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

Identifieur interne : 000166 ( PascalFrancis/Corpus ); précédent : 000165; suivant : 000167

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

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

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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A01 01  1    @0 1058-4838
A02 01      @0 CIDIEL
A03   1    @0 Clin. infect. dis.
A05       @2 57
A06       @2 12
A08 01  1  ENG  @1 Outbreak of Variant Influenza A(H3N2) Virus in the United States
A11 01  1    @1 JHUNG (Michael A.)
A11 02  1    @1 EPPERSON (Scott)
A11 03  1    @1 BIGGERSTAFF (Matthew)
A11 04  1    @1 ALLEN (Donna)
A11 05  1    @1 BALISH (Amanda)
A11 06  1    @1 BARNES (Nathelia)
A11 07  1    @1 BEAUDOIN (Amanda)
A11 08  1    @1 BERMAN (Lashondra)
A11 09  1    @1 BIDOL (Sally)
A11 10  1    @1 BLANTON (Lenee)
A11 11  1    @1 BLYTHE (David)
A11 12  1    @1 BRAMMER (Lynnette)
A11 13  1    @1 D'MELLO (Tiffany)
A11 14  1    @1 DANILA (Richard)
A11 15  1    @1 DAVIS (William)
A11 16  1    @1 DE FIJTER (Sietske)
A11 17  1    @1 DIORIO (Mary)
A11 18  1    @1 DURAND (Lizette O.)
A11 19  1    @1 EMERY (Shannon)
A11 20  1    @1 FOWLER (Brian)
A11 21  1    @1 GARTEN (Rebecca)
A11 22  1    @1 GRANT (Yoran)
A11 23  1    @1 GREENBAUM (Adena)
A11 24  1    @1 GUBAREVA (Larisa)
A11 25  1    @1 HAVERS (Fiona)
A11 26  1    @1 HAUPT (Thomas)
A11 27  1    @1 HOUSE (Jennifer)
A11 28  1    @1 IBRAHIM (Sherif)
A11 29  1    @1 JIANG (Victoria)
A11 30  1    @1 JAIN (Seema)
A11 31  1    @1 JERNIGAN (Daniel)
A11 32  1    @1 KAZMIERCZAK (James)
A11 33  1    @1 KLIMOV (Alexander)
A11 34  1    @1 LINDSTROM (Stephen)
A11 35  1    @1 LONGENBERGER (Allison)
A11 36  1    @1 LUCAS (Paul)
A11 37  1    @1 LYNFIELD (Ruth)
A11 38  1    @1 MCMORROW (Meredith)
A11 39  1    @1 MOLL (Maria)
A11 40  1    @1 MORIN (Craig)
A11 41  1    @1 OSTROFF (Stephen)
A11 42  1    @1 PAGE (Shannon L.)
A11 43  1    @1 PARK (Sarah Y.)
A11 44  1    @1 PETERS (Susan)
A11 45  1    @1 QUINN (Celia)
A11 46  1    @1 REED (Carrie)
A11 47  1    @1 RICHARDS (Shawn)
A11 48  1    @1 SCHEFTEL (Joni)
A11 49  1    @1 SIMWALE (Owen)
A11 50  1    @1 BO SHU
A11 51  1    @1 SOYEMI (Kenneth)
A11 52  1    @1 STAUFFER (Jill)
A11 53  1    @1 STEFFENS (Craig)
A11 54  1    @1 SU SU
A11 55  1    @1 TORSO (Lauren)
A11 56  1    @1 UYEKI (Timothy M.)
A11 57  1    @1 VETTER (Sara)
A11 58  1    @1 VILLANUEVA (Julie)
A11 59  1    @1 WONG (Karen K.)
A11 60  1    @1 SHAW (Michael)
A14 01      @1 Influenza Division, National Center for Immunization and Respiratory Disease @3 USA @Z 1 aut. @Z 2 aut. @Z 3 aut. @Z 5 aut. @Z 6 aut. @Z 8 aut. @Z 10 aut. @Z 12 aut. @Z 13 aut. @Z 15 aut. @Z 19 aut. @Z 21 aut. @Z 24 aut. @Z 29 aut. @Z 30 aut. @Z 31 aut. @Z 33 aut. @Z 34 aut. @Z 38 aut. @Z 46 aut.
A14 02      @1 Epidemic Intelligence Service assigned to the Influenza Division, Centers for Disease Control and Prevention @2 Atlanta, Georgia @3 USA @Z 18 aut. @Z 23 aut. @Z 25 aut. @Z 59 aut.
A14 03      @1 Epidemic Intelligence Service assigned to the Ohio Department of Health @2 Columbus @3 USA @Z 45 aut.
A14 04      @1 Illinois Department of Public Health @2 Springfield @3 USA @Z 36 aut. @Z 51 aut.
A14 05      @1 Epidemic Intelligence Service assigned to the Illinois Department of Public Health @2 Springfield @3 USA @Z 22 aut.
A14 06      @1 Michigan Department of Community Health @2 Lansing @3 USA @Z 9 aut. @Z 44 aut.
A14 07      @1 Minnesota Department of Health @2 St. Paul @3 USA @Z 14 aut. @Z 37 aut. @Z 40 aut. @Z 48 aut. @Z 57 aut.
A14 08      @1 Indiana State Department of Health @2 Indianapolis @3 USA @Z 4 aut. @Z 27 aut. @Z 47 aut. @Z 52 aut.
A14 09      @1 Epidemic Intelligence Service assigned to the Pennsylvania Department of Health @2 Harrisburg @3 USA @Z 7 aut.
A14 10      @1 Pennsylvania Department of Health @2 Harrisburg @3 USA @Z 35 aut. @Z 39 aut. @Z 41 aut. @Z 49 aut. @Z 55 aut.
A14 11      @1 Hawaii Department of Health @2 Honolulu @3 USA @Z 43 aut.
A14 12      @1 Ohio Department of Health @2 Columbus @3 USA @Z 16 aut. @Z 17 aut. @Z 20 aut. @Z 42 aut.
A14 13      @1 Wisconsin Department of Health Services @2 Madison @3 USA @Z 26 aut. @Z 32 aut.
A14 14      @1 West Virginia Bureau for Public Health @2 Charleston @3 USA @Z 28 aut.
A14 15      @1 Maryland Department of Health and Mental Hygiene @2 Baltimore @3 USA @Z 11 aut.
A20       @1 1703-1712
A21       @1 2013
A23 01      @0 ENG
A43 01      @1 INIST @2 18407 @5 354000507496890070
A44       @0 0000 @1 © 2014 INIST-CNRS. All rights reserved.
A45       @0 56 ref.
A47 01  1    @0 14-0017918
A60       @1 P
A61       @0 A
A64 01  1    @0 Clinical infectious diseases
A66 01      @0 GBR
C01 01    ENG  @0 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.
C02 01  X    @0 002B05
C03 01  X  FRE  @0 Epidémie @5 07
C03 01  X  ENG  @0 Epidemic @5 07
C03 01  X  SPA  @0 Epidemia @5 07
C03 02  X  FRE  @0 Etats-Unis @2 NG @5 08
C03 02  X  ENG  @0 United States @2 NG @5 08
C03 02  X  SPA  @0 Estados Unidos @2 NG @5 08
C03 03  X  FRE  @0 Infection @5 09
C03 03  X  ENG  @0 Infection @5 09
C03 03  X  SPA  @0 Infección @5 09
C03 04  X  FRE  @0 Virus grippal A @2 NW @5 10
C03 04  X  ENG  @0 Influenza A virus @2 NW @5 10
C03 04  X  SPA  @0 Influenza A virus @2 NW @5 10
C07 01  X  FRE  @0 Amérique du Nord @2 NG
C07 01  X  ENG  @0 North America @2 NG
C07 01  X  SPA  @0 America del norte @2 NG
C07 02  X  FRE  @0 Amérique @2 NG
C07 02  X  ENG  @0 America @2 NG
C07 02  X  SPA  @0 America @2 NG
C07 03  X  FRE  @0 Influenzavirus A @2 NW
C07 03  X  ENG  @0 Influenzavirus A @2 NW
C07 03  X  SPA  @0 Influenzavirus A @2 NW
C07 04  X  FRE  @0 Orthomyxoviridae @2 NW
C07 04  X  ENG  @0 Orthomyxoviridae @2 NW
C07 04  X  SPA  @0 Orthomyxoviridae @2 NW
C07 05  X  FRE  @0 Virus @2 NW
C07 05  X  ENG  @0 Virus @2 NW
C07 05  X  SPA  @0 Virus @2 NW
N21       @1 020
N44 01      @1 OTO
N82       @1 OTO

Format Inist (serveur)

NO : PASCAL 14-0017918 INIST
ET : Outbreak of Variant Influenza A(H3N2) Virus in the United States
AU : JHUNG (Michael A.); EPPERSON (Scott); BIGGERSTAFF (Matthew); ALLEN (Donna); BALISH (Amanda); BARNES (Nathelia); BEAUDOIN (Amanda); BERMAN (Lashondra); BIDOL (Sally); BLANTON (Lenee); BLYTHE (David); BRAMMER (Lynnette); D'MELLO (Tiffany); DANILA (Richard); DAVIS (William); DE FIJTER (Sietske); DIORIO (Mary); DURAND (Lizette O.); EMERY (Shannon); FOWLER (Brian); GARTEN (Rebecca); GRANT (Yoran); GREENBAUM (Adena); GUBAREVA (Larisa); HAVERS (Fiona); HAUPT (Thomas); HOUSE (Jennifer); IBRAHIM (Sherif); JIANG (Victoria); JAIN (Seema); JERNIGAN (Daniel); KAZMIERCZAK (James); KLIMOV (Alexander); LINDSTROM (Stephen); LONGENBERGER (Allison); LUCAS (Paul); LYNFIELD (Ruth); MCMORROW (Meredith); MOLL (Maria); MORIN (Craig); OSTROFF (Stephen); PAGE (Shannon L.); PARK (Sarah Y.); PETERS (Susan); QUINN (Celia); REED (Carrie); RICHARDS (Shawn); SCHEFTEL (Joni); SIMWALE (Owen); BO SHU; SOYEMI (Kenneth); STAUFFER (Jill); STEFFENS (Craig); SU SU; TORSO (Lauren); UYEKI (Timothy M.); VETTER (Sara); VILLANUEVA (Julie); WONG (Karen K.); SHAW (Michael)
AF : Influenza Division, National Center for Immunization and Respiratory Disease/Etats-Unis (1 aut., 2 aut., 3 aut., 5 aut., 6 aut., 8 aut., 10 aut., 12 aut., 13 aut., 15 aut., 19 aut., 21 aut., 24 aut., 29 aut., 30 aut., 31 aut., 33 aut., 34 aut., 38 aut., 46 aut.); Epidemic Intelligence Service assigned to the Influenza Division, Centers for Disease Control and Prevention/Atlanta, Georgia/Etats-Unis (18 aut., 23 aut., 25 aut., 59 aut.); Epidemic Intelligence Service assigned to the Ohio Department of Health/Columbus/Etats-Unis (45 aut.); Illinois Department of Public Health/Springfield/Etats-Unis (36 aut., 51 aut.); Epidemic Intelligence Service assigned to the Illinois Department of Public Health/Springfield/Etats-Unis (22 aut.); Michigan Department of Community Health/Lansing/Etats-Unis (9 aut., 44 aut.); Minnesota Department of Health/St. Paul/Etats-Unis (14 aut., 37 aut., 40 aut., 48 aut., 57 aut.); Indiana State Department of Health/Indianapolis/Etats-Unis (4 aut., 27 aut., 47 aut., 52 aut.); Epidemic Intelligence Service assigned to the Pennsylvania Department of Health/Harrisburg/Etats-Unis (7 aut.); Pennsylvania Department of Health/Harrisburg/Etats-Unis (35 aut., 39 aut., 41 aut., 49 aut., 55 aut.); Hawaii Department of Health/Honolulu/Etats-Unis (43 aut.); Ohio Department of Health/Columbus/Etats-Unis (16 aut., 17 aut., 20 aut., 42 aut.); Wisconsin Department of Health Services/Madison/Etats-Unis (26 aut., 32 aut.); West Virginia Bureau for Public Health/Charleston/Etats-Unis (28 aut.); Maryland Department of Health and Mental Hygiene/Baltimore/Etats-Unis (11 aut.)
DT : Publication en série; Niveau analytique
SO : Clinical infectious diseases; ISSN 1058-4838; Coden CIDIEL; Royaume-Uni; Da. 2013; Vol. 57; No. 12; Pp. 1703-1712; Bibl. 56 ref.
LA : Anglais
EA : 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.
CC : 002B05
FD : Epidémie; Etats-Unis; Infection; Virus grippal A
FG : Amérique du Nord; Amérique; Influenzavirus A; Orthomyxoviridae; Virus
ED : Epidemic; United States; Infection; Influenza A virus
EG : North America; America; Influenzavirus A; Orthomyxoviridae; Virus
SD : Epidemia; Estados Unidos; Infección; Influenza A virus
LO : INIST-18407.354000507496890070
ID : 14-0017918

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Pascal:14-0017918

Le document en format XML

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<s1>Michigan Department of Community Health</s1>
<s2>Lansing</s2>
<s3>USA</s3>
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</inist:fA14>
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<name sortKey="Blythe, David" sort="Blythe, David" uniqKey="Blythe D" first="David" last="Blythe">David Blythe</name>
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<s1>Maryland Department of Health and Mental Hygiene</s1>
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<s3>USA</s3>
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<name sortKey="Brammer, Lynnette" sort="Brammer, Lynnette" uniqKey="Brammer L" first="Lynnette" last="Brammer">Lynnette Brammer</name>
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<name sortKey="D Mello, Tiffany" sort="D Mello, Tiffany" uniqKey="D Mello T" first="Tiffany" last="D'Mello">Tiffany D'Mello</name>
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<name sortKey="Danila, Richard" sort="Danila, Richard" uniqKey="Danila R" first="Richard" last="Danila">Richard Danila</name>
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<inist:fA14 i1="07">
<s1>Minnesota Department of Health</s1>
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<s3>USA</s3>
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<name sortKey="Davis, William" sort="Davis, William" uniqKey="Davis W" first="William" last="Davis">William Davis</name>
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<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<author>
<name sortKey="De Fijter, Sietske" sort="De Fijter, Sietske" uniqKey="De Fijter S" first="Sietske" last="De Fijter">Sietske De Fijter</name>
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<inist:fA14 i1="12">
<s1>Ohio Department of Health</s1>
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<s3>USA</s3>
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<name sortKey="Diorio, Mary" sort="Diorio, Mary" uniqKey="Diorio M" first="Mary" last="Diorio">Mary Diorio</name>
<affiliation>
<inist:fA14 i1="12">
<s1>Ohio Department of Health</s1>
<s2>Columbus</s2>
<s3>USA</s3>
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<name sortKey="Durand, Lizette O" sort="Durand, Lizette O" uniqKey="Durand L" first="Lizette O." last="Durand">Lizette O. Durand</name>
<affiliation>
<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>
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<name sortKey="Emery, Shannon" sort="Emery, Shannon" uniqKey="Emery S" first="Shannon" last="Emery">Shannon Emery</name>
<affiliation>
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
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<author>
<name sortKey="Fowler, Brian" sort="Fowler, Brian" uniqKey="Fowler B" first="Brian" last="Fowler">Brian Fowler</name>
<affiliation>
<inist:fA14 i1="12">
<s1>Ohio Department of Health</s1>
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<sZ>16 aut.</sZ>
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<name sortKey="Garten, Rebecca" sort="Garten, Rebecca" uniqKey="Garten R" first="Rebecca" last="Garten">Rebecca Garten</name>
<affiliation>
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
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<name sortKey="Grant, Yoran" sort="Grant, Yoran" uniqKey="Grant Y" first="Yoran" last="Grant">Yoran Grant</name>
<affiliation>
<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>
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</author>
<author>
<name sortKey="Greenbaum, Adena" sort="Greenbaum, Adena" uniqKey="Greenbaum A" first="Adena" last="Greenbaum">Adena Greenbaum</name>
<affiliation>
<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>
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<author>
<name sortKey="Gubareva, Larisa" sort="Gubareva, Larisa" uniqKey="Gubareva L" first="Larisa" last="Gubareva">Larisa Gubareva</name>
<affiliation>
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
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<name sortKey="Havers, Fiona" sort="Havers, Fiona" uniqKey="Havers F" first="Fiona" last="Havers">Fiona Havers</name>
<affiliation>
<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>
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<author>
<name sortKey="Haupt, Thomas" sort="Haupt, Thomas" uniqKey="Haupt T" first="Thomas" last="Haupt">Thomas Haupt</name>
<affiliation>
<inist:fA14 i1="13">
<s1>Wisconsin Department of Health Services</s1>
<s2>Madison</s2>
<s3>USA</s3>
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<author>
<name sortKey="House, Jennifer" sort="House, Jennifer" uniqKey="House J" first="Jennifer" last="House">Jennifer House</name>
<affiliation>
<inist:fA14 i1="08">
<s1>Indiana State Department of Health</s1>
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<author>
<name sortKey="Ibrahim, Sherif" sort="Ibrahim, Sherif" uniqKey="Ibrahim S" first="Sherif" last="Ibrahim">Sherif Ibrahim</name>
<affiliation>
<inist:fA14 i1="14">
<s1>West Virginia Bureau for Public Health</s1>
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</inist:fA14>
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<author>
<name sortKey="Jiang, Victoria" sort="Jiang, Victoria" uniqKey="Jiang V" first="Victoria" last="Jiang">Victoria Jiang</name>
<affiliation>
<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<name sortKey="Jain, Seema" sort="Jain, Seema" uniqKey="Jain S" first="Seema" last="Jain">Seema Jain</name>
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<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<name sortKey="Jernigan, Daniel" sort="Jernigan, Daniel" uniqKey="Jernigan D" first="Daniel" last="Jernigan">Daniel Jernigan</name>
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<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<name sortKey="Kazmierczak, James" sort="Kazmierczak, James" uniqKey="Kazmierczak J" first="James" last="Kazmierczak">James Kazmierczak</name>
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<inist:fA14 i1="13">
<s1>Wisconsin Department of Health Services</s1>
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</inist:fA14>
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<name sortKey="Klimov, Alexander" sort="Klimov, Alexander" uniqKey="Klimov A" first="Alexander" last="Klimov">Alexander Klimov</name>
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<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<name sortKey="Lindstrom, Stephen" sort="Lindstrom, Stephen" uniqKey="Lindstrom S" first="Stephen" last="Lindstrom">Stephen Lindstrom</name>
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<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<name sortKey="Longenberger, Allison" sort="Longenberger, Allison" uniqKey="Longenberger A" first="Allison" last="Longenberger">Allison Longenberger</name>
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<inist:fA14 i1="10">
<s1>Pennsylvania Department of Health</s1>
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<name sortKey="Lucas, Paul" sort="Lucas, Paul" uniqKey="Lucas P" first="Paul" last="Lucas">Paul Lucas</name>
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<inist:fA14 i1="04">
<s1>Illinois Department of Public Health</s1>
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<name sortKey="Lynfield, Ruth" sort="Lynfield, Ruth" uniqKey="Lynfield R" first="Ruth" last="Lynfield">Ruth Lynfield</name>
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<inist:fA14 i1="07">
<s1>Minnesota Department of Health</s1>
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<s3>USA</s3>
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<name sortKey="Mcmorrow, Meredith" sort="Mcmorrow, Meredith" uniqKey="Mcmorrow M" first="Meredith" last="Mcmorrow">Meredith Mcmorrow</name>
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<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<name sortKey="Moll, Maria" sort="Moll, Maria" uniqKey="Moll M" first="Maria" last="Moll">Maria Moll</name>
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<s1>Pennsylvania Department of Health</s1>
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<name sortKey="Morin, Craig" sort="Morin, Craig" uniqKey="Morin C" first="Craig" last="Morin">Craig Morin</name>
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<s1>Minnesota Department of Health</s1>
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<s3>USA</s3>
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<name sortKey="Ostroff, Stephen" sort="Ostroff, Stephen" uniqKey="Ostroff S" first="Stephen" last="Ostroff">Stephen Ostroff</name>
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<s1>Illinois Department of Public Health</s1>
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<s1>Indiana State Department of Health</s1>
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<name sortKey="Su Su" sort="Su Su" uniqKey="Su Su" last="Su Su">SU SU</name>
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<title xml:lang="en" level="a">Outbreak of Variant Influenza A(H3N2) Virus in the United States</title>
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<s1>Indiana State Department of Health</s1>
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<name sortKey="Brammer, Lynnette" sort="Brammer, Lynnette" uniqKey="Brammer L" first="Lynnette" last="Brammer">Lynnette Brammer</name>
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<name sortKey="D Mello, Tiffany" sort="D Mello, Tiffany" uniqKey="D Mello T" first="Tiffany" last="D'Mello">Tiffany D'Mello</name>
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<s1>Minnesota Department of Health</s1>
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</author>
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<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
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<author>
<name sortKey="Fowler, Brian" sort="Fowler, Brian" uniqKey="Fowler B" first="Brian" last="Fowler">Brian Fowler</name>
<affiliation>
<inist:fA14 i1="12">
<s1>Ohio Department of Health</s1>
<s2>Columbus</s2>
<s3>USA</s3>
<sZ>16 aut.</sZ>
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<author>
<name sortKey="Garten, Rebecca" sort="Garten, Rebecca" uniqKey="Garten R" first="Rebecca" last="Garten">Rebecca Garten</name>
<affiliation>
<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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<author>
<name sortKey="Grant, Yoran" sort="Grant, Yoran" uniqKey="Grant Y" first="Yoran" last="Grant">Yoran Grant</name>
<affiliation>
<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>
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<author>
<name sortKey="Greenbaum, Adena" sort="Greenbaum, Adena" uniqKey="Greenbaum A" first="Adena" last="Greenbaum">Adena Greenbaum</name>
<affiliation>
<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>
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<author>
<name sortKey="Gubareva, Larisa" sort="Gubareva, Larisa" uniqKey="Gubareva L" first="Larisa" last="Gubareva">Larisa Gubareva</name>
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<inist:fA14 i1="01">
<s1>Influenza Division, National Center for Immunization and Respiratory Disease</s1>
<s3>USA</s3>
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<author>
<name sortKey="Havers, Fiona" sort="Havers, Fiona" uniqKey="Havers F" first="Fiona" last="Havers">Fiona Havers</name>
<affiliation>
<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>
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<author>
<name sortKey="Haupt, Thomas" sort="Haupt, Thomas" uniqKey="Haupt T" first="Thomas" last="Haupt">Thomas Haupt</name>
<affiliation>
<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>
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<author>
<name sortKey="House, Jennifer" sort="House, Jennifer" uniqKey="House J" first="Jennifer" last="House">Jennifer House</name>
<affiliation>
<inist:fA14 i1="08">
<s1>Indiana State Department of Health</s1>
<s2>Indianapolis</s2>
<s3>USA</s3>
<sZ>4 aut.</sZ>
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<author>
<name sortKey="Ibrahim, Sherif" sort="Ibrahim, Sherif" uniqKey="Ibrahim S" first="Sherif" last="Ibrahim">Sherif Ibrahim</name>
<affiliation>
<inist:fA14 i1="14">
<s1>West Virginia Bureau for Public Health</s1>
<s2>Charleston</s2>
<s3>USA</s3>
<sZ>28 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author>
<name sortKey="Jiang, Victoria" sort="Jiang, Victoria" uniqKey="Jiang V" first="Victoria" last="Jiang">Victoria Jiang</name>
<affiliation>
<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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<author>
<name sortKey="Jain, Seema" sort="Jain, Seema" uniqKey="Jain S" first="Seema" last="Jain">Seema Jain</name>
<affiliation>
<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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<author>
<name sortKey="Jernigan, Daniel" sort="Jernigan, Daniel" uniqKey="Jernigan D" first="Daniel" last="Jernigan">Daniel Jernigan</name>
<affiliation>
<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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<author>
<name sortKey="Kazmierczak, James" sort="Kazmierczak, James" uniqKey="Kazmierczak J" first="James" last="Kazmierczak">James Kazmierczak</name>
<affiliation>
<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>
</affiliation>
</author>
<author>
<name sortKey="Klimov, Alexander" sort="Klimov, Alexander" uniqKey="Klimov A" first="Alexander" last="Klimov">Alexander Klimov</name>
<affiliation>
<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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</author>
<author>
<name sortKey="Lindstrom, Stephen" sort="Lindstrom, Stephen" uniqKey="Lindstrom S" first="Stephen" last="Lindstrom">Stephen Lindstrom</name>
<affiliation>
<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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</author>
<author>
<name sortKey="Longenberger, Allison" sort="Longenberger, Allison" uniqKey="Longenberger A" first="Allison" last="Longenberger">Allison Longenberger</name>
<affiliation>
<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>
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</author>
<author>
<name sortKey="Lucas, Paul" sort="Lucas, Paul" uniqKey="Lucas P" first="Paul" last="Lucas">Paul Lucas</name>
<affiliation>
<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>
</affiliation>
</author>
<author>
<name sortKey="Lynfield, Ruth" sort="Lynfield, Ruth" uniqKey="Lynfield R" first="Ruth" last="Lynfield">Ruth Lynfield</name>
<affiliation>
<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>
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</affiliation>
</author>
<author>
<name sortKey="Mcmorrow, Meredith" sort="Mcmorrow, Meredith" uniqKey="Mcmorrow M" first="Meredith" last="Mcmorrow">Meredith Mcmorrow</name>
<affiliation>
<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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</author>
<author>
<name sortKey="Moll, Maria" sort="Moll, Maria" uniqKey="Moll M" first="Maria" last="Moll">Maria Moll</name>
<affiliation>
<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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</affiliation>
</author>
<author>
<name sortKey="Morin, Craig" sort="Morin, Craig" uniqKey="Morin C" first="Craig" last="Morin">Craig Morin</name>
<affiliation>
<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>
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</affiliation>
</author>
<author>
<name sortKey="Ostroff, Stephen" sort="Ostroff, Stephen" uniqKey="Ostroff S" first="Stephen" last="Ostroff">Stephen Ostroff</name>
<affiliation>
<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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</affiliation>
</author>
<author>
<name sortKey="Page, Shannon L" sort="Page, Shannon L" uniqKey="Page S" first="Shannon L." last="Page">Shannon L. Page</name>
<affiliation>
<inist:fA14 i1="12">
<s1>Ohio Department of Health</s1>
<s2>Columbus</s2>
<s3>USA</s3>
<sZ>16 aut.</sZ>
<sZ>17 aut.</sZ>
<sZ>20 aut.</sZ>
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</author>
<author>
<name sortKey="Park, Sarah Y" sort="Park, Sarah Y" uniqKey="Park S" first="Sarah Y." last="Park">Sarah Y. Park</name>
<affiliation>
<inist:fA14 i1="11">
<s1>Hawaii Department of Health</s1>
<s2>Honolulu</s2>
<s3>USA</s3>
<sZ>43 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author>
<name sortKey="Peters, Susan" sort="Peters, Susan" uniqKey="Peters S" first="Susan" last="Peters">Susan Peters</name>
<affiliation>
<inist:fA14 i1="06">
<s1>Michigan Department of Community Health</s1>
<s2>Lansing</s2>
<s3>USA</s3>
<sZ>9 aut.</sZ>
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</inist:fA14>
</affiliation>
</author>
<author>
<name sortKey="Quinn, Celia" sort="Quinn, Celia" uniqKey="Quinn C" first="Celia" last="Quinn">Celia Quinn</name>
<affiliation>
<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>
</affiliation>
</author>
<author>
<name sortKey="Reed, Carrie" sort="Reed, Carrie" uniqKey="Reed C" first="Carrie" last="Reed">Carrie Reed</name>
<affiliation>
<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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<sZ>30 aut.</sZ>
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<sZ>33 aut.</sZ>
<sZ>34 aut.</sZ>
<sZ>38 aut.</sZ>
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</inist:fA14>
</affiliation>
</author>
<author>
<name sortKey="Richards, Shawn" sort="Richards, Shawn" uniqKey="Richards S" first="Shawn" last="Richards">Shawn Richards</name>
<affiliation>
<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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</author>
<author>
<name sortKey="Scheftel, Joni" sort="Scheftel, Joni" uniqKey="Scheftel J" first="Joni" last="Scheftel">Joni Scheftel</name>
<affiliation>
<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>
</affiliation>
</author>
<author>
<name sortKey="Simwale, Owen" sort="Simwale, Owen" uniqKey="Simwale O" first="Owen" last="Simwale">Owen Simwale</name>
<affiliation>
<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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</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>
<affiliation>
<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>
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</author>
<author>
<name sortKey="Stauffer, Jill" sort="Stauffer, Jill" uniqKey="Stauffer J" first="Jill" last="Stauffer">Jill Stauffer</name>
<affiliation>
<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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</author>
<author>
<name sortKey="Steffens, Craig" sort="Steffens, Craig" uniqKey="Steffens C" first="Craig" last="Steffens">Craig Steffens</name>
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<author>
<name sortKey="Su Su" sort="Su Su" uniqKey="Su Su" last="Su Su">SU SU</name>
</author>
<author>
<name sortKey="Torso, Lauren" sort="Torso, Lauren" uniqKey="Torso L" first="Lauren" last="Torso">Lauren Torso</name>
<affiliation>
<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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<author>
<name sortKey="Uyeki, Timothy M" sort="Uyeki, Timothy M" uniqKey="Uyeki T" first="Timothy M." last="Uyeki">Timothy M. Uyeki</name>
</author>
<author>
<name sortKey="Vetter, Sara" sort="Vetter, Sara" uniqKey="Vetter S" first="Sara" last="Vetter">Sara Vetter</name>
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<inist:fA14 i1="07">
<s1>Minnesota Department of Health</s1>
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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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<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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<ET>Outbreak of Variant Influenza A(H3N2) Virus in the United States</ET>
<AU>JHUNG (Michael A.); EPPERSON (Scott); BIGGERSTAFF (Matthew); ALLEN (Donna); BALISH (Amanda); BARNES (Nathelia); BEAUDOIN (Amanda); BERMAN (Lashondra); BIDOL (Sally); BLANTON (Lenee); BLYTHE (David); BRAMMER (Lynnette); D'MELLO (Tiffany); DANILA (Richard); DAVIS (William); DE FIJTER (Sietske); DIORIO (Mary); DURAND (Lizette O.); EMERY (Shannon); FOWLER (Brian); GARTEN (Rebecca); GRANT (Yoran); GREENBAUM (Adena); GUBAREVA (Larisa); HAVERS (Fiona); HAUPT (Thomas); HOUSE (Jennifer); IBRAHIM (Sherif); JIANG (Victoria); JAIN (Seema); JERNIGAN (Daniel); KAZMIERCZAK (James); KLIMOV (Alexander); LINDSTROM (Stephen); LONGENBERGER (Allison); LUCAS (Paul); LYNFIELD (Ruth); MCMORROW (Meredith); MOLL (Maria); MORIN (Craig); OSTROFF (Stephen); PAGE (Shannon L.); PARK (Sarah Y.); PETERS (Susan); QUINN (Celia); REED (Carrie); RICHARDS (Shawn); SCHEFTEL (Joni); SIMWALE (Owen); BO SHU; SOYEMI (Kenneth); STAUFFER (Jill); STEFFENS (Craig); SU SU; TORSO (Lauren); UYEKI (Timothy M.); VETTER (Sara); VILLANUEVA (Julie); WONG (Karen K.); SHAW (Michael)</AU>
<AF>Influenza Division, National Center for Immunization and Respiratory Disease/Etats-Unis (1 aut., 2 aut., 3 aut., 5 aut., 6 aut., 8 aut., 10 aut., 12 aut., 13 aut., 15 aut., 19 aut., 21 aut., 24 aut., 29 aut., 30 aut., 31 aut., 33 aut., 34 aut., 38 aut., 46 aut.); Epidemic Intelligence Service assigned to the Influenza Division, Centers for Disease Control and Prevention/Atlanta, Georgia/Etats-Unis (18 aut., 23 aut., 25 aut., 59 aut.); Epidemic Intelligence Service assigned to the Ohio Department of Health/Columbus/Etats-Unis (45 aut.); Illinois Department of Public Health/Springfield/Etats-Unis (36 aut., 51 aut.); Epidemic Intelligence Service assigned to the Illinois Department of Public Health/Springfield/Etats-Unis (22 aut.); Michigan Department of Community Health/Lansing/Etats-Unis (9 aut., 44 aut.); Minnesota Department of Health/St. Paul/Etats-Unis (14 aut., 37 aut., 40 aut., 48 aut., 57 aut.); Indiana State Department of Health/Indianapolis/Etats-Unis (4 aut., 27 aut., 47 aut., 52 aut.); Epidemic Intelligence Service assigned to the Pennsylvania Department of Health/Harrisburg/Etats-Unis (7 aut.); Pennsylvania Department of Health/Harrisburg/Etats-Unis (35 aut., 39 aut., 41 aut., 49 aut., 55 aut.); Hawaii Department of Health/Honolulu/Etats-Unis (43 aut.); Ohio Department of Health/Columbus/Etats-Unis (16 aut., 17 aut., 20 aut., 42 aut.); Wisconsin Department of Health Services/Madison/Etats-Unis (26 aut., 32 aut.); West Virginia Bureau for Public Health/Charleston/Etats-Unis (28 aut.); Maryland Department of Health and Mental Hygiene/Baltimore/Etats-Unis (11 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Clinical infectious diseases; ISSN 1058-4838; Coden CIDIEL; Royaume-Uni; Da. 2013; Vol. 57; No. 12; Pp. 1703-1712; Bibl. 56 ref.</SO>
<LA>Anglais</LA>
<EA>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.</EA>
<CC>002B05</CC>
<FD>Epidémie; Etats-Unis; Infection; Virus grippal A</FD>
<FG>Amérique du Nord; Amérique; Influenzavirus A; Orthomyxoviridae; Virus</FG>
<ED>Epidemic; United States; Infection; Influenza A virus</ED>
<EG>North America; America; Influenzavirus A; Orthomyxoviridae; Virus</EG>
<SD>Epidemia; Estados Unidos; Infección; Influenza A virus</SD>
<LO>INIST-18407.354000507496890070</LO>
<ID>14-0017918</ID>
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