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07 Aug 2012

Health Advisory – Influenza A H3N2v Identified in Indiana

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The following is an official Indiana Health Alert Network Advisory Message. This information has been provided by the Indiana State Department of Health as of 8/1/12.
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Influenza A H3N2v Identified in Jackson County
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The Indiana State Department of Health (ISDH) has identified one case of variant influenza A (H3N2v) in a Jackson County resident.  This is the fifth confirmed case of H3N2v in Indiana in 2012.  To date, all cases of H3N2v have had direct contact with swine.   Initial RT-PCR testing conducted at the ISDH Laboratory indicated possible H3N2v; samples were forwarded to the CDC where partial genome sequencing confirmed H3N2v with the M gene from the influenza A (H1N1)pdm09 virus, which is similar to results from the previous 17 U.S. cases in 2011 and 2012.  The ISDH submitted five additional specimens from Jackson (4) and Tipton (1) counties to the CDC laboratory for confirmation.  The ISDH is testing specimens on suspect cases from White and Monroe counties.
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The ISDH has received several calls from healthcare providers seeing patients with influenza-like illness (ILI), and we anticipate the number of cases of H3N2v infection to increase in Indiana and possibly other states.  The Ohio State Department of Health and the Hawaii Department of Health have also identified cases of H3N2v. Because this virus has been identified in more than one county with reports of human illness in other counties, influenza should be considered as a diagnosis in patients presenting with respiratory symptoms.  The ISDH Laboratory has tested 22 specimens since H3N2v was identified in four LaPorte County residents. Additional testing is being conducted to assess similarity between viruses infecting swine and humans.
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Health care providers who see patients with ILI should collect a nasopharygeal swab for testing at the ISDH Laboratory. Currently available rapid influenza diagnostic tests for use in physician’s offices may not adequately detect this virus. Contact the ISDH Surveillance and Investigation Division at 317-233-7125 to obtain authorization prior to sample submission. Authorization must be obtained prior to specimen submission.  Public health officials will conduct a case investigation to determine the source of illness and potential transmission.  Health care providers can remind their patients that influenza is not transmitted to people through eating properly handled and prepared pork or other products derived from pigs.
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Five confirmed cases of variant influenza A have been identified in Indiana since mid-July in LaPorte and Jackson counties.  Laboratory testing is pending on additional cases in Jackson, Jennings, Tipton, Monroe, White, and Washington counties.  To date, all cases have had contact with swine.  The ISDH continues to monitor influenza activity statewide.
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ISDH Opening Call Center for Influenza Questions
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The Indiana State Department of Health (ISDH) has launched a call center open Monday through Friday from 8:15-4:45 to answer questions on influenza infection. The general call number will be (877) 826-0011.  For medical questions, health care providers may call the call center provider line at 855-219-0011.
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For more information, please visit:
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ISDH influenza web site: http://www.in.gov/isdh/25462.htm
ISDH variant influenza A quick fact:  http://www.in.gov/isdh/files/2012QuickFact_Influenza.pdfCenters
Disease Control and Prevention (CDC) web site:  http://www.cdc.gov/flu/swineflu

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