Jim wrote:
Has the CDC reported these 23 cases of ILI in contacts? If not, I wonder why and whether they have collected additional samples for sequencing. With more than one-third of contacts exhibiting ILI, I would say that this indicates much more efficient H2H transmission than the CDC has acknowledged so far. Even with the Iowa cluster they kept stating that H2H transmission was limited.
I talked to the West Virginia Dept of Health when they were waiting for CDC results on the contact. I am virtually certain that the one case (3F - A/West Virginia/07/2011) was there only sample and it was NOT in good shape. In fact they were apologizing for positing it, because even the influenza A designation was borderline.
However, the CDC asked them to send it and three short sequences have now been published - I strongly suspect here are issues trying to get it cloned, which is also true for the second case in Maine, and all three cases from Pennsylvania (only cloned sequences for the two cases from Indiana, the first case from Maine, and the three cases from Iowa have been released).
I am writing up a couple of commentaries on the sustained transmission, including the fact that the West Virginia cluster sequences have a different N2 (usually in swine trH3N2), which has acquired two sequential seasonal H3N2 polymorphisms.
The latest weekly report from West Virginia still lists two flu cases (both from the Mineral County cluster).
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