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PostPosted: Mon Sep 12, 2011 11:39 am 
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CHICAGO - Two U.S. children were infected with flu viruses that originated in pigs in the past two months, and an analysis of both viruses showed they had picked up genetic material from the 2009 pandemic influenza A H1N1 virus, government researchers said on Friday.

They issued a warning to health workers to watch out for suspect viruses because those that cross between species can be especially virulent.

In both children, one from Indiana and one from Pennsylvania, an analysis of the viruses showed they contained a gene of the 2009 pandemic flu virus, according to a report released by the U.S. Centers for Disease Control and Prevention.

Flu viruses that jump from one species to another are a concern because they can swap genes and form an entirely new virus, making them harder to protect against.

"Pandemic viruses get started when they reassort and they emerge as a new virus. That is why we have to keep close watch on new influenza viruses as they emerge," CDC spokesman Tom Skinner said.

"They are constantly changing, and that is why we have to have really good surveillance systems in place to detect them when they do emerge," he said. So far, this new virus does not appear to be able to easily pass from human to human, but Skinner said the CDC is still investigating.

Since 2005, there have been about 22 cases of human infection from swine-origin influenza viruses similar to the cases now being reported, Skinner said. All 22 people have recovered.

In one of the two new cases, a young boy from Indiana who had gotten a flu vaccine last September developed fever, cough, shortness of breath, diarrhea and a sore throat in late July. He was taken to the emergency department and a swab of his throat indicated that he had been infected by an influenza A virus.

The boy was sent home untreated but returned to the hospital the next day to be admitted and treated for multiple chronic health conditions, which had gotten worse because of his infection.

The boy recovered and was sent home, but further testing by state officials suggested his virus had originated in pigs, and his sample was sent to the CDC for confirmation.

According to the CDC report, the child had no prior direct contact with pigs, but a child-care worker who looked after the boy did report having contact with pigs before the child's symptoms appeared.

In the second case, a Pennsylvania girl under age 5 who had received a flu shot the prior year developed a suspected infection with swine-origin influenza A (H3N2) in August.

Later testing by state officials and the CDC confirmed that she, too, had developed a form of flu that originated in pigs, likely from direct contact at an agricultural fair.

The girl was not treated and has completely recovered.

So far, the CDC has not seen any additional cases of people developing a pig form of influenza, but Skinner said the CDC is publishing the report to remind doctors and health workers to be watchful for suspicious cases of flu.

The H1N1 pandemic flu strain was discovered in Mexico and the United States in March 2009 and spread rapidly across the world. The World Health Organization estimates about 18,450 people died from the virus up to August 2010, including many pregnant women and young people.

Seasonal flu vaccines being offered across the world protect against the H1N1 strain. Flu vaccines are made by several drugmakers including Glaxosmithkline, Sanofi and Novartis.



Read more: http://www.canada.com/health/children+d ... z1XkjibSNg

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PostPosted: Tue Sep 13, 2011 12:00 pm 
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http://www.recombinomics.com/News/09131 ... sting.html

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PostPosted: Tue Sep 13, 2011 10:38 pm 
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INFLUENZA (54): (PENNSYLVANIA), SWINE-ORIGIN H3N2 REASSORTANT, COMMENT
**********************************************************************
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: Mon 12 Sep 2011
From: James Wilson <jim.wilson@praecipiointernational.org> [edited]


A comment in response to: "Influenza (52): (PA), swine-origin H3N2
reassortant, 3 cases 20110906.2723"
---------------------------------------
What would be far more helpful to ProMED readers who are clinically
practicing are specific recommendations for when to report such cases
and how to distinguish them clinically (or epidemiologically) from
other cases of influenza. This appears to be especially problematic
when this virus does not appear to produce clinical findings much
different from seasonal influenza.

Given swine H3N2 has been circulating for years now, it would probably
be helpful to understand in this instance how these cases came to the
attention of the PA Dept. of Agriculture. Was there an influenza
surveillance system already in place where virus samples were being
collected passively and sequenced? If so, this does not bode well for
clinically-based recognition of "unusual" morbidity versus mortality,
given the number of areas in the country without such capabilities.
Thus, these warnings of swine H3N2/pandemic H1N1 recombinants have
limited practical value for the reporting base that public health
depends on: the clinicians.

As a nation (and indeed, the world), this places us in a "fall-back"
position of waiting for an abrupt, unusual influx of morbidity into
the healthcare infrastructure, with the attendant occasional high
morbidity/mortality seen in the ICU setting. In such acute
presentations, as we have seen with the pandemics of 1889, 1918, 1957,
1968, other seasons of "bad influenza (vaccine drift)," and the recent
pandemic of 2009, human recognition of such signature patterns is NOT
based on laboratory surveillance. Indeed, such bias prevented rapid
recognition of the 2009 pandemic influenza signature patterns in
Mexico in early 2009 and the surprised, reactive response observed.
Minimization of surprise is essential for a well-considered response.

What I am attempting to highlight here is the operational difference
between laboratory surveillance that highlights a potential threat of
public health significance and event-based surveillance that
highlights the "so what"/verification of significance. Finding a way
to bridge different surveillance approaches that feed into a proactive
warning system remains an essential need for our country and, indeed,
the world.

--
James M. Wilson V, MD
Executive Director
Praecipio International
Washington-Houston-Port au Prince
<jim.wilson@praecipiointernational.org>

[ProMED-mail welcomes the opportunity to communicate James Wilson's
observations and questions to a wider readership. This moderator does
not have information to contribute at this stage. Interested readers
should communicate directly with Dr. Wilson, and any outcomes may be
posted. - Mod.CP]

[see also:
Influenza (52): (PA), swine-origin H3N2 reassortant, 3 cases
20110906.2723
Influenza (51): swine-origin H3N2 reassortant, children 20110902.2685
Influenza (47): ECDC report, virus characterization 20110816.2477]
.................................................cp/msp/mpp

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PostPosted: Wed Sep 14, 2011 6:04 am 
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http://www.recombinomics.com/News/09141 ... 2_MMM.html

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PostPosted: Wed Sep 14, 2011 9:51 am 
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http://www.recombinomics.com/News/09141 ... usion.html

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PostPosted: Wed Sep 14, 2011 11:17 am 
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Reported Human Infections with Swine-Origin Influenza Viruses (SOIV) in the United States since 2005
As of September 9, 2011, 25 cases of human infection with swine origin influenza viruses have been reported in the United States. These are viruses that normally infect pigs. Like human influenza viruses, there are different subtypes and strains of swine-origin influenza viruses. The main swine influenza viruses circulating in U.S. pigs in recent years are swine triple reassortant (tr) H1N1 influenza virus, trH3N2 virus and trH1N2 virus. Of the 25 human cases reported since 2005, 12 have been trH1N1 viruses, 12 have been trH3N2 viruses and one has been a trH1N2 virus. All 25 persons infected with swine viruses recovered from their illness. Eighteen cases occurred in children (persons 18 or younger) and 7 cases occurred in adults. In 21 cases, direct or indirect exposure to swine prior to onset of illness has been identified. Likely transmission of swine-origin influenza virus from close contact with an infected person has been observed in investigations of human infections with swine-origin influenza A virus, but has not resulted in sustained human-to-human transmission.

Related Links & Past Reports
Have You Heard, September 6, 2011: Number of Swine Origin H3 Infections in Pennsylvania Rises to ThreeSwine-Origin Influenza A (H3N2) Virus Infection in Two Children — Indiana and Pennsylvania, July — August 2011. MMWR 2011; 60 (Early Release); 1-4.Update: Influenza Activity — United States, October 3, 2010-February 5, 2011. MMWR 2011; 60(06):175-181Update: Influenza Activity — United States, October 3, 2010-December 11, 2010. MMWR 2010; 59(50):1651-1655December 17, 2010 “Have You Heard”November 12, 2010 “Have You Heard”Information about 11 cases occurring between 2005 and 2009 can be found in the New England Journal of Medicine article entitled “Triple-Reassortant Swine Influenza A (H1) in Humans in the United States, 2005–2009” [262 KB, 10 pages]

http://www.cdc.gov/flu/swineflu/soiv_cases.htm

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PostPosted: Wed Sep 14, 2011 11:48 am 
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niman wrote:
Reported Human Infections with Swine-Origin Influenza Viruses (SOIV) in the United States since 2005
Likely transmission of swine-origin influenza virus from close contact with an infected person has been observed in investigations of human infections with swine-origin influenza A virus, but has not resulted in sustained human-to-human transmission.

http://www.cdc.gov/flu/swineflu/soiv_cases.htm

Although the above is an improvement on the earlier claim of no lab confirmation of human transmission of trH3N2, the claim of no sustained transmission is NOT supported by the sequence data, and is solely based on negative data which is HIGHLY suspect because the CDC has yet to identify of source for any of the four recent cases and can't identify a swine contact for 3 of the 4 (and the trH3N2 sequences from those three cases are virtually IDENTICAL).

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PostPosted: Wed Sep 14, 2011 1:17 pm 
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http://www.recombinomics.com/News/09141 ... enial.html

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PostPosted: Wed Sep 14, 2011 4:36 pm 
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http://www.recombinomics.com/News/09141 ... ncern.html

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PostPosted: Wed Sep 14, 2011 5:31 pm 
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Although the CDC acknowledges 12 trH3N2 cases, only 10 have been reported on the MMWR notifiable dieases page.

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