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Two more cases of a new strain of swine flu were confirmed Monday by Pennsylvania officials. Both are connected to an agricultural fair in southwestern Pennsylvania and bring the total number of cases reported to date to four.

On Friday, the Centers for Disease Control and Prevention reported two infections of the novel influenza A virus. One involved an Indiana boy and the other was a girl from Pennsylvania who had been to the Washington County Fair the week of Aug. 13-20, the same fair attended by those in the two newest cases.

All of those who have fallen ill were children. Those whose illnesses were reported Friday have fully recovered and those whose cases were reported Monday are also recovering, according to a press release from the Pennsylvania Department of Health.

The particular strain hasn't been seen before, Tom Skinner, CDC spokesman, told msnbc.com on Friday.

While the CDC typically sees a few cases a year of (an influenza A virus), usually as result of contact with swine, "what's new is that it has picked up a gene from the H1N1 pandemic strain," said Skinner.

The two children in the earliest reported cases had received flu vaccines in September 2010, which protected against H1N1, but wouldn't protect against the new strain.

In July, the boy was taken to a hospital emergency department with flulike symptoms of fever, cough and diarrhea, where a respiratory test confirmed influenza A (H3). The boy, who has multiple chronic health conditions, was briefly hospitalized. He had not been directly exposed to swine but a caretaker had been in direct contact with swine in the weeks before the boy became ill.


In August, the girl was also taken to a hospital emergency department with similar symptoms and discharged. A few days before she became sick with a fever, cough and lethargy, she reportedly visited an agricultural fair where she was exposed to swine.

The Pennsylvania departments of health and agriculture and the CDC are investigating the cases.

"There's no evidence of sustained transmission from human to human," Skinner said.

Anyone who attended the Washington County Fair and has flu-like symptoms should contact their local health care provider or call 1-877-PA-HEALTH.

http://www.msnbc.msn.com/id/44373159/ns ... d_and_flu/

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Best video on outbreak

http://www.wtae.com/video/29090974/detail.html

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Ag Dept. links ill children, area fair

Staff & Wire Reports

This article has been read 1986 times

State officials said Monday that three Pennsylvania children who attended Washington County Agricultural Fair earlier this month have contracted a new strain of influenza containing the H1N1 virus.
Authorities said all three children attended the fair the week of Aug. 13-20.

They said one child has recovered, while two confirmed ill over the weekend are recuperating.

However, a county fair official said Monday evening the fair was told last week by the state Department of Agriculture that it did not appear that the influenza cases had their origins at the local fairgrounds.

Jeff Lash, vice president of Washington County Agricultural Fair, said fair board President Dick Horstman was in contact with the agricultural department Aug. 30.
"As of (Aug. 30), they didn't feel any of this was actually related to the fair," Lash said. Hostman was not available for comment Monday.

Lash acknowledged that one person from an eastern Pennsylvania county had visited the fair and later came down with the virus.

"We only knew of one person who was visiting from another county" and later became ill, Lash said.

Department of Health press secretary Christine Cronkright told the Observer-Reporter later Monday the health department is working closely with the Centers for Disease Control to learn more about the influenza virus.

"We're still in the very beginning of the investigation with this," Cronkright said Monday night. "Right now, the (Washington County) fair is the common denominator among the three cases."

The health department stressed it was not telling people not to attend public venues or fairs.

While investigators have not yet uncovered how the illness was transmitted to the three people, Cronkright said no additional human infections with this virus have been identified.

"There's been no evidence of human transmission," she said.

She said the fact that the strain was identified so quickly gives investigators an advantage that earlier flu outbreaks have not always provided.

Cronkright also noted that the flu the children contracted "is sort of a rare strain of influenza."

The health department said the three cases identified are similar to previous, rare human infections with swine-origin H3N2 viruses but are unique in that they contain a genetic component of the H1N1 virus.

"While it's not unusual for an influenza virus to evolve, what's unusual is that it does include a genetic component of the H1N1 virus" that was linked to the 2009 flu pandemic, Cronkright said.

The health department is asking all who attended the Washington County fair and have flu-like symptoms to contact their medical provider or call 1-877-PA-HEALTH.

It said symptoms would be similar to that of seasonal influenza and would include fever, lethargy (extreme tiredness), lack of appetite and coughing. Other flu symptoms may include a runny nose, sore throat, eye irritation, nausea, vomiting and diarrhea.

The Department of Health and the CDC are conducting increased surveillance and tracking in Southwestern Pennsylvania, as well as setting up informational booths about influenza at agricultural fairs, while the Department of Agriculture is continuing with monitoring the health of animals at all exhibitions.

Cronkright said Monday she was not sure which fairs were receiving informational booths. The West Alexander Fair opened Monday and will be open through Saturday.

"We're not telling people to avoid public venues or fairs," said DOH Secretary Dr. Eli Avila. "But until we complete our investigation, we want to make sure that the public is aware and is taking the proper precautions to protect their health."

http://www.observer-reporter.com/or/sto ... sh-Co-Fair

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Hmmmmm......

Yes, the story is still missing quite a bit of detail, especially for the two more severe cases (who have been ill for more than 2 weeks if linked to the fair).

It is likely that there were MANY more than the three confirmed cases who were infected because many would have milder symptoms, and attendees would have many more contact with other people than swine.

These fairs present a greater liklihood of TESTING for trH3N2 because it is off season, and those in contact with swine have a greater suspicion of trH3N2, but the level of testing those without a connection is very low.

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Commentary

http://www.recombinomics.com/News/09061 ... r_CDC.html

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Swine flu has been spotted again in Pennsylvania. Last week two children were identified as having contracted the virus, and early this week state officials confirmed two more cases both in children. The two children from last week have recovered, and the other two are being treated. However, all four cases are connected to the Washington County Agricultural Fair held the week of Aug. 13-20. The virus is referred to as swine flu because it has been infecting pigs for the last several years, and the reappearance of the virus raises many questions due to the 2009 pandemic.


I was at the Washington County Fair -- should I be worried?



Anyone who was at the Washington County Fair that has developed flu-like symptoms is being asked to call (800) PA-HEALTH -- (800) 724-32584. While location of the confirmed cases might be a coincidence, so far it is the common thread in all four situations. However, no cases of human-to-human transfer of the virus have been confirmed.

What are the symptoms of swine flu?



The symptoms of swine flu are very similar to seasonal flu and include: fatigue, coughing, and fever. While other symptoms are possible, as a precaution anyone with flu like symptoms is being asked to call the contact number.

Is the fair at fault?



The Pennsylvania Department of Agriculture monitors the health of all the animals at fairs. Since no animals were reported ill, the fair believes it is not to blame for the infections. It is not yet determined that the sick children contracted the virus at the fair or at another location.

Why are these cases so special?


These cases stand out because this particular strain of the virus contains a gene from the original virus that caused the pandemic. The current flu shots do not contain vaccinations against this particular strain of virus, although it does contain two for common swine flu classifications: H1N1 and H3N2. The virus that has sickened the children can be spread from animal to human or from one human to another.


Is another pandemic on the way?



Thoughts of all residents are shifting to 2009 when 2,000 people in Western Pennsylvania fell ill to the virus and caused at least 18 deaths. So far rather than be concerned about a pandemic, residents should monitor the research of the path the illness has taken and be prepared to take appropriate action.

Jason Gallagher is a long-time Pennsylvania resident. He has experiences in trends and developments in many regions from having lived in many parts of the Keystone State, and currently resides in the Pittsburgh area.

http://news.yahoo.com/swine-flu-back-pe ... 00754.html

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Sep 6, 2011 (CIDRAP News) – Two more children in Pennsylvania were infected with a novel swine influenza A/H3N2 virus that includes a gene from the 2009 pandemic H1N1 virus, raising the number of such infections in the state to three, the Pennsylvania Department of Health (PDH) announced yesterday.

The two children, like the first case-patient reported Sep 2, attended the Washington County Agricultural Fair in southwestern Pennsylvania the week of Aug 13 to 20, PDH officials said in a press release. The first patient has recovered, and the other two patients are recovering, they said.

On Sep 2 the Centers for Disease Control and Prevention (CDC) announced that one child each in Indiana and Pennsylvania had been infected with a swine-origin H3N2 virus that included the matrix gene from the 2009 H1N1 virus. The viruses were described as similar but not identical. Both of the children recovered. The Indiana child might have caught the virus from a caregiver who had had contact with pigs, the CDC said.

Investigators from the PDH and CDC have not yet determined exactly how the three Pennsylvania patients became infected, according to the PDH. The earlier CDC announcement, however, said the first patient, a girl, was exposed to pigs and other animals at the fair.

None of the three patients had any direct link to the others, according to Brandi Hunter-Davenport, a PDH spokeswoman. "Their only commonality was attending the fair," she told CIDRAP News today.

She said the latest patients have had typical flu-like symptoms. Citing confidentiality concerns, she declined to give their ages.

Hunter-Davenport also said no information was available yet on whether pigs at the fair were infected with the novel virus. "We're still investigating what the linkages are here, if it's human-to-human or animal-to-human transmission," she said.

The PDH and CDC are increasing surveillance in southwestern Pennsylvania and setting up information booths at agriculture fairs, and the Pennsylvania Department of Agriculture is monitoring the health of animals at fairs, according to the PDH release.

The statement said anyone who attended the Washington County Fair and has flu-like symptoms should contact their local health provider or call the health department.

State officials also said people should take everyday precautions to prevent the spread of respiratory viruses and should wash their hands after having contact with animals at fairs and other public places.

"We're not telling people to avoid public venues or fairs," said PDH Secretary Dr. Eli Avila, in the press release. "But, until we complete our investigation, we want to make sure that the public is aware and is taking the proper precautions to protect their health."

In its Sep 2 announcement about the first two cases, the CDC said the viruses are similar to eight other swine-origin H3N2 viruses found in humans in the past 2 years, but different in that they contain a gene from the 2009 H1N1 virus. The agency said reports of human infections with swine-origin flu viruses have increased in recent years, at least partly because of increased testing and recent reporting recommendations.

See also:

Sep 5 PDH news release



Sep 2 CIDRAP News story "Novel H3N2 swine flu viruses infected 2 children, CDC says"
http://www.cidrap.umn.edu/cidrap/conten ... neflu.html

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NewsDepartment of Agriculture: No Sick Animals Reported
The state departments of Health and Agriculture said the investigation into a rare flu linked to the Washington County Agricultural Fair will continue.

By Amanda Gillooly
The departments of Health and Agriculture are investigating a rare flu strain linked to the Washington County Agricultural Fair. Aimee Obidzinski Photos (1)
The state Department of Agriculture on Tuesday said there have been no reports of sick animals in the wake of three children who were sickened by a rare flu virus linked to the Washington County Agricultural Fair.

“There has been no scientific link to swine at the fair (and these cases),” said Department of Agriculture Press Secretary Samantha
Elliot Krepps. “All we know for sure is that they were all at the
fair.”

The first individual to become ill, announced on Friday, has fully recovered from the illness. Two other individuals, confirmed ill over the weekend, are recovering. All three are children who reported attending the Washington County Agricultural Fair the week of Aug. 13-20.

Reached Tuesday, a spokesman for the Department of Health said no
additional information was being released regarding the three cases.

But a release issued by a spokesman suggested people refrain from hitting the panic button regarding the strain spreading.

"Currently, we don’t have any evidence to support that this novel influenza A virus will lead to a pandemic, as we haven’t yet been able to prove that it is being transmitted from human to human," the release indicated. "As with any new influenza A virus, public health officials are working to learn more about the source of this particular strain and to determine how/if it can be spread from person to person."

As for vaccinations?

"The 2011‐2012 vaccine is the same as last year, covering two strains of influenza A (pandemic H1N1 and a H3N2 strain that has been circulating for a few years now) as well as a strain of influenza B," the release stated. "It is too early to tell whether or not this new strain will even need vaccination."

The cases in Pennsylvania are similar to previous, rare human
infections with swine-origin H3N2 viruses, but are unique in that they
contain a genetic component of the H1N1 virus.

A continuing investigation, which is being jointly undertaken by the
departments of Health and Agriculture, as well as the Centers for
Disease Control and Prevention, has not yet uncovered how the illness
was transmitted to the three individuals.

However, no additional human infections with this virus have been
identified to date.

Anyone who attended the Washington County Fair and has flu-like
symptoms should contact their local health care provider or call
1-877-PA-HEALTH.

http://canon-mcmillan.patch.com/article ... s-reported

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Three independent events signals efficient transmission, as in H2H due to the H1N1 M gene.

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