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Ohio: Human infections with H3N2v virus - 102 cases in 23 Counties - 1 fatality

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  • Ohio: Human infections with H3N2v virus - 102 cases in 23 Counties - 1 fatality



    Health officials investigating flu illnesses from Butler County Fair
    Updated: Wednesday, 01 Aug 2012, 10:11 AM EDT
    Published : Wednesday, 01 Aug 2012, 9:28 AM EDT

    David Robinson
    COLUMBUS, Ohio (WDTN) - Ohio heath offiicals are investigating an outbreak of flu-like ilnnesses associated with people who attended the Butler County Fair.

    Preliminary lab results on ten samples indicate similarities to the influenza virus H3N2, according to the Butler County Health Department.

    Investigators said all the individuals had direct contact with swine, however the Centers for Disease Control and Prevention (CDC) have not yet confirmed any of the cases.

    Butler County Health Department continues to collect information and is working with the Ohio Departments of Health and and CDC to determine the extent of the illnesses.

    More information is available from CDC at: http://www.cdc.gov/flu/spotlights/safe-fair-going.htm

  • #2
    Re: Ohio: Butler County fair results in sveral suspected human H3N2v cases

    Several suspected (human and swine) H3N2v outbreaks were reported yesterday from fairs in neighboring Indiana:

    Comment


    • #3
      Re: Ohio: Butler County fair results in several suspected human H3N2v cases



      Flu-like outbreak linked to pigs at Butler County fair
      10:19 AM, Aug. 1, 2012

      HAMILTON ? State and local health officials are investigating an outbreak of flu-like illnesses that may be linked pigs at the Butler County Fair.

      Preliminary laboratory results in 10 cases indicate similarities to the influenza virus. All of the people who became sick had direct contact with swine at the fair, health officials said in a press release issued Wednesday morning.

      However, the Centers for Disease Control and Prevention (CDC) has not yet confirmed any of the cases.

      Officials said fair goers are safe but should wash their hands after being close to livestock and keep food and drinks out of the animal exhibits.

      The influenza virus, H3N2, is not unusual in pigs and can be directly transmitted from swine to humans and vice versa, officials said.

      The Ohio Department of Agriculture is alerting veterinarians, who monitor livestock daily at the fair, to closely check pigs as they arrive on the fairgrounds for signs of the illness.

      People who became sick after working in the swine barns of showing swine at the fair are asked to contact their physician or the county health department at 513-863-1770.

      Comment


      • #4
        Re: Ohio: Butler County fair results in several suspected human H3N2v cases



        Ohio officials probe possible swine flu cases
        Wednesday August 1, 2012 9:15 AM
        HAMILTON, Ohio (AP) ? Ohio health and agriculture officials are investigating 10 sick humans whose cases have similarities to a swine flu virus. All had attended a southern Ohio county fair.

        State and Butler County health departments say preliminary laboratory tests indicate possible H3N2 variant flu virus, which can be contracted by humans from being around infected hogs. Officials say all 10 had contact with hogs at the Butler County Fair, which ended last weekend.

        The U.S. Centers for Disease Control and Prevention is also investigating, but hasn't confirmed swine flu.

        Health officials say all 10 are recovering from their illness. Swine flu symptoms include cough, sore throat, fever and body aches.

        [snip]

        Comment


        • #5
          Re: Ohio: Butler County fair results in several suspected human H3N2v cases



          [Source: US State of Ohio, Health Department, full PDF document: (LINK). Edited.]


          HEALTH OFFICIALS INVESTIGATING FLU ILLNESSES FROM BUTLER COUNTY FAIR


          COLUMBUS — The Ohio Departments of Health (ODH) and Agriculture (ODA), along with the Butler County Health Department are actively investigating human illnesses associated with the Butler County Fair.

          Preliminary laboratory results on ten samples indicate similarities to the influenza virus, (H3N2)v.

          All individuals in Butler County’s investigation had direct contact with swine, however the Centers for Disease Control and Prevention (CDC) have not yet confirmed any of the cases.

          Butler County Health Department continues to collect information and is working with ODH and CDC to determine the extent of the illnesses. ODA is asking fair exhibitors to take precautions and is alerting attending veterinarians to closely monitor swine as they arrive on the fairgrounds for signs of influenza.

          Fair attendance is safe; visitors should remember to always wash their hands after being in close-proximity to livestock and to keep food and drink out of animal exhibits. All fair animals, especially pigs, are monitored for illness and signs of flu-like symptoms and are checked by veterinarians every day they are at the fair.

          This is to protect the health of both the people visiting the fair and the other animals in the barns.

          Influenza viruses such as H3N2 and its variants are not unusual in swine and can be directly transmitted from swine to people and from people to swine in the same way that all viruses can be transmitted between people. When humans are in close proximity to live infected swine, such as in barns and livestock exhibits at fairs, movement of these viruses can occur back and forth between humans and animals. Influenza viruses cannot be transmitted by eating pork or pork products.

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

          Ohioans who have direct, routine contact with swine, such as working in swine barns or showing swine at fairs, and have experienced cough or influenza-like illness should contact their health care provider or local health department. Symptoms include cough, sore throat, fever, body aches, and possibly other symptoms, such as nausea, vomiting, or diarrhea.

          More information is available from CDC at: http://www.cdc.gov/flu/spotlights/safe-fair-going.htm

          ###

          Contacts:
          Ohio Department of Health: 614-644-8562
          Ohio Department of Agriculture: 614-752-9817
          Butler County Health Department: 513-863-1770

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          Comment


          • #6
            Re: Ohio: Butler County fair results in several suspected human H3N2v cases



            Flu-like outbreak linked to hogs at Butler County fair?

            1:34 PM, Aug. 1, 2012 | 3 Comments

            HAMILTON — State and local health officials are investigating an outbreak of flu-like illnesses that may be linked to hogs at the Butler County Fair.

            The Butler County Health Department received 41 calls reporting that 39 children and two adults had become sick after attending the week-long fair, which ended Saturday, said director Pat Burg.

            Most of the people who became sick with the suspected H3N2v (variant) influenza virus had direct contact with hogs at the fair, she said.

            Vast majority of the 41 in contact with pigs. Might be children exhibiting or friends of children exhigiitn

            There were 350 hog exhibitors at the fair, Burg said.

            H3N2v can be transmitted from swine to humans and vice versa, officials said, but it is rarely transmitted between humans.

            Swab samples from 10 cases have been sent to the Center for Disease Control to confirm whether the illnesses were from the H3N2v (variant) virus, which is common in swine. Lab results from those cases are expected later today or on Thursday morning.

            A sample from an 11th possible case is on its way to the federal agency, Burg said.Others who fell sick were not tested because they had recovered before calling the health department

            [snip]

            Comment


            • #7
              Re: Ohio: Butler County fair results in several suspected human H3N2v cases

              Without any doubt, the H3N2v influenza virus is an increasing trouble for the US pigs industry and its spillover into human communities deserves an heightened surveillance in America and in other part of the world.

              Comment


              • #8
                Re: Ohio: Butler County fair results in several suspected human H3N2v cases

                [Source: Ohio Department of Health, Department of Agriculture / Butler County Health Department, full PDF document: (LINK). Edited.]


                August 2, 2012

                For Immediate Release

                HEALTH OFFICIALS CONFIRM FLU VIRUS STRAIN FROM BUTLER COUNTY FAIR



                Columbus, OH ?The Centers for Disease Control and Prevention (CDC) today confirmed that nine of 10 suspected influenza cases in Butler County have tested positive for the H3N2v strain.

                The 10th case is still being tested.

                The Ohio Department of Health (ODH) and the Butler County Health Department are actively investigating human illnesses associated with the Butler County Fair.

                The strain matches the flu virus that recently infected four people with swine exposure at a county fair in Indiana.

                All individuals in Butler County?s investigation also had direct contact with swine but none are currently hospitalized.

                Butler County Health Department continues to collect information and is working with ODH and CDC to determine the extent of the illnesses.

                The Ohio Department of Agriculture (ODA) is asking fair exhibitors to take precautions and is alerting attending veterinarians to closely monitor swine as they arrive on the fairgrounds for signs of influenza.

                Fair attendance is safe; visitors should remember to always wash their hands after being in close-proximity to livestock and to keep food and drink out of animal exhibits. All fair animals, especially pigs, are monitored for illness and signs of flu-like symptoms and are checked by veterinarians every day they are at the fair. This is to protect the health of both the people visiting the fair and the other animals in the barns.

                Influenza viruses such as H3N2 and its variants are not unusual in swine and can be directly transmitted from swine to people and from people to swine in the same way that all viruses can be transmitted between people. When humans are in close proximity to live infected swine, such as in barns and livestock exhibits at fairs, movement of these viruses can occur back and forth between humans and animals. Influenza viruses cannot be transmitted by eating pork or pork products.

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

                Ohioans who have direct, routine contact with swine, such as working in swine barns or showing swine at fairs, and have experienced cough or influenza-like illness should contact their health care provider or local health department. Symptoms include cough, sore throat, fever, body aches, and possibly other symptoms, such as nausea, vomiting, or diarrhea.

                More information is available from CDC at: http://www.cdc.gov/flu/spotlights/safe-fair-going.htm


                ###


                Contacts:
                Ohio Department of Health: 614-644-8562
                Ohio Department of Agriculture: 614-752-9817
                Butler County Health Department: 513-863-1770



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                Comment


                • #9
                  Re: Ohio: Butler County fair results in several suspected human H3N2v cases

                  Although there is swine contact with these cases, with nearly 10 confirmed cases and close to 40 calls reporting cases, it sounds like H2H transmission as well.
                  "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta

                  Comment


                  • #10
                    Re: Ohio: Butler County fair results in several suspected human H3N2v cases

                    [Source: Government of the US State of Ohio, full PDF document: (LINK). Edited.]


                    STATE OFFICIALS CONTINUE FLU SURVEILLANCE AND PREVENTION

                    Ohio Departments of Agriculture and Health Monitoring State and County Fairs



                    COLUMBUS ? The Ohio Departments of Agriculture (ODA) and Health (ODH), along with local health officials and representatives from the Centers for Disease Control and Prevention (CDC), continue to monitor influenza-like illness in animals and humans throughout the remainder of the Ohio State Fair as well as county fair season in Ohio, and today reminded Ohioans to exercise common sense health practices while around animals.

                    State Veterinarian Dr. Tony Forshey has veterinarians monitoring hogs weighing-in for exhibition at the Ohio State Fair and taking the temperatures of any that look ill. ODA is also contacting county fair boards and 4-H clubs with information that can be displayed in livestock barns while urging the installation of additional hand sanitizers.

                    ODH continues to partner with local health departments and health care providers across the state on any reports of human illness. Individuals who have reported close contact with swine and are exhibiting flu-like systems will undergo testing.

                    Samples will be sent to the ODH laboratory for preliminary testing and then to CDC for confirmation. ODH will provide notice of any additional H3N2v human case confirmations.

                    With the Ohio State Fair running through Sunday, August 5, ODA and ODH remind residents and visitors that fair attendance is safe.

                    Those attending the fair should remember:
                    • Wash your hands frequently with soap and running water before and after exposure to animals.
                    • Never eat, drink or put things in your mouth in animal areas, and don?t take food or drink into animal areas.
                    • Young children, pregnant women, people 65 and older and people with weakened immune systems should be extra careful around animals.
                    • If you have animals ? including swine ? watch them for signs of illness and call a veterinarian if you suspect they might be sick.
                    • Avoid close contact with animals that look or act ill, when possible.
                    • Avoid contact with swine if you are experiencing flu-like symptoms.
                    More information is available from ODH at: http://bit.ly/OhioH3N2vUpdates.



                    Chronology
                    • 8/2 ODH sends MedScape alert to all subscribing health care providers encouraging them to monitor for influenza-like illness, especially in those who had close contact with swine.
                    • 8/2 Two swine sent home from Ohio State fair after showing flu-like symptoms; testing of samples underway.
                    • 8/2 CDC confirms nine individuals who had direct contact with swine at Butler County Fair have Influenza A variant H3N2.
                    • 8/1 ODA works with the Ohio Expo Commission to move extra hand sanitation stations and informational signage to the O?Neil Swine Arena at the Ohio State Fair.
                    • 8/1 ODA asks fair exhibitors to take precautions and alerts attending veterinarians to closely monitor swine as they arrive on the fairgrounds for signs of influenza.
                    • 8/1 ODH investigates flu illness from Butler County fair. Preliminary positive results indicate H3N2v strain of influenza.
                    • 7/31 ODH notifies local health departments to monitor influenza-like illness in their area.
                    ###

                    Contacts:
                    Ohio Department of Health: 614-644-8562
                    Ohio Department of Agriculture: 614-752-9817



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                    Comment


                    • #11
                      Re: Ohio: Butler County fair results in several suspected human H3N2v cases - 15 human infections confirmed



                      ADDITIONAL H3N2v CASES IN OHIO CONFIRMED BY CDC
                      Ohioans Encouraged to Take Precautions, Prevent Spread of Influenza
                      COLUMBUS ? The Ohio Department of Health (ODH) today announced that additional cases of Influenza A variant H3N2 have been confirmed by the Centers for Disease Control and Prevention (CDC). There are currently 14 humans cases identified in Butler County, linked to swine exposure at the Butler County Fair; and one confirmed human case in Clark County, linked to swine exposure at the Ohio State Fair. Those with confirmed cases of H3N2v are between the ages of 3 and 36 years old, and to date, none of the confirmed cases have resulted in hospitalization.
                      On Monday, ODH hosted a statewide conference call with all local health departments to provide an update on the situation. Local health departments have been urged to work with agriculture and fair officials to post necessary signage and to speak directly with those working in livestock facilities to ensure necessary care is taken to avoid further transmission of the H3N2v strain.
                      ODH continues to partner with local health departments and health care providers across the state on any reports of human influenza-like illness. Individuals who have reported close contact with swine and are exhibiting flu-like systems will undergo testing. Samples will be sent to the ODH laboratory for preliminary testing and then to CDC for confirmation. ODH will provide notice of any additional H3N2v human case confirmations.
                      The Ohio Department of Agriculture (ODA) is actively working with industry partners to assist with public education efforts and to increase the number of hand sanitation stations available at county fairs. ODA will make contact this week with each upcoming fair veterinarian instructing them to post signage for both the exhibitors and for the visiting public, to closely monitor swine health and to take temperatures of any ill swine and notify ODA immediately of the results. ODA will continue to swab and test animals as needed throughout the fair season.
                      With county fairs running into the first week of October in Ohio, ODA and ODH remind residents and visitors that fair attendance is safe. Those attending the fair should remember:
                      ? Wash your hands frequently with soap and running water before and after exposure to animals.
                      ? Never eat, drink or put things in your mouth in animal areas, and don?t take food or drink into animal areas.
                      ? Young children, pregnant women, people 65 and older and people with weakened immune systems should be extra careful around animals.
                      ? If you have animals ? including swine ? watch them for signs of illness and call a veterinarian if you suspect they might be sick.
                      ? Avoid close contact with animals that look or act ill, when possible.
                      ? Avoid contact with swine if you are experiencing flu-like symptoms.
                      -more-
                      More information is available from ODH at: http://bit.ly/OhioH3N2vUpdates.
                      August 6, 2012
                      For Immediate Release
                      Chronology
                      ? 8/6 ODH holds statewide conference call with local health departments to provide an update on the situation.
                      ? 8/5 CDC confirms additional human cases of H3N2v. The totals include 14 in Butler County and one in Clark County.
                      ? 8/3 CDC holds national call to provide media with an overview of the H3N2v investigation.
                      ? 8/2 ODH sends MedScape alert to all subscribing health care providers encouraging them to monitor for influenza-like illness, especially in those who had close contact with swine; an additional alert is sent to hospitals and local health departments asking for increased influenza surveillance.
                      ? 8/2 Two swine sent home from Ohio State fair after showing flu-like symptoms; testing of samples underway.
                      ? 8/2 CDC confirms nine individuals who had direct contact with swine at Butler County Fair have Influenza A variant H3N2.
                      ? 8/1 ODA works with the Ohio Expo Commission to move extra hand sanitation stations and informational signage to the O?Neil Swine Arena at the Ohio State Fair.
                      ? 8/1 ODA asks fair exhibitors to take precautions and alerts attending veterinarians to closely monitor swine as they arrive on the fairgrounds for signs of influenza.
                      ? 8/1 ODH investigates flu illness from Butler County fair. Preliminary positive results indicate H3N2v strain of influenza.
                      ? 7/31 ODH notifies local health departments to monitor influenza-like illness in their area.
                      ###
                      Contacts:
                      Ohio Department of Health: 614-644-8562
                      Ohio Department of Agriculture: 614-752-9817
                      Butler County Health Department: 513-863-1770
                      Clark County Combined Health District: 937-390-5600

                      Comment


                      • #12
                        Re: Ohio: Butler County fair results in several suspected human H3N2v cases

                        All these reports emphasize swine exposure in the confirmed cases, but this could be somewhat misleading for a couple of reasons. First, current CDC guidance is to collect samples for sequencing when there is suspected flu with swine exposure, which introduces substantial bias in the sequences reported. Very few samples are being sent in without swine exposure. Second, I've seen news reports from Ohio and Indiana where even doctors are interviewed and state that this variant of H3N2 passes from pig to pig and from pig to human, but cannot pass from human to human. I think we all know that this makes no sense. If I'm not mistaken, it's the virus's ability to bind to cells in the host's respiratory system that drives transmission efficiency and not the source of the virus. So whether the virus originated in a pig or human should not, in itself, affect transmission efficiency.

                        Finally, with the number of confirmed and suspected cases, swine to human transmission has to be quite efficient. If so, there is no reason to believe that human to human transmission is not taking place as well. If not, then we should expect to see outbreaks of swine-origin flu viruses in people working with pigs on a routine basis. However, this is, in fact, a relatively rare occurence.
                        "I know God will not give me anything I can't handle. I just wish that He didn't trust me so much." - Mother Teresa of Calcutta

                        Comment


                        • #13
                          Re: Ohio: Butler County fair results in several suspected human H3N2v cases

                          Originally posted by JimO View Post
                          If I'm not mistaken, it's the virus's ability to bind to cells in the host's respiratory system that drives transmission efficiency and not the source of the virus. So whether the virus originated in a pig or human should not, in itself, affect transmission efficiency.
                          It could. We know that H5N1 spreads bird-to-human a lot easier than it spreads H2H, even though it is the same human lung cells it is infecting in both cases. Some of the efficientcy of transmission is also linked to the amount of virus discharged when coughing. If pigs cough up more H3N2v virus than humans (perhaps because more of the virus is in their UPPER respiratory system), then they could transmit H3N2v to humans more efficiently than a human could.

                          Not saying this is what is going on, but it is a possibility.

                          What is the big unknown right now is how prevalent H3N2v is in swine. Even with the increased testing by the CDC (which is finding some H3N2v) it is possible that a large epizootic of undiagnosed H3N2v in swine is being missed in the United States, and the human cases linked to fairs might be what we are detecting. Alternatively, H3N2v could be circulating in humans undetected, and only gets detected when it produces an outbreak in swine at a fair.

                          I think the clearest way to tell which is going on is if a cluster appears in a geograhpic area where no infected swine are (i.e. New York City or Hong Kong).

                          I will admit we seem to be finding a LOT of sick pigs lately...

                          Comment


                          • #14
                            Re: Ohio: Butler County fair results in several suspected human H3N2v cases

                            Haemagglutinin IS from human seasonal virus strain. So, the effectiveness in infecting upper and lower respiratory epithelium cells in human should be the same as its seasonal counterparts.

                            The trouble for a sustained chain of transmission is perhaps elsewhere: or in the genetic makeup and / or in the cross-protective Abs in the host.

                            Comment


                            • #15
                              Re: Ohio: Butler County fair results in several suspected human H3N2v cases

                              Lots of trouble coming out of Ohio...



                              [snip]


                              Adams said there was a problem last week in Gallia County in which around 95 people came down with an influenza type illness, 78 were children that had been to the county fair and 17 were adults. Thirty-seven of those tested positive for influenza A. Those specimens were sent to Atlanta in order to determine if they have the H3N2 type. He said two of the children were hospitalized one day and released the next day.

                              -------------



                              [snip]

                              No confirmed cases of swine flu in Gallia, 37 cases sent for further testing
                              By Michelle Miller
                              8/6/2012

                              GALLIPOLIS – According to Gallia County Health Commissioner Dr. Gerald E. Vallee, there have been no confirmed cases of H3N2v or variant influenza A, a type of swine flu, in Gallia County, however, as of this afternoon, there were 37 cases that tested positive for influenza A using the rapid flu test. Those results have been sent for further testing. According to the Centers for Disease Control and Prevention website, a rapid flu test is unable to distinguish between subtypes of influenza A.

                              The majority of the suspected cases tested in Gallia County were children, with two cases being hospitalized and later released.

                              --------------



                              62 Sickened In Gallia Co. After Contact With Pigs
                              By Michael Locklear
                              Published Tue, Aug 7, 2012 5:54 pm Dateline Gallipolis, OH
                              Updated Wed, Aug 8, 2012 10:39 am
                              Update 10:40 a.m. Twenty-five more people have come down with the flu in Gallia County, bringing the total number to 62.

                              The Gallia County Health Department says the people they've been able to interview so far have had contact with pigs.

                              Health Commissioner Gerald Vallee said Tuesday that the original 37 tested positive for the flu after all but one had been at the fair.

                              He said officials are "presuming" they caught the H3N2v influenza virus through contact with pigs, but no cases have been confirmed.

                              The Centers for Disease Control and Prevention and the Ohio Department of Health are doing further testing.

                              Results are expected next week.

                              Officials say it's safe to go to the fair as long as precautions are taken, such as washing hands after visiting the livestock barns.


                              --------------------------------------------------------------------------------

                              Thirty-seven people have tested positive for the flu, and all but one had been at the Gallia County Fair.

                              Health Commissioner Gerald Vallee says officials are "presuming" they caught the H3N2v influenza virus through contact with pigs, but no cases have been confirmed.

                              He says at least 30 of those sickened were children.

                              Specimens have been sent to a lab at the Ohio Department of Health for further testing, which could take five to seven days.

                              Vallee says a presumptive positive could come sooner.

                              Exposure to pigs at other fairs in Ohio have resulted in more than a dozen human cases of the virus.

                              Comment

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