Seroprevalence Study: Avian Flu In Chinese Pigs

 

Since pigs can be infected by more than one flu virus at the same time, the potential exists for two viruses to swap genetic material (reassort), resulting in a new hybrid strain.

 

# 6796

 

Although we tend to think of H5N1 whenever someone mentions `avian flu’, in truth there are many different avian influenza viruses.  If you go back far enough, all influenza A strains – even those thought of today as primarily adapted to humans, equines, or swine – appear to have an avian origin.

 

Influenza A viruses have 8 gene segments (PB2, PB1, PA, HA, NP, NA, M1, M2, NS1, NS2) and are broadly categorized by their HA (hemagglutinin) and NA (neuraminidase) genes.

 

With the recent discovery of H17N10 (see A New Flu Comes Up To Bat), scientists have now identified 17 different serotypes of Hemagglutinin (HA) and 10 serotypes of Neuraminidase (NA), which make many different combinations of HA and NA proteins possible.

Thus far, only about 100 of these combinations have been isolated in nature.

 

But the flu universe is far more diverse than that might lead to you believe, as influenza’s 8 gene segments are largely interchangeable parts. If you were to take two different influenza A viruses (say H3N2 and H5N1) and reshuffle them using reverse genetics, you can come up with 254 possible reassortments.

 

And within each of these HA/NA combinations you can have multiple clades (genetically distinct families), and within each clade, many minor variants – all of which makes for tremendous variety in these viruses.

 

Many of the the H1, H2, and H3 viruses have adapted to human physiology, but we occasionally see infection by other `novel’ strains. Most worrisome, due to its high fatality rate, is H5N1.  But we occasionally see (usually mild) infections by other avian strains.

 

MMWR: Mild H7N3 Infections In Two Poultry Workers - Jalisco, Mexico)

EID Journal: Human Infection With H10N7 Avian Influenza

PLoS One: Seroprevalence Of H9N2 In Poultry Workers – Pune, India

 

Last year scores of dead seals were discovered along the shoreline of New England, predominantly from the North Shore of Massachusetts to the southern coast of Maine.  Investigations showed (see mBio: A Mammalian Adapted H3N8 In Seals) their deaths to be due to a variant of the H3N8 avian flu strain, versions of which are known to also infect horses and dogs.

 

With the propensity of these avian strains to evolve and adapt, scientists are understandably very interested in any avian flu virus that appears to be moving towards `humanization’.

 

While it is possible for a flu virus to jump directly from birds to humans, often it requires an intermediate host to aid in its development. The graphic below illustrates that swine – which are generally susceptible to human and avian flu viruses - are considered excellent mixing vessels’ for influenza viruses.

 

 

The H1N1 `swine flu’ virus of 2009 kicked around in pigs for up to a decade before it adapted well enough to human physiology to spark a human pandemic. Over the past few years we’ve watched attempts by three other swine `variant’ viruses (H1N1v, H1N2v, H3N2v) to jump to mankind. 

 

Which makes the active surveillance of swine a potentially important tool for the early detection of emerging influenza viruses.

 

Unfortunately, while there are some surveillance systems in place, only a tiny fraction of the world’s swine population is actively monitored  (see Helen Branswell’s SciAm Article from late 2010 called Flu Factories).

 

All of which serves as prelude to a new study, recently published in the Journal of Clinical Microbiology, that found low levels of H3, H4, and H6 subtypes of avian influenza in Chinese pigs. Somewhat reassuringly, evidence of infection with the H5N1 virus was not found.

 

These H3, H4, and H6 avian viruses were not seen in a similar study done in 2001, suggesting their arrival into the swine population may be a recent development.

 

 

Seroepidemiological Evidence of Avian Influenza A Virus Transmission to Pigs in Southern China

Shuo Su, Wenbao Qi, Jidang Chen, Wanjun Zhu, Zhen Huang, Jiexiong Xie, and Guihong Zhang

J. Clin. Microbiol. published ahead of print 21 November 2012 doi:10.1128/JCM.02625-12

ABSTRACT

Recently, three novel avian-origin swine influenza viruses (SIVs) were first isolated from pigs in Guangdong Province, southern China, yet little is known about the seroprevalence of avian influenza among pigs in southern China. Here, we report for the first time the seroprevalence of avian H3, H4, and H6 influenza viruses in swine populations and the lack of seroepidemiological evidence of avian H5 influenza transmission to pigs in China.

 

A copy of the study can be downloaded here.

 

The American Society for Microbiology has published a press release with more information, excerpts of which you’ll find below:

 

 

 

Pigs in southern China infected with avian flu

WASHINGTON, DC – December 19, 2012 -- Researchers report for the first time the seroprevalence of three strains of avian influenza viruses in pigs in southern China, but not the H5N1 avian influenza virus.  Their research, published online ahead of print in the Journal of Clinical Microbiology, has implications for efforts to protect the public health from pandemics.

 

Influenza A virus is responsible both for pandemics that have killed millions worldwide, and for the much less severe annual outbreaks of influenza. Because pigs can be infected with both human and avian influenza viruses, they are thought to serve as “mixing vessels” for genetic reassortment that could lead to pandemics, and pigs have been infected experimentally by all avian H1-H13 subtypes. But natural transmission of avian influenza to pigs has been documented only rarely.

 

In the study, from 2010-2012, Guihong Zhang and colleagues of the College of Veterinary Medicine, South China Agricultural University, Guangzhou, People’s Republic of China, tested 1080 21-25 week old pigs for H3, H4, H5, and H6 subtypes of avian influenza virus, and H1 and H3 subtypes of swine influenza virus. Thirty-five percent of the serum samples were positive for H1N1, and 19.7 percent were positive for H3N2 swine flu virus, and 0.93 percent, 1.6 percent, and 1.8 percent were positive, respectively, for the H3, H4, and H6 subtypes of avian influenza A virus. However, no serum samples collected in 2001 were positive for any of these viruses, indicating that transmission into swine was recent.

 

Given the recent transmission of avian influenzas into swine, “We recommend strongly that the pork industry worldwide should monitor the prevalence of influenza in pigs, considering their important role in transmitting this virus to humans,” says Zhang.

 

Previously, novel reassortant H2N3 influenza viruses were isolated from US pigs, which “were infectious and highly transmissible in swine and ferrets without prior adaptation,” according to a 2009 paper in the Journal of Molecular and Genetic Medicine by Wenjun Ma et al. Those viruses resembled, but were not identical to the H2N2 human pandemic virus of 1957.

 

 

The ability of influenza viruses to evolve, mutate, or reassort in swine hosts has been a frequent topic of discussion in this blog.  For more on this, you may wish to revisit:

 

H3N2v: When Pigs Flu

You Say You Want An Evolution?

The (Swine) Influenza Reassortment Puzzle

»» Read More

Asymptomatic Pigs: Revisited

Credit Wikipedia

 

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A couple of months ago in EID Journal: Flu In Healthy-Looking Pigs we looked at a report indicating that it isn’t always possible to identify pigs carrying an influenza virus based simply on their appearance.

 

A dispatch from the EID Journal reported that nearly 1 in 5 healthy-looking pigs they tested at the Minnesota State Fair during the 2009 H1N1 influenza pandemic were actually infected with a flu virus.

 

This came out during the midst of several swine variant flu outbreaks this summer, involving several hundred people across 10 states. Viruses apparently contracted from pigs on display at local fairs (see MMWR: H3N2v Related Hospitalizations In Ohio – Summer 2012).

 

While fair officials were turning away pigs with overt signs of infection, this report suggested that perhaps those measures might not be sufficient.

 

Today, a pair of studies from Ohio State University -  one that finds a surprisingly large percentage of flu infected swine to be asymptomatic - and another that establishes just how closely linked the human and swine variant strains of influenza this summer really were.

 

In both cases, the lead author is Andrew Bowman, a  Ph.D. candidate in veterinary preventive medicine at Ohio State.

 

First, from the EID Journal, research that found more than 80% of the pigs that tested positive for influenza at the Ohio State fair between 2009 and 2011 showed no signs of illness.

 

Subclinical Influenza Virus A Infections in Pigs Exhibited at Agricultural Fairs, Ohio, USA, 2009–2011

Andrew S. Bowman , Jacqueline M. Nolting, Sarah W. Nelson, and Richard D. Slemons

Author affiliations: The Ohio State University, Columbus, Ohio, USA

Abstract

Agricultural fairs are associated with bidirectional, interspecies transmission of influenza virus A between humans and pigs. We examined pigs exhibited at agricultural fairs in Ohio during 2009–2011 for signs of influenza-like illness and collected nasal swab specimens from a representative subset of these animals.

 

Influenza virus A was recovered from pigs at 12/53 (22.6%) fairs during the 3-year sampling period. Pigs at 10/12 (83.3%) fairs from which influenza virus A was recovered did not show signs of influenza-like illness. Hemagglutinin, neuraminidase, and matrix gene combinations of the isolates were consistent with influenza virus A concurrently circulating among swine herds in the United States.

 

Subclinical influenza virus A infections in pigs at agricultural fairs may pose a risk to human health and create challenges for passive surveillance programs for influenza virus A in swine herds.

(Continue . . . )

 

 

 

Ohio State University has published a lengthy press release that discusses both papers.

 

Studies: Pigs Look Healthy But Test Positive for Flu at Fairs; Flu Transmission Seen Between Pigs and Humans

COLUMBUS, Ohio – More than 80 percent of pigs that tested positive for influenza A virus at Ohio county fairs between 2009 and 2011 showed no signs of illness, according to a new study.

 

Ohio State University researchers tested 20 pigs each at 53 fair events over those three summers and found at least one flu-positive pig at 12 fairs – almost a quarter of fairs tested.

 

The influenza strains identified in pigs in this study include H1N2 and H3N2 viruses – strains that have been circulating in pigs since 1998. In 2011, all of the H3N2 and H1N2 isolates found in pigs at the fairs contained a gene from the 2009 pandemic strain of H1N1, which is similar to the H3N2v strain causing human illness this year.

 

Though this finding alone is no cause for panic, it does show how quickly influenza viruses can change, said Andrew Bowman, lead author of the study and a Ph.D. candidate in veterinary preventive medicine at Ohio State.

 

In a second study led by Bowman, researchers compared the genomic sequences of influenza A viruses recovered in July 2012 from pigs and people. The analysis, showing a greater than 99 percent genetic similarity among the viruses, confirms that pigs and humans were infected with the same virus, indicating interspecies transmission.

(Continue . . .)

 

This second study appears in the journal Emerging Microbes & Infections.

 

Although the timing of the illnesses (and initial sub-typing) in humans and swine at the Ohio State Fair last July strongly suggested interspecies transmission, a >99% genomic match pretty much erases all doubt.

 

Molecular evidence for interspecies transmission of H3N2pM/H3N2v influenza A viruses at an Ohio agricultural fair, July 2012

Andrew S Bowman¹, Srinand Sreevatsan², Mary L Killian³, Shannon L Page⁴, Sarah W Nelson¹, Jacqueline M Nolting¹, Carol Cardona² and Richard D Slemons¹

 

Evidence accumulating in 2011–2012 indicates that there is significant intra- and inter-species transmission of influenza A viruses at agricultural fairs, which has renewed interest in this unique human/swine interface.

 

Six human cases of influenza A (H3N2) variant (H3N2v) virus infections were epidemiologically linked to swine exposure at fairs in the United States in 2011. In 2012, the number of H3N2v cases in the Midwest had exceeded 300 from early July to September, 2012.

 

Prospective influenza A virus surveillance among pigs at Ohio fairs resulted in the detection of H3N2pM (H3N2 influenza A viruses containing the matrix (M) gene from the influenza A (H1N1) pdm09 virus). These H3N2pM viruses were temporally and spatially linked to several human H3N2v cases.

 

Complete genomic analyses of these H3N2pM isolates demonstrated >99% nucleotide similarity to the H3N2v isolates recovered from human cases. Actions to mitigate the bidirectional interspecies transmission of influenza A virus between people and animals at agricultural fairs may be warranted.

(Continue . . .)

 

 

While the vast majority of the swine-to-human flu transmissions this year have involved the H3N2v virus, as you can see from the following table, small number of H1N1v and H1N2v infections have been reported as well. 

 

 

Given the limits of surveillance, testing, and reporting – we really don’t know what the normal `background rate’ of these types of novel flu infections are in humans.

 

The smattering of reports since 2005 indicate they may be fairly rare, but are certainly not unheard of.

 

The majority of human swine variant flu infections this summer were relatively mild (out of 300+ infections, 16 were hospitalized, and 1 died), but it is always of concern anytime a novel influenza virus jumps from another species to humans.

 

Each time a novel flu jumps from a pig to a human it gives the virus another opportunity to adapt to human physiology. The CDC’s most recent assessment on the H3N2v virus reads:

 

It's possible that sporadic infections and even localized outbreaks among people with this virus will continue to occur.

While there is no evidence at this time that sustained human-to-human transmission is occurring, all influenza viruses have the capacity to change and it's possible that this virus may become widespread.

 

So far, the severity of illnesses associated with this virus in people has been similar to the severity of illnesses associated with seasonal flu virus infections. Limited serologic studies indicate that adults may have some pre-existing immunity to this virus while children do not.

 

CDC is closely monitoring human infections with all novel influenza viruses, including H3N2v viruses, and will provide more information as it becomes available.

 

 

With further evidence of asymptomatic influenza infection in pigs, fair officials and public health agencies will need to decide on the best policies to limit future exchanges (in either direction) of flu viruses between people and pigs.

»» Read More

The Return Of H1N1v

 

(click to enlarge)

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Yesterday’s FluView report, in addition to updating the number of new H3N2v cases, announced the detection of a single H1N1v flu infection in a person living in Missouri. That patient has fully recovered.

 

H1N1v is one of the `viral contenders’ I mentioned two weeks ago in An Increasingly Complex Flu Field, and until just over a year ago, was the most commonly reported variant swine flu virus detected in humans since 2005.

 

 

This week’s announced case brings to 14 the total number of H1N1v cases reported since 2005.  The last reported case of H1N1v infection came from Wisconsin in December of 2011.

 

Of particular interest, this week’s detection is the second time that the H1N1v virus has been found to contain the M (matrix) gene from the 2009 H1N1 pandemic virus. 

 

Here is how this week’s FluView describes it:

 

Confirmatory testing at CDC identified H1N1v with the matrix (M) gene from the 2009 H1N1 influenza virus in specimens collected from this patient. Cases of H1N1v have been detected previously, and the current case marks the second report of H1N1v with the M gene from the 2009 H1N1 virus.

 

This M gene  has been showing up regularly in swine variant viruses (H1N1v, H1N2v, H3N2v) for more than a year. The CDC has previously stated that `This M gene may confer increased transmissibility to and among humans, compared to other variant influenza viruses.’

 

The $64 question is, what to make of all of this? 

 

Since the outbreak of H3N2v began in earnest in mid July, the CDC and local health departments have stepped up testing for novel or variant flu viruses.

 

And as one might expect, the harder you look, the more you are likely to find.

 

Given the limits of surveillance, testing, and reporting – we really don’t know what the normal `background rate’ of these types of infections are in humans. The smattering of reports since 2005 indicate they are fairly rare, but certainly not unheard of.

 

For now, the H3N2v virus – due to roughly 300 human infections across the Midwest - has captured the bulk of our attention.

 

But these other cases serve to remind us that nature continues to churn out and test new viral variations, and that the next public health threat could come out of left field.

 

The CDC’s assessment on the H3N2v virus reads:

 

It's possible that sporadic infections and even localized outbreaks among people with this virus will continue to occur. While there is no evidence at this time that sustained human-to-human transmission is occurring, all influenza viruses have the capacity to change and it's possible that this virus may become widespread.

So far, the severity of illnesses associated with this virus in people has been similar to the severity of illnesses associated with seasonal flu virus infections. Limited serologic studies indicate that adults may have some pre-existing immunity to this virus while children do not.

CDC is closely monitoring human infections with all novel influenza viruses, including H3N2v viruses, and will provide more information as it becomes available.

 

 

For more on all of this, Robert Roos of CIDRAP NEWS, has an excellent report from last night.

 

Latest variant flu cases include rare H1N1 strain

Robert Roos News Editor

»» Read More

PNAS: Virulence & Transmissibility Of H1N2 Influenza Virus In Ferrets

 

 

 

# 6547

 

Timing is, as they say, everything.

 

And coming on the heels the announcement 10 days ago of three human infections with a swine-origin H1N2 influenza (see Minnesota Reports Swine H1N2v Flu), a study that appears today in PNAS is certainly well timed.

 

The study, conducted at Chungbuk National University South Korea examined viruses circulating in Korean swine (H1N2 & H3N2), and found - for the most part - they were not particularly pathogenic in ferrets.

 

The exception was a triple reassortant H1N2 virus dubbed Sw/1204, that had picked up two notable mutations, and it not only transmitted efficiently, it also caused severe (even fatal) disease in the test animals.

 

The study, is called:

 

Virulence and transmissibility of H1N2 influenza virus in ferrets imply the continuing threat of triple-reassortant swine viruses

Philippe Noriel Q. Pascua, Min-Suk Song, Jun Han Lee, Yun Hee Baek, Hyeok-il Kwon, Su-Jin Park, Eun Hye Choi, Gyo-Jin Lim, Ok-Jun Lee, Si-Wook Kim, Chul-Joong Kim, Moon Hee Sung, Myung Hee Kim, Sun-Woo Yoon, Elena A. Govorkova, Richard J. Webby, Robert G. Webster, and Young-Ki Choi

 

Ed Yong, writing for Nature has the details  on this paper:

 

Need for flu surveillance reiterated

Study of Korean pigs finds virus with pandemic potential.

Ed Yong 10 September 2012

 

 

One to the two mutations discussed in this paper is hemagglutinin (HA) (Asp-225-Gly) – also known as D225G – which is something we’ve looked at a number of times in the past.

 

This mutation involves a single amino acid change in the HA gene at position 225 (H3 numbering) from aspartic acid (D) or Asp to glycine (G), and was first linked to more severe pandemic flu by Norwegian Scientists in 2009.

 

The evidence for the D222G/N  amino acid substitution driving increased virulence, and deep lung infection, has been mixed, however. A few earlier blogs include:

 

Eurosurveillance: Debating The D222G/N Mutation In H1N1

Study: Receptor Binding Changes With H1N1 D222G Mutation

WER Review: D222G Mutation In H1N1

 

The second mutation, called NA-315 (serine to asparagine the in neuraminidase) isn’t as well studied, but is believed to assist the virus in breaking out of infected cells after replicating.

 

As Ed Yong mentions in his article - viruses often have multiple amino acid changes – and we are really just beginning to understand the ramifications of these different genetic combinations. 

 

Whether this particular virus ever ends up posing a public health threat is impossible to say, but it does illustrate these swine reassortant viruses aren’t always mild in mammals.

 

New strains of influenza come about from reassortment; the swapping of genetic material between two different flu strains in a common host. We tend to focus on swine, simply because they are highly susceptible to a variety of influenza viruses, and have a history of producing reassorted viruses.  

 

 

The pandemic virus that emerged in the spring of 2009 was the end product of several influenza strains that had kicked around the world’s swine population for many years, trading bits of genetic material back and forth, until they produced a version capable of jumping to humans.

 

But any host (human, swine, avian, or other mammal) could produce a reassorted virus.

 

For more on the flu risks from swine reassortments, I continue to heartily recommend Helen Branswell’s terrific piece in SciAm  from late 2010 called Flu Factories.

Flu Factories

The next pandemic virus may be circulating on U.S. pig farms, but health officials are struggling to see past the front gate

By Helen Branswell  | December 27, 2010 |

 

And for some of my earlier looks at swine influenza, you may wish to revisit:

 

H3N2v: When Pigs Flu

You Say You Want An Evolution?

The (Swine) Influenza Reassortment Puzzle

»» Read More

CDC Updates Minnesota H1N2v Cases

Credit Wikipedia

 

# 6542

 

A week ago we learned of three human infections with the H1N2v virus in Minnesota, which - while of swine origin – is a different strain than the one behind the cluster of nearly 300 H3N2v infections we’ve been watching over the summer (see Minnesota Reports Swine H1N2v Flu).

 

H1N2 is one of three swine influenza viruses that are commonly found in pigs, the others are H1N1 and H3N2. Until last week, since 2005, only 2 cases of human infection with trH1N2 (now called H1N2v) had been detected in humans.

 

The three cases reported last week are similar to the 2 previous cases, with the exception that the H1N2v virus – like H3N2v – has picked up the M gene segment from the 2009 H1N1 pandemic virus.

The CDC has previously stated that `This M gene may confer increased transmissibility to and among humans, compared to other variant influenza viruses.’

 

All of which serves as prelude to today’s update from the CDC on the H1N2v virus:

 

H1N2 Variant Virus Detected in Minnesota

September 7, 2012 -- The Minnesota Department of Health has reported detection of 3 infections with an influenza A H1N2 variant (“H1N2v”) virus with the pandemic M gene from the 2009 H1N1 virus. These cases were reportedly associated with prolonged contact with pigs at a fair. H1N2 viruses normally circulate in pigs, not people, but rare human infections with this virus have been detected in the past. This virus is different from the H3N2v virus that, as of today, is reported to have caused 296 human infections across 10 U.S. states since July 2012. These additional human infections underscore the fact that swine influenza viruses can spread to people after close contact with infected pigs, and support the importance of ongoing surveillance for both human and swine influenza viruses.

 

According to the state of Minnesota, each of the 3 people infected with the H1N2v virus had exhibited pig(s) or spent prolonged time with pig(s) at the Minnesota State Fair. Two of the three people had underlying health conditions that placed them at high risk of serious flu complications; one of the two people with high risk factors was hospitalized, highlighting again the importance of the CDC recommendation that people with high risk factors avoid close contact with pigs and pig arenas at fairs this season. All 3 people have recovered from their illnesses.

People who are at high risk of serious flu complications include children younger than 5 years, people 65 years and older, pregnant women, and people with certain long-term health conditions (like asthma and other lung disease, diabetes, heart disease, weakened immune systems, and neurological or neurodevelopmental conditions). A full list of high risk factors is available on the CDC seasonal flu site.

 

In addition to avoiding pigs and pig arenas at fairs this year, as always, people with high risk conditions who develop flu-like symptoms should seek prompt medical attention. The H1N2v virus should be susceptible to both currently recommended influenza antiviral drugs [oseltamivir (Tamiflu®) and zanamivir (Relenza®)].

 

CDC has confirmed the Minnesota samples as H1N2v viruses. Sequencing of the viruses indicates these H1N2 variant viruses are very similar to those found in humans previously; with the exception of the addition of the pandemic M gene. This is the first time this virus has included the M gene from the 2009 H1N1 pandemic virus when isolated from a person. Genetic analysis shows that the hemagglutinin (H) of this virus is similar to human seasonal influenza viruses that circulated in people as recently as 2009, so there would likely be protective immunity against this particular virus in the human population.

 

The University of Minnesota Veterinary Diagnostic Lab also isolated an H1N2 virus from swine sampled at the Minnesota State Fair. Sequencing at National Veterinary Services Laboratories in Ames, Iowa, confirmed that it matches the human isolates from Minnesota. According to the USDA Swine Influenza Surveillance program, very similar H1N2 viruses – also containing the pandemic M gene – have been found in pigs since early 2010 in Minnesota and a number of other U.S. states.

 

 

If you missed it, earlier this week in An Increasingly Complex Flu Field, we looked at some of the new `players’ on the viral field, including the H1N2v virus.

 

And for an excellent overview of the risks of new flu viruses emerging from swine operations, I can heartily recommend Helen Branswell’s  Scientific American article from December of 2010 called:

 

Flu Factories

The next pandemic virus may be circulating on U.S. pig farms, but health officials are struggling to see past the front gate

By Helen Branswell  | December 27, 2011 

»» Read More

Minnesota Reports Swine H1N2v Flu

 

 

# 6530

 

File this under - `Once you start looking, no telling what you’ll find’.

 

Enhanced surveillance for H3N2v flu cases associated with contact with pigs by Minnesota’s Department of Health has turned up 1 confirmed, and 2 probable human cases of H1N2v influenza.

 

The H1N2 virus is one of three flu strains that commonly circulate in swine (H1N1, H3N2, & H1N2).

 

H1N2 is assumed to be a reassortment between the H1N1 and H3N2 virus. It has on rare occasions been detected in humans. 

 

Credit CDC

 

Minnesota reported a human infection with A/H1N2 in December of 2011, and it was said to be similar to an H1N1 virus (A/New Caledonia /20/99-like) that circulated as recently as 2007. 

 

Michigan reported an H1N2 human infection in 2007. 

 

As has been pointed out in this blog before, we honestly don’t know how often these novel swine (or avian)origin flu viruses jump to humans. Given the limits of testing and surveillance, it is probably more common than the numbers suggest.

 

Heightened surveillance around the country for the H3N2v virus may very well tell us a good deal about other variant viruses that we know can occasionally show up in the human population.

 

 

Here is the Press release from the MDH.

 

 

News Release
August 31, 2012
 

Three human cases of influenza linked to swine exposure at State Fair

Strain is different from the one that prompted current surveillance and prevention efforts

Three people are believed to have developed a strain of influenza known as variant H1N2 (H1N2v) after exhibiting pigs or spending time in the swine barn at the Minnesota State Fair.

 

One of the three cases has been confirmed by CDC. Test results for the other two are pending.

 

The H1N2v strain is different from the H3N2v strain that has prompted stepped up surveillance and prevention efforts nationwide, after causing 289 reported cases of illness and one death since the beginning of the year.

 

Officials at the Minnesota Department of Health (MDH) say they are not currently aware of any additional human influenza cases caused by H1N2v, and they do not anticipate changing their current public health recommendations regarding human exposure to swine.

 

They emphasized, however, that they will continue to assess the situation and conduct aggressive surveillance for additional influenza cases.

 

Current recommendations include asking individuals at high risk for severe influenza to avoid swine contact at exhibitions, fairs, live markets and other venues, including the swine barn at the State Fair. High risk individuals include children under five years of age, pregnant women, people 65 years of age or older and those with chronic medical conditions.

 

"For the past two weeks, we have been looking very hard for cases of influenza in people who have been exposed to swine," said Richard Danila, Deputy State Epidemiologist. "We have also worked closely with our veterinary colleagues to remain informed about potential infections in swine at the Fair. It is because of this careful surveillance that these cases have come to our attention.

 

"Right now, we don’t have any basis for changing our recommendations to the public," Danila said.

 

The illness has been confirmed in a teenage girl who was exhibiting pigs at the fair and became ill on Aug. 26. The other two cases occurred in an elementary-school-aged boy who became ill on Aug. 27 after spending all day in the swine barn on Aug. 24, and a woman in her late seventies who became ill on Aug. 26 after spending a prolonged period of time in the swine barn and at the swine show in the Exhibit Hall on Aug 24.

 

Both the boy and the older woman had underlying health conditions, and were treated with antiviral drugs. The woman was hospitalized, but has now been released. All three patients have recovered or are recovering.

 

The teenager was tested for influenza after she reported illness to nursing staff at the Fair. The other cases were reported to MDH by health care providers. Health care providers have been asked to report cases of influenza-like illness in people who report that they have had contact with swine. Swine exhibitors have been asked to report it if they experience symptoms of influenza.

 

Fair officials have also been monitoring swine for possible symptoms of illness, so they can be tested. Two pigs at the swine exhibit were found to be infected with the same H1N2 virus earlier this week, and were both isolated from contact with other pigs. Infection with H1N2 is not considered unusual in pigs.

-MDH-

 

 

For more on the H1N2 virus, you may wish to revisit:

Hong Kong Swine Influenza Surveillance

CDC: Variant Influenza Strains

CDC Confirms 2 More Novel Flu Infections

If You’ve Seen One Triple Reassortant Swine Flu Virus . . .

»» Read More

CDC: Updated H3N2v Surveillance & Testing Guidance

 

Photo Credit CDC

 

# 6508

 

Nearly all of the recent cases of H3N2v infection in the Midwest have thus far been associated with exposure to pigs at state and county fairs. Admittedly, testing for the virus has been concentrated mostly among those with known recent swine contacts, and that may entail some bias.

 

It’s a logical place to start looking, given the swine-origin of the virus. But it’s a surveillance strategy that has the potential to miss other cases in the community.

 

Yesterday, in an attempt to cast a wider surveillance net, the CDC updated their guidance recommendations to state and local health departments on testing for the H3N2v virus.  

 

 

Interim Guidance for Enhanced Influenza Surveillance: Additional Specimen Collection for Detection of Influenza A (H3N2) Variant Virus Infections

Posted August 20, 2012

Summary

This document is an update to interim enhanced surveillance guidance first posted in December 2011. In light of the increasing numbers of cases of H3N2 variant virus (H3N2v) and increasing numbers of states reporting H3N2v cases, states should consider expanding surveillance to include rRT-PCR testing of specimens from ILINet providers statewide, and of specimens collected from people with unusual or severe presentations of ILI. States should also consider collection of specimens from outbreaks of ILI among children in child-care and school settings, since these settings have been associated with person-to-person H3N2v virus transmission in 2011. CDC will continue to evaluate new information as it becomes available and will update this guidance as needed.

<SNIP>

CDC would like state and local health departments to consider the following recommendations for influenza surveillance and testing.

1. All state public health laboratories should use the CDC Human Influenza Real-Time rRT-PCR FLU Diagnostic Panel to screen specimens for InfA, InfB, and RP.
2. Test all InfA-positive specimens with the CDC Influenza A Subtyping kit using all primer/probe sets: H1, H3, pdmInfA and pdmH1. Detailed guidance for testing can be found in the influenza surveillance diagnostic testing algorithm disseminated recently by Association of Public Health Laboratories  [27 KB, 1 page]. Specimens that are presumptive positive for H3N2v virus should be sent to CDC Influenza Division for additional testing as soon as possible.
3. Conduct contact tracing of confirmed and probable influenza A (H3N2)v cases to gather more information about the epidemiology of the virus and modes of transmission. Contact tracing is essential to evaluate potential person-to-person transmission.
4. Currently, while seasonal influenza viruses are circulating at low levels, CDC recommends increasing collection of specimens from patients with influenza-like-illness (ILI), and having these specimens sent to the state or local laboratory for rRT-PCR testing. States should specifically consider increasing collection of specimens across the state from patients presenting with ILI in the following high priority areas:
1. All ILINet providers statewide.
2. ILI outbreaks statewide, particularly among children in child care and school settings, since these settings were associated with person-to-person influenza A (H3N2)v virus transmission in 2011.
3. Unusual or severe presentations of ILI statewide, including hospitalized persons.
4. Medically attended ILI and acute respiratory infection (ARI), especially in children in counties or states where confirmed H3N2v cases have occurred.

 

With schools across the Midwest beginning their fall session this month, and scores of county and state fairs scheduled over the next couple of months, the need to pin down how this virus behaves – and whether any human-to-human transmission is occurring – increases.

 

Meanwhile, the debate over whether pigs should be excluded from public venues continues, as illustrated by this story that appeared last night on CIDRAP News, written by Lisa Schnirring.  

 

 

H3N2v infections spark debate about barring pigs from fairs

Lisa Schnirring Staff Writer

Aug 21, 2012 (CIDRAP News) – The type of flu transmission occurring mainly in young people directly exposed to pigs at fairs this summer is unprecedented, and health officials should consider keeping pigs away from the events, according to one infectious disease expert who has gone on record with his concerns.

 

As Minnesota announced its first confirmed and suspected variant H3N2 (H3N2v) infections yesterday, just a few days before the start of its state fair, local and national media outlets such as the Canadian Press aired concerns from Michael Osterholm, PhD, MPH, director of the University of Minnesota's Center for Infectious Disease Research and Policy (CIDRAP), publisher of CIDRAP News, who said that fair organizers should bar swine from fairs this year.

(Continue . . . )

»» Read More

Osterholm: Time To Close The Pig Barns

Credit Wikipedia

 

 

# 6504

 

While the CDC has yet to find evidence of sustained and efficient human-to-human transmission of the emerging H3N2v flu virus, more than 200 human cases reported over the past couple of weeks have made it pretty apparent that this virus jumps readily from pigs to humans.

 

The CDC – citing the lack of H2H transmission and the relative mildness of infections – has advised county fairs and animal exhibits to screen pigs for signs of illness and urge better hygiene among visitors, but has stopped short of recommending the closing of pig barns to the public.

 

Complicating matters, last week we saw a study that showed pigs often carry flu viruses asymptomatically (see EID Journal: Flu In Healthy-Looking Pigs), which makes the advice to identify and isolate sick pigs problematic.

 

This morning, Helen Branswell has a long interview with well known flu expert and CIDRAP  director Michael Osterholm, who believes the time has come to close the pig exhibits at county fairs.

 

Osterholm stresses that we don’t yet know where this virus is going, or how much of a public threat it poses, but that the level of transmission at these venues is sufficient to warrant stronger measures.

 

A link to Helen’s article, then I’ll return with a postscript.

 

August 21, 2012 | 7:00 am

Time to close the pig barns, flu expert says

By Helen Branswell The Canadian Press

TORONTO – It’s been found in pigs and-or people in more than 10 U.S. states and counting. In less than a month, more than 200 people — most young children — have been infected by an unwanted visitor to many of the state and county fairs that are held at this time of year.

 

A new swine flu virus is infecting a growing number of people in the United States. But the official response to this outbreak is substantially different from the one that greeted the swine H1N1 virus that emerged in 2009.

(Continue . . .)

 

 

As I’ve pointed out before, every time this virus jumps from a pig to a human it gets another chance to better adapt to human physiology. Given enough chances, it could evolve into a greater public health threat.

 

So far, we’ve been lucky enough not to have seen a child’s death, or serious illness from this virus.

 

But when we do, you can be sure some aspects of the media a will have a field day excoriating the county fair, local officials, and health department that `let it happen’.

 

Admittedly, the suggestion to close the pig exhibits to the public will not be popular in the farm belt, or among pork producers (who have gone to great lengths to distance themselves from any connection to `swine flu’).

 

But whether the industry likes to admit it or not, pigs are highly susceptible to the influenza virus - and can even serve as `mixing vessels’ - allowing viruses to reassort into new hybrid strains.

 

 

 

The pandemic virus that emerged in the spring of 2009 was the end product of several influenza strains that had kicked around the world’s swine population for many years, trading bits of genetic material back and forth, until they produced a version capable of jumping to humans.

 

The H3N2v virus is likewise a reassortant virus; swine H3N2 combined with the M (matrix) gene from the 2009 H1N1 virus. While the odds of seeing a pandemic emerge from this H3N2v virus appear low right now, they are not zero. 

 

Whatever negative publicity the pork industry might suffer from temporarily shuttering pig exhibits would pale in comparison to the backlash they would see should another swine-origin flu virus take off in a big way in the human population.

 

Nevertheless, the proposal to shutter pig barns is bound to be a sensitive one. It is going to be interesting to see how public health departments, fair officials, and the pork lobby react to Dr. Osterholm’s suggestion in the coming days. 

 

For more on the flu risks from swine reassortments, I’d heartily recommend Helen Branswell’s terrific piece in SciAm  from late 2010 called Flu Factories.

Flu Factories

The next pandemic virus may be circulating on U.S. pig farms, but health officials are struggling to see past the front gate

By Helen Branswell  | December 27, 2010 |

 

 

And for some of my earlier looks at swine influenza, you may wish to revisit:

 

H3N2v: When Pigs Flu

You Say You Want An Evolution?

The (Swine) Influenza Reassortment Puzzle

»» Read More

Minnesota Reports First H3N2v Case

 

 

# 6503

 

Today Minnesota announced that they have joined the short list of states reporting H3N2v flu infections that have predominately been associated with exposure to pigs at county fairs. 

 

This brings to 10 the number or states reporting cases since July 12th, 2012.

 

Thus far, nearly all of the cases reported have had had direct contract with pigs or their environment, and the CDC has not found sustained and efficient transmission among humans.

 

The concern, of course, is that over time this virus might evolve to a more human-adapted virus. So public health officials track these outbreaks with considerable interest.

 

 

Today’s announcement from the Minnesota Health Department follows:

 

News Release
August 20, 2012
Minnesota Department of Health - Minnesota Department of Agriculture - Minnesota Board of Animal Health

First cases of new influenza strain reported in Minnesota

Minnesota has recorded its first confirmed case and a second probable case of a new influenza strain that people acquire through contact with pigs.

 

The two cases were reported in a pre-school-age child and an older sibling from a family living in the Twin Cities metro area. Both children developed symptoms of the illness two days after the family visited a live animal market in Dakota County on Aug. 10. Neither child required hospitalization, and both are recovering.

 

Both children were tested for the virus that causes the new flu strain, but only the younger child tested positive. However, the older child is considered a “probable” case, based on the child’s history of flu-like illness and the family connection to the younger child.

 

Officials at the Minnesota Department of Health (MDH) believe both children were most likely exposed to the new flu strain from pigs while they were at the animal market.

 

People usually get the new strain of flu – known as variant H3N2 (H3N2v) - from pigs rather than other people. A few cases have been reported where an individual got the illness from another person, but there was no further spread of the illness to additional people.

 

In addition to the Minnesota case, over 200 cases of the illness have been reported in eight states since the beginning of the year. Most have occurred in children who were exhibiting pigs at state or county fairs, or people who visited swine exhibits at fairs.

(Continue . . . )

 

 

 

In a related story, the CDC updated their webpage on preventing the transmission of the H3N2v virus late this afternoon as well.

 

 

Take Action to Prevent the Spread of Flu Between People and Pigs at Fairs

Pigs have their own influenza viruses (called swine influenza) that are usually different from human flu viruses. While rare, influenza can spread from pigs to people and from people to pigs. When people get swine flu viruses, it’s usually after contact with pigs. This has happened in different settings, including fairs. Right now, the Centers for Disease Control and Prevention (CDC) is concerned about a new flu virus that has been found in U.S. pigs and that has infected people too. This virus – called H3N2v – may spread more easily to humans from pigs than is usual for swine flu viruses.

There are ways to reduce the spread of influenza viruses between pigs and people.

CDC Recommendations For People At High Risk:

• If you are at high risk of serious flu complications and are going to a fair where pigs will be present, avoid pigs and swine barns at the fair this year. This includes children younger than 5 years, people 65 years and older, pregnant women, and people with certain long-term health conditions (like asthma, diabetes, heart disease, weakened immune systems, and neurological or neurodevelopmental conditions).

CDC Recommendations for People Not at High Risk:

• Don’t take food or drink or eat, drink or put anything in your mouth in pig areas.
• Don’t take toys, pacifiers, cups, baby bottles, strollers, or similar items into pig areas.
• Wash your hands often with soap and running water before and after exposure to pigs. If soap and water are not available, use an alcohol-based hand rub.
• Avoid close contact with pigs that look or act ill.
• Take protective measures if you must come in contact with pigs that are known or suspected to be sick. This includes wearing protective clothing, gloves, masks that cover your mouth and nose, and other personal protective equipment.
• Watch your pig (if you have one) for signs of illness and call a veterinarian if you suspect it might be sick.
• Avoid contact with pigs if you have flu-like symptoms. Wait 7 days after your illness started or until you have been without fever for 24 hours without the use of fever-reducing medications, whichever is longer. If you must have contact with pigs while you are sick, take the protective actions listed above.

A seasonal flu vaccine will not protect against H3N2v, but influenza antiviral drugs that can treat H3N2v as well as seasonal flu illness in people. These are prescription drugs. Early treatment is better, so see your health care provider as soon as you get sick if you have been exposed to pigs and get flu-like symptoms. Tell your doctor about your exposure and whether you have a high risk factor.

»» Read More

Ohio: CDC Confirms Additional Cases Of H3N2v

 

Cases in Butler County (14) & Clark County (1)

# 6477

 

This afternoon the Ohio Health Department announced that five more people, who were exposed to pigs, have tested positive for the swine H3N2v virus. 

 

Fourteen cases have now been identified in Butler County, and one in Clark County.  Their ages range from 3 to 36. None of these cases have required hospitalization.

 

Of note, the single case from Clark county is associated with the Ohio State Fair – which closed on Sunday - while all of the others are associated with the Butler County Fair.  

 

Last Friday we learned that 2 hogs from the Ohio State fair had tested positive for swine influenza, and had been sent home (see 2 pigs at state fair have swine flu – Columbus Dispatch). So far, the Clark county case is the only infection to be traced to that fair.

 

Here is the press release from the Ohio Department of Health (ODH)

 

ADDITIONAL H3N2v CASES IN OHIO CONFIRMED BY CDC

Ohioans Encouraged to Take Precautions, Prevent Spread of Influenza

COLUMBUS — The Ohio Department of Health (ODH) today announced that additional cases of Influenza A variant H3N2 have been confirmed by the Centers for Disease Control and Prevention (CDC). There are currently 14 humans cases identified in Butler County, linked to swine exposure at the Butler County Fair; and one confirmed human case in Clark County, linked to swine exposure at the Ohio State Fair. Those with confirmed cases of H3N2v are between the ages of 3 and 36 years old, and to date, none of the confirmed cases have resulted in hospitalization. 

On Monday, ODH hosted a statewide conference call with all local health departments to provide an update on the situation.  Local health departments have been urged to work with agriculture and fair officials to post necessary signage and to speak directly with those working in livestock facilities to ensure necessary care is taken to avoid further transmission of the H3N2v strain.

 
ODH continues to partner with local health departments and health care providers across the state on any reports of human influenza-like illness. Individuals who have reported close contact with swine and are exhibiting flu-like systems will undergo testing. Samples will be sent to the ODH laboratory for preliminary testing and then to CDC for confirmation. ODH will provide notice of any additional H3N2v human case confirmations.

 

The Ohio Department of Agriculture (ODA) is actively working with industry partners to assist with public education efforts and to increase the number of hand sanitation stations available at county fairs.  ODA will make contact this week with each upcoming fair veterinarian instructing them to post signage for both the exhibitors and for the visiting public, to closely monitor swine health and to take temperatures of any ill swine and notify ODA immediately of the results.  ODA will continue to swab and test animals as needed throughout the fair season.

 

With county fairs running into the first week of October in Ohio, ODA and ODH remind residents and visitors that fair attendance is safe. Those attending the fair should remember:

• Wash your hands frequently with soap and running water before and after exposure to animals.
• Never eat, drink or put things in your mouth in animal areas, and don’t take food or drink into animal areas.
• Young children, pregnant women, people 65 and older and people with weakened immune systems should be extra careful around animals.
• If you have animals – including swine – watch them for signs of illness and call a veterinarian if you suspect they might be sick.
• Avoid close contact with animals that look or act ill, when possible.
• Avoid contact with swine if you are experiencing flu-like symptoms.

More information is available from ODH at: http://bit.ly/OhioH3N2vUpdates.

 

 

It is likely, as these epidemiological investigations continue, that we will hear of additional infections with this emerging variant virus.

 

So far, the CDC has not found evidence of sustained and efficient human-to-human transmission of this swine variant virus, and all of the recent cases have involved direct contact with pigs.

 

You’ll find additional information on the CDC’s  H3N2v Webpage:

 

Information on Influenza A (H3N2) Variant Viruses (“H3N2v”)

 

 

Ohio’s State Health Department has also put up a webpage on this variant flu, with advice on how to stay healthy while visiting county fairs this fall.

 

Health Tips for Ohio's Fair Season

 

For more background on swine variant viruses, you may be interested in reading these recent blogs:

 

A Variant Flu Review

Novel Viruses & Chekhov’s Gun

»» Read More

CDC Teleconference & HAN Advisory On H3N2v

Credit Wikipedia

# 6472

 

 

Today has been a busy day at the CDC as they addressed the recent spike in swine H3N2v flu infections across the heartland.  There have been 16 human cases identified over the past 3 weeks, and of those, 12 are from this week.

Earlier today we saw an update (see The CDC On Recent H3N2v Cases) giving the current case counts, and background information.  At 12pm EDT today, the CDC held a teleconference for the media.

 

Dr Joe Bresee of the CDC’s influenza division and Dr. Lisa Ferguson from the National Animal Health Policy Program office at the USDA answered reporter’s questions for roughly 40 minutes.

 

While providing no major revelations beyond what had already been reported the past couple of days, today’s conference does provide clarity on some of details of these novel outbreaks, and a good feel for how the CDC is approaching the situation.

 

Fair warning, the audio link has 20 minutes of canned music before the conference begins.

 

Press Briefing Transcript

CDC Telebriefing: Influenza A (H3N2) Variant Virus

Friday, August 3, 2012, Noon ET

• Audio recording (MP3, 12.3MB)

 

 

The CDC also published a HAN (Health Alert Network) advisory today on the H3N2v. These HAN releases are designed to ensure that communities, agencies, health care professionals, and the general public are able to receive timely information on important public health issues.

There are 4 types of HAN releases.

 

Health Alert

Conveys the highest level of importance; warrants immediate action or attention.

Health Advisory

Provides important information for a specific incident or situation; may not require immediate action.

Health Update

Provides updated information regarding an incident or situation; unlikely to require immediate action.

Info Service
Provides general information that is not necessarily considered to be of an emergent nature.

 

Today’s HAN Message is an ADVISORY.

 

This is an official

CDC HEALTH ADVISORY

Distributed via the HAN Info Service
August 3, 2012, 11:00 EST
CDCHAN-00325-ADV-N

Increase in Influenza A H3N2v Virus Infections in Three U.S. States

Summary and Background

Multiple infections with variant* influenza A (H3N2v) viruses have been identified in 3 states in recent weeks. From July 12 through August 3, 2012, 16 cases of H3N2v were reported and confirmed by CDC. This virus was first detected in humans in July 2011. It has also been isolated in U.S. swine in many U.S. states. Since July 12, 2011, there have been 29 cases of H3N2v virus infection, including the 16 cases occurring in the last three weeks.  All 29 cases were infected with H3N2v viruses that contain the matrix (M) gene from the influenza A (H1N1)pdm09 virus. This M gene may confer increased transmissibility to and among humans, compared to other variant influenza viruses. All cases have been laboratory-confirmed at CDC. Each of the 16 cases identified since July 12, 2012, reported contact with swine prior to illness onset; in 15 cases, contact occurred while attending or exhibiting swine at an agricultural fair. While the viruses identified in these cases are genetically nearly identical, separate swine exposure events in each state were associated with human infections. There is no indication that the cases in different states are epidemiologically related.

 

Clinical characteristics of the 16 H3N2v recent cases have been generally consistent with signs and symptoms of seasonal influenza, and have included fever, cough, pharyngitis, myalgia, and headache. No hospitalizations or deaths have occurred among the 16 confirmed cases since July 2012. Public health and agriculture officials are investigating the extent of disease among humans and swine, and additional cases are likely to be identified as the investigation continues.

 

Novel influenza A virus infection has been a nationally notifiable condition in the United States since 2007. Since that time, human infection with animal-origin influenza viruses has been rare, with ≤6 cases reported each year, until 2011 when 14 cases were identified. While most of the cases are thought to have been infected as a result of close contact with swine, limited human-to-human transmission of this virus was identified in some cases in 2011. Therefore, enhanced influenza surveillance is indicated, especially in regions and states with confirmed H3N2v cases.

(Continue . . . .)

The bottom line right now is that the CDC is obviously concerned over the increase in H3N2v infections being reported, but is not particularly alarmed.

 

The virus does not yet appear capable of efficient and sustained transmission among people, and until that happens, poses only a relatively minor public health threat.

The rub is, the virus could acquire that ability at any time. It could happen tomorrow, or it might not happen for years.

 

Or perhaps, not at all.

 

For now the risks are primarily to those who come in contact with pigs, so the CDC is offering advice to fair goers, and those who raise swine, on how to best reduce the risk of infection.

 

More cases are likely to be announced over the next few weeks as the epidemiological investigation continues, but we’ll simply have to wait and see if this virus manages to adapt well enough to human physiology to present a significant public health threat.

 

For some of my earlier posts on this week’s surge in H3N2v cases, you may wish to revisit:

 

Indiana: Swine Flu Information Call Center To Open

CDC Confirms H3N2v In Butler County Outbreak

ISDH: Fifth H3N2v Case In Indiana

A Variant Flu Review

Ohio Investigating Possible H3N2v Outbreak

Hawaii’s DOH on H3N2v Flu Detected On Maui

Swine Flu Precautions Close Pig Barn At Indiana County Fair

»» Read More

ISDH: Fifth H3N2v Case In Indiana

Credit Wikipedia

# 6467

 

Today the ISDH (Indiana State Health Department) announced that a fifth case of H3N2v infection has been confirmed  - this time in Jackson County.  While few details are offered in this update, this case is once again apparently linked to exposure to swine.

 

As the epidemiological investigation expands, it is likely we will learn of additional cases.  

 

Health Officials Continue to Investigate Flu Illness

Start Date: 8/2/2012

INDIANAPOLIS—The Indiana State Department of Health has identified a case of variant influenza A in Jackson County, bringing the total to five cases statewide.  All cases have been linked to swine.  Laboratory testing is pending on potential additional cases.

The State Health Department has detected increased influenza activity in different areas of the state.  Flu symptoms usually include fever and respiratory symptoms, such as cough, sore throat, and runny nose, and possibly other symptoms, such as body aches, nausea or vomiting, or diarrhea.  Symptoms usually last about 2 to 5 days.

Variant Influenza A virus can be directly transmitted from swine to people and from people to swine. Human infections are most likely to occur when people are in close proximity to live infected pigs, such as working with them in barns and livestock exhibits at fairs.  Influenza viruses are not transmitted by eating pork and pork products.

While influenza is not an uncommon diagnosis in pigs, the State Board of Animal Health encourages swine owners to contact a veterinarian if their animals show signs consistent with flu, including coughing, respiratory illness, off-feed and fever. Most county fairs have a private veterinary practitioner on call for on-site assistance.

Hoosiers are encouraged to wash hands with soap and water before and after petting or touching any animal.  Never eat, drink, or put anything in your mouth when visiting animal areas.  Older adults, pregnant women, young children, and people with weakened immune systems should be extra careful around animals.

The best way to prevent spread of influenza is to practice good hygiene.  Wash your hands frequently. Cough or sneeze into your sleeve or elbow.  If possible, avoid contact with those who are ill.  Stay home if you develop influenza symptoms and contact your health care provider.

Additional information regarding influenza can be found at the Indiana State Department of Health website at wwwS.in.gov/isdh/25462.htm.

 

 

Reports of recent cases of H3N2v over the past week can be viewed at:

Ohio Investigating Possible H3N2v Outbreak

Hawaii’s DOH on H3N2v Flu Detected On Maui

Swine Flu Precautions Close Pig Barn At Indiana County Fair

H3N2v: CDC Offers Advice To Fair Goers

»» Read More