Outbreak of Variant Influenza A(H3N2) Virus in the United States

被引：139

作者：

Jhung, Michael A. ^{[1
]}

Epperson, Scott ^{[1
]}

Biggerstaff, Matthew ^{[1
]}

Allen, Donna ^{[8
]}

Balish, Amanda ^{[1
,9
]}

Barnes, Nathelia ^{[1
]}

Beaudoin, Amanda

Berman, LaShondra ^{[1
]}

Bidol, Sally ^{[6
]}

Blanton, Lenee ^{[1
]}

Blythe, David ^{[15
]}

Brammer, Lynnette ^{[1
]}

D'Mello, Tiffany ^{[1
]}

Danila, Richard ^{[7
]}

Davis, William ^{[1
]}

de Fijter, Sietske ^{[12
]}

DiOrio, Mary ^{[12
]}

Durand, Lizette O. ^{[2
]}

Emery, Shannon ^{[1
]}

Fowler, Brian ^{[12
]}

Garten, Rebecca ^{[1
]}

Grant, Yoran ^{[5
]}

Greenbaum, Adena ^{[2
]}

Gubareva, Larisa ^{[1
]}

Havers, Fiona ^{[2
]}

Haupt, Thomas ^{[13
]}

House, Jennifer ^{[8
]}

Ibrahim, Sherif ^{[14
]}

Jiang, Victoria ^{[1
]}

Jain, Seema ^{[1
]}

Jernigan, Daniel ^{[1
]}

Kazmierczak, James ^{[13
]}

Klimov, Alexander ^{[1
]}

Lindstrom, Stephen ^{[1
]}

Longenberger, Allison ^{[10
]}

Lucas, Paul ^{[4
]}

Lynfield, Ruth ^{[7
]}

McMorrow, Meredith ^{[1
]}

Moll, Maria ^{[10
]}

Morin, Craig ^{[7
]}

Ostroff, Stephen ^{[10
]}

Page, Shannon L. ^{[12
]}

Park, Sarah Y. ^{[11
]}

Peters, Susan ^{[6
]}

Quinn, Celia ^{[3
]}

Reed, Carrie ^{[1
]}

Richards, Shawn ^{[8
]}

Scheftel, Joni ^{[7
]}

Simwale, Owen ^{[10
]}

Shu, Bo ^{[1
]}

机构：

[1] Ctr Dis Control & Prevent, Influenza Div, Natl Ctr Immunizat & Resp Dis, Atlanta, GA 30333 USA

[2] Ctr Dis Control & Prevent, Epidem Intelligence Serv, Influenza Div, Atlanta, GA 30333 USA

[3] Ohio Dept Hlth, Epidem Intelligence Serv, Columbus, OH 43266 USA

[4] Illinois Dept Publ Hlth, Springfield, IL 62761 USA

[5] Illinois Dept Publ Hlth, Epidem Intelligence Serv, Springfield, IL 62761 USA

[6] Michigan Dept Community Hlth, Lansing, MI USA

[7] Minnesota Dept Hlth, St Paul, MN USA

[8] Indiana State Dept Hlth, Indianapolis, IN 46202 USA

[9] Penn Dept Hlth, Epidem Intelligence Serv, Harrisburg, PA 17108 USA

[10] Penn Dept Hlth, Harrisburg, PA 17108 USA

[11] Hawaii Dept Hlth, Honolulu, HI USA

[12] Ohio Dept Hlth, Columbus, OH 43266 USA

[13] Wisconsin Dept Hlth Serv, Madison, WI USA

[14] West Virginia Bur Publ Hlth, Charleston, SC USA

[15] Maryland Dept Hlth & Mental Hyg, Baltimore, MD USA

来源：

CLINICAL INFECTIOUS DISEASES | 2013年 / 57卷 / 12期

关键词：

influenza; outbreak; pandemic; variant influenza; SWINE INFLUENZA; A H1N1; HUMAN INFECTIONS; AGRICULTURAL FAIR; PIGS; TRANSMISSION; HUMANS; USA; PATHOGENICITY; NEURAMINIDASE;

D O I：

10.1093/cid/cit649

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. Variant influenza virus infections are rare but may have pandemic potential if person-to-person transmission is efficient. We describe the epidemiology of a multistate outbreak of an influenza A(H3N2) variant virus (H3N2v) first identified in 2011. Methods. We identified laboratory-confirmed cases of H3N2v and used a standard case report form to characterize illness and exposures. We considered illness to result from person-to-person H3N2v transmission if swine contact was not identified within 4 days prior to illness onset. Results. From 9 July to 7 September 2012, we identified 306 cases of H3N2v in 10 states. The median age of all patients was 7 years. Commonly reported signs and symptoms included fever (98%), cough (85%), and fatigue (83%). Sixteen patients (5.2%) were hospitalized, and 1 fatal case was identified. The majority of those infected reported agricultural fair attendance (93%) and/or contact with swine (95%) prior to illness. We identified 15 cases of possible person-to-person transmission of H3N2v. Viruses recovered from patients were 93%-100% identical and similar to viruses recovered from previous cases of H3N2v. All H3N2v viruses examined were susceptible to oseltamivir and zanamivir and resistant to adamantane antiviral medications. Conclusions. In a large outbreak of variant influenza, the majority of infected persons reported exposures, suggesting that swine contact at an agricultural fair was a risk for H3N2v infection. We identified limited person-to-person H3N2v virus transmission, but found no evidence of efficient or sustained person-to-person transmission. Fair managers and attendees should be aware of the risk of swine-to-human transmission of influenza viruses in these settings.

引用

页码：1703 / 1712

页数：10

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