Rhiza Labs FluTracker Forum

You clearly don't understand the sequences or the swine "exposure" issue. Maine has now confirmed that both cases are linked to the same fair and the 2 week gap between the disease onset dates for the two cases indicates at least one is NOT linked to the swine at the fair. Flu has a 2 day incubation period, not 2 weeks. The Fryeburg fair can be used to get a date for the first case, but not the second, and the ProMED denial of infected swine in New Hampshire also signals the Fryeburg fair (which is adjacent to the New hampshire border) as the source of the swine under investigation (which tested NEGATIVE for SOIV in initial tests).

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Recombinomics has discussed the Maine cases with the Maine CDC and Maine Department of Agriculture who have confirmed that both cases were linked to the same fair, which is almost certainly the Fryeburg Fair based on dates, comments from ProMED, and a preponderance of evidence. The Fryeburg fair ended Oct 9, while disease onset for the second Maine case was October 22, too late for the swine "exposure" at the fair.

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More on Fryeburg fair (near New Hampshire) and coughing video

viewtopic.php?f=5&t=7712

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Maine CDC confirmed that both trH3N2 cases attended the same fair and the second case participated in a pig scramble. This case had further swine contact after the fair, but the subsequent swine contacts were asymptomatic.

Thus far all testing on symptomatic swine have been negative.

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Detail on Indiana case (59M - Veterinarian)

• An adult male developed fever, cough, shortness of breath, nausea, vomiting and body aches on October 20, 2011. The patient was hospitalized, but has been discharged and is recovered from his illness.
• The patient did not receive influenza antiviral medications.
• On October 22, 2011, a respiratory specimen was collected during hospital admission and after conflicting results were obtained at the hospital laboratory, the specimen was forwarded to the Indiana state public health laboratory.
• On October 28, 2011, testing at the Indiana public health laboratory indicated a likely swine-origin influenza A (H3) virus.
• The specimen was forwarded to CDC on October 29, 2011. On October 31, partial genome sequencing confirmed the virus as a swine-origin triple reassortant influenza A (H3N2) virus with the M gene from pH1N1.
• The patient reported exposure to pigs in the week prior to illness onset.
• No additional ill persons have been identified, but investigation is ongoing.
• There are no epidemiologic links between this case and the previous case identified in Indiana.

https://linksweb.oph.dhh.louisiana.gov/ ... 202011.doc

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Week 45 MMWR on notifiable diseases running late

http://wonder.cdc.gov/mmwr/mmwr_reps.as ... wr_table=1

http://wonder.cdc.gov/mmwr/mmwr_reps.as ... wr_table=1

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Veterinarian (59M from Indiana) still not in MMWR

Novel influenza A infection virus *** - 8 0 4 43,774 2 4 NN

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Commentary

http://www.recombinomics.com/News/11171 ... sting.html

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Your comments are fed by the CDC "narrative" on "swine exposure". However, the CDC has yet to link a single 2011 trH3N2 case to swine positive for SOIV (which would then require the SOIV to be H3N2 and the H3N2 would have to be the novel constellation found in all 7 human cases). The "swine exposure" leads to trH3N2 TESTING, but it has NOTHING to do with trH3N2 TRANSMISSION.
The latest example from Maine is a case in point. He was tested with the new PCR kit, and gave a pattern for seasonal H3N2 (H3 positive and negative for both swine markers, H1 and NP), but was sent to the CDC because of swine "exposure" which included attendance at the Fryeburg fair, participation in pig scramble at fair, exposure to swine after the fair.

• On October 28, 2011, diagnostic testing at the state laboratory was weakly positive for influenza A (H3), but negative for swine-origin influenza targets. The specimen was forwarded to CDC.
• On October 30, 2011, partial genome sequencing confirmed the virus as a swine-origin triple reassortant influenza A (H3N2) virus with the M gene from pH1N1.
• The patient reported multiple instances of close contact with pigs where sick pigs were present.
• No other ill persons have been identified at this time and no human-to-human transmission of this virus is suspected.

However, the exposure at the fair was too early (on or befor October 9 with initial symptoms on October 22), and the post-fair exposures were to ASYMPTOMATIC pigs (which are NOT tested). Moreover, the symptomatic pigs at the fair were NEGATIVE for SOIV. Thus, there is NO credible data supporting the swine as the source of the trH3N2, which was virtaully identical for the two Maine cases, which were from cases who developed symptoms 2 weeks apart.
A "swine exposure exposed" commentary will be posted soon.

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November 4 "Have You Heard?"
http://www.cdc.gov/media/haveyouheard/s ... irus2.html

Detailed CDC 2011 reports on trH3N2 cases for health professionals
http://www.dhh.state.la.us/offices/page ... etail=9732
Including November 4 report on the two most recent trH3N2 cases
https://linksweb.oph.dhh.louisiana.gov/ ... 202011.doc

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