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

Identifieur interne : 000222 ( PascalFrancis/Checkpoint ); précédent : 000221; suivant : 000223

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

Auteurs : Michael A. Jhung [États-Unis] ; Scott Epperson [États-Unis] ; Matthew Biggerstaff [États-Unis] ; Donna Allen [États-Unis] ; Amanda Balish [États-Unis] ; Nathelia Barnes [États-Unis] ; Amanda Beaudoin [États-Unis] ; Lashondra Berman [États-Unis] ; Sally Bidol [États-Unis] ; Lenee Blanton [États-Unis] ; David Blythe [États-Unis] ; Lynnette Brammer [États-Unis] ; Tiffany D'Mello [États-Unis] ; Richard Danila [États-Unis] ; William Davis [États-Unis] ; Sietske De Fijter [États-Unis] ; Mary Diorio [États-Unis] ; Lizette O. Durand [États-Unis] ; Shannon Emery [États-Unis] ; Brian Fowler [États-Unis] ; Rebecca Garten [États-Unis] ; Yoran Grant [États-Unis] ; Adena Greenbaum [États-Unis] ; Larisa Gubareva [États-Unis] ; Fiona Havers [États-Unis] ; Thomas Haupt [États-Unis] ; Jennifer House [États-Unis] ; Sherif Ibrahim [États-Unis] ; Victoria Jiang [États-Unis] ; Seema Jain [États-Unis] ; Daniel Jernigan [États-Unis] ; James Kazmierczak [États-Unis] ; Alexander Klimov [États-Unis] ; Stephen Lindstrom [États-Unis] ; Allison Longenberger [États-Unis] ; Paul Lucas [États-Unis] ; Ruth Lynfield [États-Unis] ; Meredith Mcmorrow [États-Unis] ; Maria Moll [États-Unis] ; Craig Morin [États-Unis] ; Stephen Ostroff [États-Unis] ; Shannon L. Page [États-Unis] ; Sarah Y. Park [États-Unis] ; Susan Peters [États-Unis] ; Celia Quinn [États-Unis] ; Carrie Reed [États-Unis] ; Shawn Richards [États-Unis] ; Joni Scheftel [États-Unis] ; Owen Simwale [États-Unis] ; BO SHU ; Kenneth Soyemi [États-Unis] ; Jill Stauffer [États-Unis] ; Craig Steffens ; SU SU ; Lauren Torso [États-Unis] ; Timothy M. Uyeki ; Sara Vetter [États-Unis] ; Julie Villanueva ; Karen K. Wong [États-Unis] ; Michael Shaw

Source :

RBID : Pascal:14-0017918

Descripteurs français

English descriptors

Abstract

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 oselta-mivir 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.


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Pascal:14-0017918

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<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
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<affiliation wicri:level="1">
<inist:fA14 i1="05">
<s1>Epidemic Intelligence Service assigned to the Illinois Department of Public Health</s1>
<s2>Springfield</s2>
<s3>USA</s3>
<sZ>22 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Epidemic Intelligence Service assigned to the Illinois Department of Public Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Greenbaum, Adena" sort="Greenbaum, Adena" uniqKey="Greenbaum A" first="Adena" last="Greenbaum">Adena Greenbaum</name>
<affiliation wicri:level="2">
<inist:fA14 i1="02">
<s1>Epidemic Intelligence Service assigned to the Influenza Division, Centers for Disease Control and Prevention</s1>
<s2>Atlanta, Georgia</s2>
<s3>USA</s3>
<sZ>18 aut.</sZ>
<sZ>23 aut.</sZ>
<sZ>25 aut.</sZ>
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<country>États-Unis</country>
<placeName>
<region type="state">Géorgie (États-Unis)</region>
</placeName>
</affiliation>
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<author>
<name sortKey="Gubareva, Larisa" sort="Gubareva, Larisa" uniqKey="Gubareva L" first="Larisa" last="Gubareva">Larisa Gubareva</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<author>
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<inist:fA14 i1="02">
<s1>Epidemic Intelligence Service assigned to the Influenza Division, Centers for Disease Control and Prevention</s1>
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<sZ>18 aut.</sZ>
<sZ>23 aut.</sZ>
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<country>États-Unis</country>
<placeName>
<region type="state">Géorgie (États-Unis)</region>
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<author>
<name sortKey="Haupt, Thomas" sort="Haupt, Thomas" uniqKey="Haupt T" first="Thomas" last="Haupt">Thomas Haupt</name>
<affiliation wicri:level="1">
<inist:fA14 i1="13">
<s1>Wisconsin Department of Health Services</s1>
<s2>Madison</s2>
<s3>USA</s3>
<sZ>26 aut.</sZ>
<sZ>32 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Wisconsin Department of Health Services</wicri:noRegion>
</affiliation>
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<author>
<name sortKey="House, Jennifer" sort="House, Jennifer" uniqKey="House J" first="Jennifer" last="House">Jennifer House</name>
<affiliation wicri:level="1">
<inist:fA14 i1="08">
<s1>Indiana State Department of Health</s1>
<s2>Indianapolis</s2>
<s3>USA</s3>
<sZ>4 aut.</sZ>
<sZ>27 aut.</sZ>
<sZ>47 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Indiana State Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Ibrahim, Sherif" sort="Ibrahim, Sherif" uniqKey="Ibrahim S" first="Sherif" last="Ibrahim">Sherif Ibrahim</name>
<affiliation wicri:level="1">
<inist:fA14 i1="14">
<s1>West Virginia Bureau for Public Health</s1>
<s2>Charleston</s2>
<s3>USA</s3>
<sZ>28 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>West Virginia Bureau for Public Health</wicri:noRegion>
</affiliation>
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<author>
<name sortKey="Jiang, Victoria" sort="Jiang, Victoria" uniqKey="Jiang V" first="Victoria" last="Jiang">Victoria Jiang</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
<sZ>1 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
</affiliation>
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<author>
<name sortKey="Jain, Seema" sort="Jain, Seema" uniqKey="Jain S" first="Seema" last="Jain">Seema Jain</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
<sZ>1 aut.</sZ>
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<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
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<author>
<name sortKey="Jernigan, Daniel" sort="Jernigan, Daniel" uniqKey="Jernigan D" first="Daniel" last="Jernigan">Daniel Jernigan</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
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<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
</affiliation>
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<author>
<name sortKey="Kazmierczak, James" sort="Kazmierczak, James" uniqKey="Kazmierczak J" first="James" last="Kazmierczak">James Kazmierczak</name>
<affiliation wicri:level="1">
<inist:fA14 i1="13">
<s1>Wisconsin Department of Health Services</s1>
<s2>Madison</s2>
<s3>USA</s3>
<sZ>26 aut.</sZ>
<sZ>32 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Wisconsin Department of Health Services</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Klimov, Alexander" sort="Klimov, Alexander" uniqKey="Klimov A" first="Alexander" last="Klimov">Alexander Klimov</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
<sZ>1 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
</affiliation>
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<author>
<name sortKey="Lindstrom, Stephen" sort="Lindstrom, Stephen" uniqKey="Lindstrom S" first="Stephen" last="Lindstrom">Stephen Lindstrom</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
<sZ>1 aut.</sZ>
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<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
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<author>
<name sortKey="Longenberger, Allison" sort="Longenberger, Allison" uniqKey="Longenberger A" first="Allison" last="Longenberger">Allison Longenberger</name>
<affiliation wicri:level="1">
<inist:fA14 i1="10">
<s1>Pennsylvania Department of Health</s1>
<s2>Harrisburg</s2>
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<sZ>35 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Pennsylvania Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Lucas, Paul" sort="Lucas, Paul" uniqKey="Lucas P" first="Paul" last="Lucas">Paul Lucas</name>
<affiliation wicri:level="1">
<inist:fA14 i1="04">
<s1>Illinois Department of Public Health</s1>
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<s3>USA</s3>
<sZ>36 aut.</sZ>
<sZ>51 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Illinois Department of Public Health</wicri:noRegion>
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</author>
<author>
<name sortKey="Lynfield, Ruth" sort="Lynfield, Ruth" uniqKey="Lynfield R" first="Ruth" last="Lynfield">Ruth Lynfield</name>
<affiliation wicri:level="1">
<inist:fA14 i1="07">
<s1>Minnesota Department of Health</s1>
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<s3>USA</s3>
<sZ>14 aut.</sZ>
<sZ>37 aut.</sZ>
<sZ>40 aut.</sZ>
<sZ>48 aut.</sZ>
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</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Minnesota Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Mcmorrow, Meredith" sort="Mcmorrow, Meredith" uniqKey="Mcmorrow M" first="Meredith" last="Mcmorrow">Meredith Mcmorrow</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<country>États-Unis</country>
<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
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</author>
<author>
<name sortKey="Moll, Maria" sort="Moll, Maria" uniqKey="Moll M" first="Maria" last="Moll">Maria Moll</name>
<affiliation wicri:level="1">
<inist:fA14 i1="10">
<s1>Pennsylvania Department of Health</s1>
<s2>Harrisburg</s2>
<s3>USA</s3>
<sZ>35 aut.</sZ>
<sZ>39 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Pennsylvania Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Morin, Craig" sort="Morin, Craig" uniqKey="Morin C" first="Craig" last="Morin">Craig Morin</name>
<affiliation wicri:level="1">
<inist:fA14 i1="07">
<s1>Minnesota Department of Health</s1>
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<s3>USA</s3>
<sZ>14 aut.</sZ>
<sZ>37 aut.</sZ>
<sZ>40 aut.</sZ>
<sZ>48 aut.</sZ>
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</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Minnesota Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Ostroff, Stephen" sort="Ostroff, Stephen" uniqKey="Ostroff S" first="Stephen" last="Ostroff">Stephen Ostroff</name>
<affiliation wicri:level="1">
<inist:fA14 i1="10">
<s1>Pennsylvania Department of Health</s1>
<s2>Harrisburg</s2>
<s3>USA</s3>
<sZ>35 aut.</sZ>
<sZ>39 aut.</sZ>
<sZ>41 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Pennsylvania Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Page, Shannon L" sort="Page, Shannon L" uniqKey="Page S" first="Shannon L." last="Page">Shannon L. Page</name>
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<s1>Ohio Department of Health</s1>
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<sZ>16 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Ohio Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Park, Sarah Y" sort="Park, Sarah Y" uniqKey="Park S" first="Sarah Y." last="Park">Sarah Y. Park</name>
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<inist:fA14 i1="11">
<s1>Hawaii Department of Health</s1>
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<s3>USA</s3>
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</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Hawaii Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Peters, Susan" sort="Peters, Susan" uniqKey="Peters S" first="Susan" last="Peters">Susan Peters</name>
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<inist:fA14 i1="06">
<s1>Michigan Department of Community Health</s1>
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<s3>USA</s3>
<sZ>9 aut.</sZ>
<sZ>44 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Michigan Department of Community Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Quinn, Celia" sort="Quinn, Celia" uniqKey="Quinn C" first="Celia" last="Quinn">Celia Quinn</name>
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<inist:fA14 i1="03">
<s1>Epidemic Intelligence Service assigned to the Ohio Department of Health</s1>
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<s3>USA</s3>
<sZ>45 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Epidemic Intelligence Service assigned to the Ohio Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Reed, Carrie" sort="Reed, Carrie" uniqKey="Reed C" first="Carrie" last="Reed">Carrie Reed</name>
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<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<sZ>1 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Richards, Shawn" sort="Richards, Shawn" uniqKey="Richards S" first="Shawn" last="Richards">Shawn Richards</name>
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<inist:fA14 i1="08">
<s1>Indiana State Department of Health</s1>
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<sZ>4 aut.</sZ>
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<sZ>47 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Indiana State Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Scheftel, Joni" sort="Scheftel, Joni" uniqKey="Scheftel J" first="Joni" last="Scheftel">Joni Scheftel</name>
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<inist:fA14 i1="07">
<s1>Minnesota Department of Health</s1>
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<s3>USA</s3>
<sZ>14 aut.</sZ>
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<sZ>40 aut.</sZ>
<sZ>48 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Minnesota Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Simwale, Owen" sort="Simwale, Owen" uniqKey="Simwale O" first="Owen" last="Simwale">Owen Simwale</name>
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<inist:fA14 i1="10">
<s1>Pennsylvania Department of Health</s1>
<s2>Harrisburg</s2>
<s3>USA</s3>
<sZ>35 aut.</sZ>
<sZ>39 aut.</sZ>
<sZ>41 aut.</sZ>
<sZ>49 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Pennsylvania Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Bo Shu" sort="Bo Shu" uniqKey="Bo Shu" last="Bo Shu">BO SHU</name>
</author>
<author>
<name sortKey="Soyemi, Kenneth" sort="Soyemi, Kenneth" uniqKey="Soyemi K" first="Kenneth" last="Soyemi">Kenneth Soyemi</name>
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<inist:fA14 i1="04">
<s1>Illinois Department of Public Health</s1>
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<s3>USA</s3>
<sZ>36 aut.</sZ>
<sZ>51 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Illinois Department of Public Health</wicri:noRegion>
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<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
</affiliation>
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<author>
<name sortKey="Grant, Yoran" sort="Grant, Yoran" uniqKey="Grant Y" first="Yoran" last="Grant">Yoran Grant</name>
<affiliation wicri:level="1">
<inist:fA14 i1="05">
<s1>Epidemic Intelligence Service assigned to the Illinois Department of Public Health</s1>
<s2>Springfield</s2>
<s3>USA</s3>
<sZ>22 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Epidemic Intelligence Service assigned to the Illinois Department of Public Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Greenbaum, Adena" sort="Greenbaum, Adena" uniqKey="Greenbaum A" first="Adena" last="Greenbaum">Adena Greenbaum</name>
<affiliation wicri:level="2">
<inist:fA14 i1="02">
<s1>Epidemic Intelligence Service assigned to the Influenza Division, Centers for Disease Control and Prevention</s1>
<s2>Atlanta, Georgia</s2>
<s3>USA</s3>
<sZ>18 aut.</sZ>
<sZ>23 aut.</sZ>
<sZ>25 aut.</sZ>
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</inist:fA14>
<country>États-Unis</country>
<placeName>
<region type="state">Géorgie (États-Unis)</region>
</placeName>
</affiliation>
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<author>
<name sortKey="Gubareva, Larisa" sort="Gubareva, Larisa" uniqKey="Gubareva L" first="Larisa" last="Gubareva">Larisa Gubareva</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
<sZ>1 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
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<author>
<name sortKey="Havers, Fiona" sort="Havers, Fiona" uniqKey="Havers F" first="Fiona" last="Havers">Fiona Havers</name>
<affiliation wicri:level="2">
<inist:fA14 i1="02">
<s1>Epidemic Intelligence Service assigned to the Influenza Division, Centers for Disease Control and Prevention</s1>
<s2>Atlanta, Georgia</s2>
<s3>USA</s3>
<sZ>18 aut.</sZ>
<sZ>23 aut.</sZ>
<sZ>25 aut.</sZ>
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<country>États-Unis</country>
<placeName>
<region type="state">Géorgie (États-Unis)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Haupt, Thomas" sort="Haupt, Thomas" uniqKey="Haupt T" first="Thomas" last="Haupt">Thomas Haupt</name>
<affiliation wicri:level="1">
<inist:fA14 i1="13">
<s1>Wisconsin Department of Health Services</s1>
<s2>Madison</s2>
<s3>USA</s3>
<sZ>26 aut.</sZ>
<sZ>32 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Wisconsin Department of Health Services</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="House, Jennifer" sort="House, Jennifer" uniqKey="House J" first="Jennifer" last="House">Jennifer House</name>
<affiliation wicri:level="1">
<inist:fA14 i1="08">
<s1>Indiana State Department of Health</s1>
<s2>Indianapolis</s2>
<s3>USA</s3>
<sZ>4 aut.</sZ>
<sZ>27 aut.</sZ>
<sZ>47 aut.</sZ>
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</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Indiana State Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Ibrahim, Sherif" sort="Ibrahim, Sherif" uniqKey="Ibrahim S" first="Sherif" last="Ibrahim">Sherif Ibrahim</name>
<affiliation wicri:level="1">
<inist:fA14 i1="14">
<s1>West Virginia Bureau for Public Health</s1>
<s2>Charleston</s2>
<s3>USA</s3>
<sZ>28 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>West Virginia Bureau for Public Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Jiang, Victoria" sort="Jiang, Victoria" uniqKey="Jiang V" first="Victoria" last="Jiang">Victoria Jiang</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
<sZ>1 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Jain, Seema" sort="Jain, Seema" uniqKey="Jain S" first="Seema" last="Jain">Seema Jain</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
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<country>États-Unis</country>
<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
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<author>
<name sortKey="Jernigan, Daniel" sort="Jernigan, Daniel" uniqKey="Jernigan D" first="Daniel" last="Jernigan">Daniel Jernigan</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
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<country>États-Unis</country>
<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Kazmierczak, James" sort="Kazmierczak, James" uniqKey="Kazmierczak J" first="James" last="Kazmierczak">James Kazmierczak</name>
<affiliation wicri:level="1">
<inist:fA14 i1="13">
<s1>Wisconsin Department of Health Services</s1>
<s2>Madison</s2>
<s3>USA</s3>
<sZ>26 aut.</sZ>
<sZ>32 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Wisconsin Department of Health Services</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Klimov, Alexander" sort="Klimov, Alexander" uniqKey="Klimov A" first="Alexander" last="Klimov">Alexander Klimov</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
<sZ>1 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Lindstrom, Stephen" sort="Lindstrom, Stephen" uniqKey="Lindstrom S" first="Stephen" last="Lindstrom">Stephen Lindstrom</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
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<country>États-Unis</country>
<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Longenberger, Allison" sort="Longenberger, Allison" uniqKey="Longenberger A" first="Allison" last="Longenberger">Allison Longenberger</name>
<affiliation wicri:level="1">
<inist:fA14 i1="10">
<s1>Pennsylvania Department of Health</s1>
<s2>Harrisburg</s2>
<s3>USA</s3>
<sZ>35 aut.</sZ>
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</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Pennsylvania Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Lucas, Paul" sort="Lucas, Paul" uniqKey="Lucas P" first="Paul" last="Lucas">Paul Lucas</name>
<affiliation wicri:level="1">
<inist:fA14 i1="04">
<s1>Illinois Department of Public Health</s1>
<s2>Springfield</s2>
<s3>USA</s3>
<sZ>36 aut.</sZ>
<sZ>51 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Illinois Department of Public Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Lynfield, Ruth" sort="Lynfield, Ruth" uniqKey="Lynfield R" first="Ruth" last="Lynfield">Ruth Lynfield</name>
<affiliation wicri:level="1">
<inist:fA14 i1="07">
<s1>Minnesota Department of Health</s1>
<s2>St. Paul</s2>
<s3>USA</s3>
<sZ>14 aut.</sZ>
<sZ>37 aut.</sZ>
<sZ>40 aut.</sZ>
<sZ>48 aut.</sZ>
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</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Minnesota Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Mcmorrow, Meredith" sort="Mcmorrow, Meredith" uniqKey="Mcmorrow M" first="Meredith" last="Mcmorrow">Meredith Mcmorrow</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
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<country>États-Unis</country>
<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Moll, Maria" sort="Moll, Maria" uniqKey="Moll M" first="Maria" last="Moll">Maria Moll</name>
<affiliation wicri:level="1">
<inist:fA14 i1="10">
<s1>Pennsylvania Department of Health</s1>
<s2>Harrisburg</s2>
<s3>USA</s3>
<sZ>35 aut.</sZ>
<sZ>39 aut.</sZ>
<sZ>41 aut.</sZ>
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</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Pennsylvania Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Morin, Craig" sort="Morin, Craig" uniqKey="Morin C" first="Craig" last="Morin">Craig Morin</name>
<affiliation wicri:level="1">
<inist:fA14 i1="07">
<s1>Minnesota Department of Health</s1>
<s2>St. Paul</s2>
<s3>USA</s3>
<sZ>14 aut.</sZ>
<sZ>37 aut.</sZ>
<sZ>40 aut.</sZ>
<sZ>48 aut.</sZ>
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</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Minnesota Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Ostroff, Stephen" sort="Ostroff, Stephen" uniqKey="Ostroff S" first="Stephen" last="Ostroff">Stephen Ostroff</name>
<affiliation wicri:level="1">
<inist:fA14 i1="10">
<s1>Pennsylvania Department of Health</s1>
<s2>Harrisburg</s2>
<s3>USA</s3>
<sZ>35 aut.</sZ>
<sZ>39 aut.</sZ>
<sZ>41 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Pennsylvania Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Page, Shannon L" sort="Page, Shannon L" uniqKey="Page S" first="Shannon L." last="Page">Shannon L. Page</name>
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<inist:fA14 i1="12">
<s1>Ohio Department of Health</s1>
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<sZ>16 aut.</sZ>
<sZ>17 aut.</sZ>
<sZ>20 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Ohio Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Park, Sarah Y" sort="Park, Sarah Y" uniqKey="Park S" first="Sarah Y." last="Park">Sarah Y. Park</name>
<affiliation wicri:level="1">
<inist:fA14 i1="11">
<s1>Hawaii Department of Health</s1>
<s2>Honolulu</s2>
<s3>USA</s3>
<sZ>43 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Hawaii Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Peters, Susan" sort="Peters, Susan" uniqKey="Peters S" first="Susan" last="Peters">Susan Peters</name>
<affiliation wicri:level="1">
<inist:fA14 i1="06">
<s1>Michigan Department of Community Health</s1>
<s2>Lansing</s2>
<s3>USA</s3>
<sZ>9 aut.</sZ>
<sZ>44 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Michigan Department of Community Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Quinn, Celia" sort="Quinn, Celia" uniqKey="Quinn C" first="Celia" last="Quinn">Celia Quinn</name>
<affiliation wicri:level="1">
<inist:fA14 i1="03">
<s1>Epidemic Intelligence Service assigned to the Ohio Department of Health</s1>
<s2>Columbus</s2>
<s3>USA</s3>
<sZ>45 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Epidemic Intelligence Service assigned to the Ohio Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Reed, Carrie" sort="Reed, Carrie" uniqKey="Reed C" first="Carrie" last="Reed">Carrie Reed</name>
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<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<sZ>1 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Influenza Division, National Center for Immunization and Respiratory Disease</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Richards, Shawn" sort="Richards, Shawn" uniqKey="Richards S" first="Shawn" last="Richards">Shawn Richards</name>
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<inist:fA14 i1="08">
<s1>Indiana State Department of Health</s1>
<s2>Indianapolis</s2>
<s3>USA</s3>
<sZ>4 aut.</sZ>
<sZ>27 aut.</sZ>
<sZ>47 aut.</sZ>
<sZ>52 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Indiana State Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Scheftel, Joni" sort="Scheftel, Joni" uniqKey="Scheftel J" first="Joni" last="Scheftel">Joni Scheftel</name>
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<inist:fA14 i1="07">
<s1>Minnesota Department of Health</s1>
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<s3>USA</s3>
<sZ>14 aut.</sZ>
<sZ>37 aut.</sZ>
<sZ>40 aut.</sZ>
<sZ>48 aut.</sZ>
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<country>États-Unis</country>
<wicri:noRegion>Minnesota Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Simwale, Owen" sort="Simwale, Owen" uniqKey="Simwale O" first="Owen" last="Simwale">Owen Simwale</name>
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<inist:fA14 i1="10">
<s1>Pennsylvania Department of Health</s1>
<s2>Harrisburg</s2>
<s3>USA</s3>
<sZ>35 aut.</sZ>
<sZ>39 aut.</sZ>
<sZ>41 aut.</sZ>
<sZ>49 aut.</sZ>
<sZ>55 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Pennsylvania Department of Health</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Bo Shu" sort="Bo Shu" uniqKey="Bo Shu" last="Bo Shu">BO SHU</name>
</author>
<author>
<name sortKey="Soyemi, Kenneth" sort="Soyemi, Kenneth" uniqKey="Soyemi K" first="Kenneth" last="Soyemi">Kenneth Soyemi</name>
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<title level="j" type="main">Clinical infectious diseases</title>
<title level="j" type="abbreviated">Clin. infect. dis.</title>
<idno type="ISSN">1058-4838</idno>
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<date when="2013">2013</date>
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<title level="j" type="main">Clinical infectious diseases</title>
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<div type="abstract" xml:lang="en">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 oselta-mivir 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.</div>
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<fC07 i1="03" i2="X" l="SPA">
<s0>Influenzavirus A</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="04" i2="X" l="FRE">
<s0>Orthomyxoviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="04" i2="X" l="ENG">
<s0>Orthomyxoviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="04" i2="X" l="SPA">
<s0>Orthomyxoviridae</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="05" i2="X" l="FRE">
<s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="05" i2="X" l="ENG">
<s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fC07 i1="05" i2="X" l="SPA">
<s0>Virus</s0>
<s2>NW</s2>
</fC07>
<fN21>
<s1>020</s1>
</fN21>
<fN44 i1="01">
<s1>OTO</s1>
</fN44>
<fN82>
<s1>OTO</s1>
</fN82>
</pA>
</standard>
</inist>
<affiliations>
<list>
<country>
<li>États-Unis</li>
</country>
<region>
<li>Géorgie (États-Unis)</li>
<li>Maryland</li>
</region>
<settlement>
<li>Baltimore</li>
</settlement>
</list>
<tree>
<noCountry>
<name sortKey="Bo Shu" sort="Bo Shu" uniqKey="Bo Shu" last="Bo Shu">BO SHU</name>
<name sortKey="Shaw, Michael" sort="Shaw, Michael" uniqKey="Shaw M" first="Michael" last="Shaw">Michael Shaw</name>
<name sortKey="Steffens, Craig" sort="Steffens, Craig" uniqKey="Steffens C" first="Craig" last="Steffens">Craig Steffens</name>
<name sortKey="Su Su" sort="Su Su" uniqKey="Su Su" last="Su Su">SU SU</name>
<name sortKey="Uyeki, Timothy M" sort="Uyeki, Timothy M" uniqKey="Uyeki T" first="Timothy M." last="Uyeki">Timothy M. Uyeki</name>
<name sortKey="Villanueva, Julie" sort="Villanueva, Julie" uniqKey="Villanueva J" first="Julie" last="Villanueva">Julie Villanueva</name>
</noCountry>
<country name="États-Unis">
<noRegion>
<name sortKey="Jhung, Michael A" sort="Jhung, Michael A" uniqKey="Jhung M" first="Michael A." last="Jhung">Michael A. Jhung</name>
</noRegion>
<name sortKey="Allen, Donna" sort="Allen, Donna" uniqKey="Allen D" first="Donna" last="Allen">Donna Allen</name>
<name sortKey="Balish, Amanda" sort="Balish, Amanda" uniqKey="Balish A" first="Amanda" last="Balish">Amanda Balish</name>
<name sortKey="Barnes, Nathelia" sort="Barnes, Nathelia" uniqKey="Barnes N" first="Nathelia" last="Barnes">Nathelia Barnes</name>
<name sortKey="Beaudoin, Amanda" sort="Beaudoin, Amanda" uniqKey="Beaudoin A" first="Amanda" last="Beaudoin">Amanda Beaudoin</name>
<name sortKey="Berman, Lashondra" sort="Berman, Lashondra" uniqKey="Berman L" first="Lashondra" last="Berman">Lashondra Berman</name>
<name sortKey="Bidol, Sally" sort="Bidol, Sally" uniqKey="Bidol S" first="Sally" last="Bidol">Sally Bidol</name>
<name sortKey="Biggerstaff, Matthew" sort="Biggerstaff, Matthew" uniqKey="Biggerstaff M" first="Matthew" last="Biggerstaff">Matthew Biggerstaff</name>
<name sortKey="Blanton, Lenee" sort="Blanton, Lenee" uniqKey="Blanton L" first="Lenee" last="Blanton">Lenee Blanton</name>
<name sortKey="Blythe, David" sort="Blythe, David" uniqKey="Blythe D" first="David" last="Blythe">David Blythe</name>
<name sortKey="Brammer, Lynnette" sort="Brammer, Lynnette" uniqKey="Brammer L" first="Lynnette" last="Brammer">Lynnette Brammer</name>
<name sortKey="D Mello, Tiffany" sort="D Mello, Tiffany" uniqKey="D Mello T" first="Tiffany" last="D'Mello">Tiffany D'Mello</name>
<name sortKey="Danila, Richard" sort="Danila, Richard" uniqKey="Danila R" first="Richard" last="Danila">Richard Danila</name>
<name sortKey="Davis, William" sort="Davis, William" uniqKey="Davis W" first="William" last="Davis">William Davis</name>
<name sortKey="De Fijter, Sietske" sort="De Fijter, Sietske" uniqKey="De Fijter S" first="Sietske" last="De Fijter">Sietske De Fijter</name>
<name sortKey="Diorio, Mary" sort="Diorio, Mary" uniqKey="Diorio M" first="Mary" last="Diorio">Mary Diorio</name>
<name sortKey="Durand, Lizette O" sort="Durand, Lizette O" uniqKey="Durand L" first="Lizette O." last="Durand">Lizette O. Durand</name>
<name sortKey="Emery, Shannon" sort="Emery, Shannon" uniqKey="Emery S" first="Shannon" last="Emery">Shannon Emery</name>
<name sortKey="Epperson, Scott" sort="Epperson, Scott" uniqKey="Epperson S" first="Scott" last="Epperson">Scott Epperson</name>
<name sortKey="Fowler, Brian" sort="Fowler, Brian" uniqKey="Fowler B" first="Brian" last="Fowler">Brian Fowler</name>
<name sortKey="Garten, Rebecca" sort="Garten, Rebecca" uniqKey="Garten R" first="Rebecca" last="Garten">Rebecca Garten</name>
<name sortKey="Grant, Yoran" sort="Grant, Yoran" uniqKey="Grant Y" first="Yoran" last="Grant">Yoran Grant</name>
<name sortKey="Greenbaum, Adena" sort="Greenbaum, Adena" uniqKey="Greenbaum A" first="Adena" last="Greenbaum">Adena Greenbaum</name>
<name sortKey="Gubareva, Larisa" sort="Gubareva, Larisa" uniqKey="Gubareva L" first="Larisa" last="Gubareva">Larisa Gubareva</name>
<name sortKey="Haupt, Thomas" sort="Haupt, Thomas" uniqKey="Haupt T" first="Thomas" last="Haupt">Thomas Haupt</name>
<name sortKey="Havers, Fiona" sort="Havers, Fiona" uniqKey="Havers F" first="Fiona" last="Havers">Fiona Havers</name>
<name sortKey="House, Jennifer" sort="House, Jennifer" uniqKey="House J" first="Jennifer" last="House">Jennifer House</name>
<name sortKey="Ibrahim, Sherif" sort="Ibrahim, Sherif" uniqKey="Ibrahim S" first="Sherif" last="Ibrahim">Sherif Ibrahim</name>
<name sortKey="Jain, Seema" sort="Jain, Seema" uniqKey="Jain S" first="Seema" last="Jain">Seema Jain</name>
<name sortKey="Jernigan, Daniel" sort="Jernigan, Daniel" uniqKey="Jernigan D" first="Daniel" last="Jernigan">Daniel Jernigan</name>
<name sortKey="Jiang, Victoria" sort="Jiang, Victoria" uniqKey="Jiang V" first="Victoria" last="Jiang">Victoria Jiang</name>
<name sortKey="Kazmierczak, James" sort="Kazmierczak, James" uniqKey="Kazmierczak J" first="James" last="Kazmierczak">James Kazmierczak</name>
<name sortKey="Klimov, Alexander" sort="Klimov, Alexander" uniqKey="Klimov A" first="Alexander" last="Klimov">Alexander Klimov</name>
<name sortKey="Lindstrom, Stephen" sort="Lindstrom, Stephen" uniqKey="Lindstrom S" first="Stephen" last="Lindstrom">Stephen Lindstrom</name>
<name sortKey="Longenberger, Allison" sort="Longenberger, Allison" uniqKey="Longenberger A" first="Allison" last="Longenberger">Allison Longenberger</name>
<name sortKey="Lucas, Paul" sort="Lucas, Paul" uniqKey="Lucas P" first="Paul" last="Lucas">Paul Lucas</name>
<name sortKey="Lynfield, Ruth" sort="Lynfield, Ruth" uniqKey="Lynfield R" first="Ruth" last="Lynfield">Ruth Lynfield</name>
<name sortKey="Mcmorrow, Meredith" sort="Mcmorrow, Meredith" uniqKey="Mcmorrow M" first="Meredith" last="Mcmorrow">Meredith Mcmorrow</name>
<name sortKey="Moll, Maria" sort="Moll, Maria" uniqKey="Moll M" first="Maria" last="Moll">Maria Moll</name>
<name sortKey="Morin, Craig" sort="Morin, Craig" uniqKey="Morin C" first="Craig" last="Morin">Craig Morin</name>
<name sortKey="Ostroff, Stephen" sort="Ostroff, Stephen" uniqKey="Ostroff S" first="Stephen" last="Ostroff">Stephen Ostroff</name>
<name sortKey="Page, Shannon L" sort="Page, Shannon L" uniqKey="Page S" first="Shannon L." last="Page">Shannon L. Page</name>
<name sortKey="Park, Sarah Y" sort="Park, Sarah Y" uniqKey="Park S" first="Sarah Y." last="Park">Sarah Y. Park</name>
<name sortKey="Peters, Susan" sort="Peters, Susan" uniqKey="Peters S" first="Susan" last="Peters">Susan Peters</name>
<name sortKey="Quinn, Celia" sort="Quinn, Celia" uniqKey="Quinn C" first="Celia" last="Quinn">Celia Quinn</name>
<name sortKey="Reed, Carrie" sort="Reed, Carrie" uniqKey="Reed C" first="Carrie" last="Reed">Carrie Reed</name>
<name sortKey="Richards, Shawn" sort="Richards, Shawn" uniqKey="Richards S" first="Shawn" last="Richards">Shawn Richards</name>
<name sortKey="Scheftel, Joni" sort="Scheftel, Joni" uniqKey="Scheftel J" first="Joni" last="Scheftel">Joni Scheftel</name>
<name sortKey="Simwale, Owen" sort="Simwale, Owen" uniqKey="Simwale O" first="Owen" last="Simwale">Owen Simwale</name>
<name sortKey="Soyemi, Kenneth" sort="Soyemi, Kenneth" uniqKey="Soyemi K" first="Kenneth" last="Soyemi">Kenneth Soyemi</name>
<name sortKey="Stauffer, Jill" sort="Stauffer, Jill" uniqKey="Stauffer J" first="Jill" last="Stauffer">Jill Stauffer</name>
<name sortKey="Torso, Lauren" sort="Torso, Lauren" uniqKey="Torso L" first="Lauren" last="Torso">Lauren Torso</name>
<name sortKey="Vetter, Sara" sort="Vetter, Sara" uniqKey="Vetter S" first="Sara" last="Vetter">Sara Vetter</name>
<name sortKey="Wong, Karen K" sort="Wong, Karen K" uniqKey="Wong K" first="Karen K." last="Wong">Karen K. Wong</name>
</country>
</tree>
</affiliations>
</record>

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