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CDC reports two more novel flu cases
Lisa Schnirring Staff Writer


Dec 9, 2011 (CIDRAP News) – The US Centers for Disease Control and Prevention (CDC) today confirmed two more infections with novel flu viruses, in children in Minnesota and West Virginia, only one of which involves the novel H3N2 strain found this year in four other states.

Though both of the viruses have been detected in US pig populations, investigations so far haven't revealed any connections between the two kids or their close contacts to pigs, which could signal limited human-to-human transmission, the CDC said in a statement today. Both of the children have recovered, the agency said.

The infection in the West Virginia child involved a swine-origin H3N2 reassortant strain that includes the M gene from the 2009 H1N1 pandemic virus, raising the number of such cases detected in the United States so far to 11. At the end of November, Iowa reported that the virus infected three children who had contact with each other but no known swine exposure, making theirs the first known cases to involve likely human-to-human spread.

The CDC said the virus is distantly related to human H3N2 viruses that circulated in the 1990s, which suggests that adults may have some protection against it. These factors might explain why 10 of the 11 cases so far have been reported in children.

Toby Wagoner, spokesperson for the West Virginia Department of Health and Human Resources, told CIDRAP News that state health officials have increased their surveillance for flu-like illnesses and are reminding the public about the importance of basic flu prevention methods, such as covering coughs and sneezes, observing proper hand hygiene, and staying home when sick.

Minnesota's novel flu case involves an H1N2 virus that circulates in swine but doesn't usually infect humans, the CDC said, adding that it is only the second novel H1N2 case reported since 2007, when novel flu infections became nationally notifiable. The first case was identified in Michigan in 2007.

The agency said some of the virus's characteristics are similar to a seasonal human H1N1 virus (A/New Caledonia/20/99-like) that circulated as recently as 2007, and that people who were exposed to the latter may therefore have some protection against the novel Minnesota strain.

Since 2005, 33 human infections with swine-origin flu viruses have been reported in the United States, the CDC said. Among those cases, 12 were triple-reassortant H1N1, 19 were triple-reassortant H3N2, and two involved triple-reassortant H1N2. All of the patients, who included 25 children, recovered from their illnesses.

In 24 cases, people had direct or indirect exposure to pigs before they got sick. Investigations of other cases have suggested likely transmission from close contacts, but none have led to sustained human-to-human transmission, according to CDC background information on human infections with swine-origin flu viruses.

Though human infections with novel viruses typically found in swine are rare, the CDC said detections have become more frequent, for which there are three possible reasons: Improvements in lab testing for flu viruses since the 2009 H1N1 pandemic may be causing identification of viruses that wouldn't have been detected before, flu surveillance has increased as the nation enters its winter flu season, or the findings could signal a true increase in the number of cases from infected swine or limited human-to-human exposure.

The CDC continues to recommend the flu vaccine to prevent seasonal flu but said it isn't likely to protect against viruses that circulate in pigs. It said tests on the two novel viruses show that both are susceptible to the antiviral medications oseltamivir (Tamiflu) and zanamivir (Relenza). The agency reiterated that flu isn't transmissible through eating properly handled and prepared pork products.

It advised people who seek medical attention for flu symptoms after direct or close contact with pigs to mention the exposure to healthcare providers.

In other flu developments, the CDC said today that seasonal flu activity in the US remained at low levels last week. The percentage of respiratory samples that tested positive for flu dipped slightly to 1.7%, and the percentage of doctor's visits for flu-like illnesses was 1.2%, below the national baseline.

The number of deaths from flu and pneumonia increased slightly, but was still below the epidemic threshold. The CDC received reports of two pediatric flu deaths, but they occurred during the 2010-11 season, raising the total to 122. So far no pediatric flu deaths have been reported for the current season.

Lab analysis of 36 flu viruses showed that the H3N2 and 2009 H1N1 isolates closely matched the seasonal flu vaccine components. Of 10 influenza B strains that were characterized, 6 belonged to the Victoria lineage vaccine component, while 4 belonged to the Yamagata lineage. The CDC said it is too soon in the season to determine how well the seasonal flu vaccine and circulating strains match.

Only one state, Virginia, reported local flu activity. The number of states reporting sporadic flu activity rose to 30, an increase of 2 from the previous week.

See also:

Dec 9 CDC "Have you heard?" statement

Dec 9 CDC flu surveillance update

CDC background on human swine-origin flu virus infections

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

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Commentary

http://www.recombinomics.com/News/12091 ... N2_MM.html

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More nonsense. There was never any real data to indicate the first Indiana case was not due to human to human spread, which was acknowledged by the CDC in the MMWR.

Media trying to re-write history and correct their pigs to people nonsense used to keep the CDC narative alive, which was based PURELY on heavily biased sampling of samples from cases with "swine expoure".

There will be a FLOOD of new trH3 cases in the next several weeks.

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Canada - Fearmongering over swine flu
12 Dec 2011
Two new cases of human infection with a flu virus that has been sporadically jumping to people from pigs have been spotted in the United States, the Centers for Disease Control reported Friday.

The new cases, in Maine and Indiana, bring to seven the number seen in the U.S. since July. To date Canada has seen no infections with this virus, the National Microbiology Laboratory said.

While the infections have been mainly mild, the CDC is keeping a close eye on the situation. The head of the Atlanta-based agency's influenza division said a seed strain for a vaccine that would protect against this virus has already been developed and has been given to vaccine manufacturers.

"We're really trying to be in front of events in terms of preparedness," Dr. Nancy Cox said in an interview.

"We're being very vigilant because we realize that there's a portion of the population ... that really has very little cross-reactive antibodies to the swine reassortant virus."

The group Cox was referring to is children. Most of the infections -- two from Maine, three from Pennsylvania and two from Indiana -- have been in young children, though Cox noted one of the cases was a 59-year-old person..........

http://www.meattradenewsdaily.co.uk/new ... e_flu.aspx

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Published Date: 2011-12-10 18:43:43
Subject: PRO/EDR> Influenza (76): USA, two novel influenza A viruses
Archive Number: 20111210.3563

INFLUENZA (76): USA, TWO NOVEL INFLUENZA 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 9 Dec 2011Source: CDC Online Newsroom [edited]http://www.cdc.gov/media/haveyouheard/stories/novel_influenza.html


CDC confirms 2 human infections with novel influenza viruses
------------------------------------------------------------
The Centers for Disease Control and Prevention (CDC) have confirmed 2
cases of human infection with 2 different novel influenza A viruses in
different states. Both patients have fully recovered. While the
viruses infecting both patients have been found in US swine and some
of the prior human infections with these viruses have been associated
with direct or close swine contact, there are no reports of direct or
close contact with swine prior to illness onset in either of these
cases. Laboratory testing at CDC has confirmed that both novel viruses
are susceptible to the antiviral medications oseltamivir (Tamiflu) and
zanamivir (Relenza).

West Virginia
-------------
One case of human infection with a novel influenza virus was reported
by West Virginia and involves infection of a child with the novel
influenza A (H3N2) virus with genes from swine, human, and avian
lineages with the M gene from the 2009 H1N1 virus that was first
identified in August 2011. Ten prior human infections with this virus
in 4 other states have been confirmed. These occurred in Indiana (2),
Pennsylvania (3), Maine (2), and Iowa (3).

These novel influenza A (H3N2) viruses are substantially different
from currently circulating seasonal (human) influenza A (H3N2)
viruses, but are distantly related to human influenza viruses that
circulated among people in the 1990s. For that reason, some adults may
have some residual immunity against this virus. This might help
explain why 10 of the 11 cases that have been detected have occurred
in children.

Most human infections with viruses that circulate in swine (but not
humans) have been associated with swine exposure, but limited
human-to-human transmission associated with these viruses is thought
to have occurred as well, most recently in Iowa. While an
investigation is ongoing in West Virginia, no direct or indirect
contact with swine has been reported, implying that limited
human-to-human transmission of this virus may have occurred again.

No ongoing community transmission of this virus has been detected in
the United States. However, CDC is taking this situation very
seriously. Surveillance surrounding reported cases is being further
enhanced and, as a precaution, a vaccine virus has been developed and
provided to manufacturers for them to begin vaccine production should
that become necessary.

Minnesota
---------
The other case of novel influenza A virus infection was reported by
Minnesota, and is associated with a different influenza virus; an
influenza A (H1N2) virus that circulates in swine in the United
States, but does not normally infect or cause illness in humans. This
case also was in a child. This is only the second case of human
infection with this novel influenza A (H1N2) virus reported to CDC
since novel influenza virus infections became nationally notifiable in
2007. The first such case was identified in Michigan in 2007. By some
characteristics, this H1N2 virus is close to human influenza A (H1N1)
viruses called "A/New Caledonia /20/99-like", which circulated and
caused illness among people as recently as 2007. As a result, people
who were exposed to A/New Caledonia/20/99-like viruses may have some
existing immune protection against the virus detected in Minnesota.
Again, no direct or indirect contact with swine has been reported with
this case, implying that limited human-to-human transmission may have
occurred in this instance as well.

Detection of swine influenza infections in humans
-------------------------------------------------
Human infections with novel influenza A viruses normally found in
swine are rare events. Recently, however, the frequency of such
detections has increased. This could be occurring for a number of
reasons, including one or more of the following factors:
Firstly, laboratory methods for testing for these viruses in the
United States were improved following the 2009 H1N1 pandemic. These
improvements may be resulting in viruses being identified now that
would have gone undetected previously.
Secondly, this could be due to increased surveillance in the United
States for influenza at this time of year. CDC has requested that
states analyze, and then send, their first influenza virus specimens
of the season for seasonal influenza surveillance purposes. This
practice, coupled with very low levels of seasonal flu activity at
this time, could mean that sporadic novel influenza infections are
more likely to be tested.
Thirdly, it is possible that the increased frequency of detection of
novel influenza viruses with swine origins identified by CDC
represents a true increase in the number of such cases, possibly
occurring from exposure to infected swine or through subsequent,
limited human-to-human transmission.

The novel influenza A (H1N2) virus identified in Minnesota is known to
circulate in US swine herds. While the prevalence of the novel
influenza A H3N2 virus with the 2009 H1N1 M gene in swine is unknown,
the virus has been detected in US swine through the United States
Department of Agriculture’s swine influenza surveillance program.

In response to recent human infections with novel influenza viruses,
CDC would like to convey the following information:

* CDC recommends an annual seasonal flu vaccine to protect against
seasonal influenza viruses; however, a seasonal flu vaccine is
unlikely to protect against flu viruses that normally circulate in
swine.
* There are two FDA–cleared drugs that are expected to be effective
in treating illness associated with these viruses. The antiviral drugs
oseltamivir and zanamivir -– which are used to treat infection with
human seasonal influenza viruses –- also have shown activity against
influenza viruses from swine. (For more information about influenza
antiviral medications, please see
)
* Influenza has not been shown to be transmissible to people through
eating properly handled and prepared pork (pig meat) or other products
derived from pigs. For more information about the proper handling and
preparation of pork, visit the USDA website fact sheet "Fresh Pork
>From Farm to Table".

At this time, CDC recommends the following:
* People who experience flu symptoms following direct or close contact
with swine and who require medical attention (see below) should
mention this exposure to their doctor or health care provider. (A list
of flu symptoms is available at
.)
* For people who have NOT had exposure to swine and develop ILI
(influenza-like illness), CDC’s recommendations for seeking
treatment are the same as they are for seasonal influenza.
* If you have symptoms of flu and are very sick or worried about your
illness contact your health care provider.
* Certain people are at greater risk of serious flu-related
complications (including young children, elderly people pregnant women
and people with certain long-term medical conditions) and this is true
both for seasonal flu and novel flu virus infections. (For a full list
of people at higher risk of flu related complications, see
).
* If these people develop ILI, it’s best for them to contact their
doctor. (The majority of recent novel influenza A (H3N2) cases have
been in children.)
* Your doctor may prescribe antiviral drugs that can treat the flu.
These drugs work better for treatment the sooner they are started.

More information about swine influenza and links to all previous
reports related cases of novel influenza A (H3N2) viruses infections
are available on the CDC swine influenza website at
.

--
communicated by:
Larry Madoff, MD
Director, Division of Epidemiology and Immunization
Massachusetts Department of Public Health
William A. Hinton State Laboratory Institute
305 South Street
Jamaica Plain, MA 02130, USA


[As of 2 Oct 2011, surveillance data have indicated that influenza is
circulating at low levels in the United States; low activity typically
is noted in this early portion of the influenza season. Antigenic
characterization of the viral isolates that have been submitted
demonstrated that the majority of these isolates are antigenically
similar to the influenza virus strains in the Northern Hemisphere
2011-12 vaccine [see ProMED-mail post: Influenza (75): USA update
20111208.3553].

In the above report CDC reports 2 cases of human infection with 2
different novel influenza A viruses, one in the state of West Virgina
(a child), and one in the state of Minnesota (also a child). Neither
was seriouosly ill. The child in West Virginia was infected by the
novel influenza A(H3N2) virus that was first identified in August
2011. This virus posseses genes from swine, human, and avian lineages
and with the M gene from the 2009 H1N1 pandemic virus. The child in
Minnesota was infected by the influenza A (H1N2) virus that circulates
in swine in the United States. This virus rarely infects humans, the
first case occurring in Michigan in 2007.

Overall human infections with novel influenza A viruses normally
present in swine are rare events. Recently, however, the frequency of
such detections has increased. It is likely that this may be a
consequence both of the virtual absence of seasonal influenza and
enhanced surveillance of h humans and swine for atypical influenza
viruses. So far such atypical viruses have not been discovered in
Europe where surveillance is being similarly enhanced. It may be
significant in this respect that there is no trade in live swine
between the USA and Europe (see ProMED-mail post: Influenza (72):
Europe, swine-origin H3N2 reassortant, risk assessment 20111130.3494).
- Mod.CP]

See Also

Influenza (75): USA update 20111208.3553
Influenza (74): swine-origin H3N2 reassortant, vaccine candidate
20111203.3526
Influenza (73): WHO update 20111202.3519
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 (67): WHO update 20111118.3403
Influenza (66): USA swine-origin H3N2 reassortant, update
20111105.3298
Influenza (64): WHO update 20111104.3289
Influenza (63): USA (ME, NOT NH) corr. 20111106.3307
Influenza (63): USA (ME, NOT NH) swine-origin H3N2 reassortant
20111102.3260
Influenza (61): WHO update 20111021.3140
Influenza (60): USA (ME) swine-origin H3N2 reassortant 20111021.3134
Influenza (58): WHO update 20111007.3019]
.................................................lm/cp/sh

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ProMED continues to push the swine exposure nonsense.

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Commentary

http://www.recombinomics.com/News/12121 ... l_H2H.html

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Now the CDC has a new "urban legend", claiming H3N2pdm11 is not in "big cites".

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Commentary

http://www.recombinomics.com/News/12121 ... Urban.html

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Closely monitor the new Hong Kong pandemic influenza virus

Release time :2011 -12-14 20:19 Source: Xinhua Author: Zeng Fanjuan Web Editor: thanks
Xinhua Hong Kong, December 14 (Reporter Zeng Fanjuan) Hong Kong SAR Government The Secretary for Food and Health York Chow said yesterday that authorities have been discovered in the United States has closely monitored the new influenza A virus H3N2 (S-OtrH3N2) of developments, has written to the World Health Organization and the U.S. CDC to understand the situation, and make relevant preparations.

Council meeting to be held, a Member pointed out that recently the United States by the health department of a variant of the H1N1 influenza virus genes from the new H3N2 (S-OtrH3N2) influenza virus expressed concern that the new variant of influenza virus synthesis the general human influenza, H5N1 and H1N1 avian influenza virus genes can spread from person to person, and have the opportunity of large-scale outbreaks. The members consulted the Government paid attention to this situation, and what to prepare.

Dr Chow said in a written reply, according to the WHO and U.S. CDC data, the United States since July this year has recorded 11 infected with this recombinant virus cases, all patients had recovered, most mild. As the virus and human pandemic influenza (H3N2) virus is not the same, the current seasonal flu vaccine only in adults, the virus provided limited cross-protection of children is not the protective effect.

Dr Chow said so far, not found in Hong Kong was infected with the species in the United States emerged H3N2 (S-OtrH3N2) influenza virus.

Dr Chow said the Government has taken various measures to prevent and control influenza outbreaks, and has developed "flu pandemic contingency planning framework", set out the Hong Kong influenza pandemic of command structure, preparation and control measures. These include a number of the new influenza pandemic influenza as well as the prevention and control measures, such as strengthening surveillance, rapid diagnosis, to maintain medical services, basic protective measures such as promoting personal and environmental hygiene, and risk communication and so on.

http://www.bjd.com.cn/10jsxw/201112/14/ ... 99772.html

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