N1 2009 strain was isolated from 3 patients, all of whom worked at the same large hog operation in Saskatchewan, Canada. The genomic composition of the isolates has not been previously reported, to our knowledge, and was the product of a genetic reassortment between seasonal H1N1 and triple-reassortant influenza virus that emerged in North American swine during the late 1990s. The neuraminidase and hemagglutinin genes of A/Saskatchewan/5350/2009, A/Saskatchewan/5351/2009, and A/Saskatchewan/5131/2009 were derived from human H1N1 virus and were closely related to those of A/Brisbane/59/2007.

http://www.ncbi.nlm.nih.gov/pubmed/20199242

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www.twitter.com/hniman

A Riley County child has been infected with a strain of swine influenza not commonly seen in humans, but has fully recovered following a mild illness. No other cases have been identified, but an investigation is underway.

The influenza strain that infected the child was identified as an H3N2 virus that commonly circulates in pigs in North America. It is different from the pandemic H1N1 virus, also of swine origin, that was first detected in the United States in mid-April.

“It is critical for people to understand that this H3N2 virus is not related to the pandemic H1N1 virus,” said Jason Eberhart-Phillips, Kansas State Health Officer and Director of Health at the Kansas Department of Health and Environment (KDHE). “This is not a mutation or a recombination of the pandemic strain, and it does not appear at this time to be a threat to human health.”

The child was likely exposed to the virus during the Riley County Fair in late July, where the child had direct contact with pigs. The child later developed influenza-like symptoms and sought medical care. The child has fully recovered and no other family members have reported illness.

KDHE is working closely with the Centers for Disease Control and Prevention (CDC), the U.S. Department of Agriculture (USDA), the Riley County Health Department and the Kansas Animal Health Department to investigate this case.

KDHE and the local health department are working to determine if the Riley County Fair swine exhibitors, or their pigs, have been ill.

Swine flu viruses do not normally infect humans, but human infections occur from time to time. Typically CDC has received reports of approximately one human infection with a swine influenza virus each year.

That number has risen slightly in the past few years. The increased number of reported cases this year is likely the result of increased influenza testing related to the H1N1 pandemic.

So far this year, 14 cases of human infections with swine influenza viruses have been reported in the United States. That number does not include the number of H1N1 cases, as the H1N1 virus has not been detected in swine in the U.S.

“Most instances of human infection with animal influenza viruses, like the swine H3N2 virus, do not result in human-to-human transmission,” Dr. Eberhart-Phillips said. “However, each case needs to be fully investigated to be sure that the viruses are not spreading among humans.”

http://www.wibw.com/home/headlines/52612017.html

also at

http://www.kdheks.gov/news/web_archives ... 62009a.htm

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The above media report descibes a CHILD who was exposed to swine in late July and H3N2 was isolated and presumably sequenced.

The characterization sheet for A/Kansas/13/2009 indicates the sample was collected July 27, 2009 and orginated from the Kansas Department of Health and Environment. However, the patients is said to be a 22M. The Note states "Human case of swine-orgin H3N2 triple reassortant" which is consistant with the sequences from the 8 gene segments.

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Early identification and investigation of novel influenza A cases is critical to evaluate possible human-to-human transmission. CDC conducts surveillance for human infections with novel influenza A viruses year-round and carries out extensive epidemiologic investigations on each case. During the 2009-10 season, in addition to the pandemic strain virus infections, three cases of human infection with novel influenza A viruses were identified and then characterized at CDC. These three cases, identified in Kansas, Iowa, and Minnesota, were isolated cases of human infections with contemporary North American swine-lineage influenza A (H3N2) viruses currently circulating in swine herds. No additional human cases were linked to these three patients. Although the Minnesota patient reported visiting a live animal market in the days preceding illness onset (May 8, 2010), only the Kansas patient specifically reported contact with pigs in the week preceding symptom onset (July 28, 2009). The Iowa patient had onset of symptoms in September 2009. The Kansas and Iowa patients did not require hospitalization; the Minnesota patient was hospitalized, and recovered fully.

http://jama.ama-assn.org/cgi/content/full/304/9/957

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