Friday September 7, 2012 -- New Swine Flu Found in Minnesota
The Minnesota Department of Health reported human infections of an influenza A H1N2 variant (“H1N2v”) virus with the pandemic M gene from the 2009 H1N1 virus. These cases were reportedly associated with prolonged contact with pigs at a fair. H1N2 viruses normally circulate in pigs. This virus is different from the H3N2v virus.
The three people infected with the H1N2v virus exhibited pigs or spent prolonged time with pigs at the Minnesota State Fair. Two of the three people had underlying health conditions that placed them at high risk of serious flu complications.
The CDC has confirmed the Minnesota samples as H1N2v viruses. This is the first time this virus has included the M gene from the 2009 H1N1 pandemic virus when isolated from a person. CDC officials also reported genetic analysis shows that the hemagglutinin (H) of this virus is similar to human seasonal influenza viruses that circulated in people as recently as 2007, thus it is likely there is protective immunity against this particular virus in the human population.
August 31, 2012 -- First Human Death from H3N2v
The Ohio Department of Health has just reported the first human death from H3N2v. The woman was 61 and though she did have health problems, the H3N2v virus contributed to her death. The deceased had contact with pigs at a county fair. The Ohio State Health Director is urging at-risk groups to avoid swine exhibits and take other precautions. Those groups include young children, older residents, pregnant women and people with weakened immune systems or other medical conditions.
Shared by Dr. Julie Smith from email she received:
4-H National Headquarters and the Center for Disease Control (CDC) strongly urge you to disseminate this FACT SHEET (PDF 2012Aug30) to all swine exhibitors, their families, and staff working at swine exhibits or shows immediately. It is vitally important that this information be received prior to anyone attending a swine exhibit or show. The recommendations in this fact sheet should not be taken lightly. The number of flu outbreaks and states impacted continues to grow and it is the expectation that 4-H programs will take all reasonable measures to ensure the safety of participants and their projects.
August 9, 2012 -- Healthy Fairs Webinar Recorded for Viewing
National 4-H Headquarters, NIFA, and USDA hosted a Healthy Fairs Webinar to provide an overview of current public issues on H3N2v outbreaks related to fairs and exposure to swine, what can be done to help prevent infection with H3N2v, and what to do if faced with H3N2v in your states and counties.
This webinar was to help foster an environment where federal agencies, CDC and APHIS, and 4-H, USDA NIFA can be proactive alongside state partners address public health issues which are currently occurring at county fairs with regards to H3N2v outbreaks:
· To ensure educational opportunities take place in a safe environment from a positive youth development frame.
· Health is one of the H's in 4-H.
· A high percentage of youth participants at fairs are 4-H members.
To view the webinar -- Healthy Fairs
CDC and APHIS are currently working to provide guidance and support for the safe environment through tools which will be shared once clearance has been completed..
August 2012 -- Human Cases H3N2v rise and CDC provides interim precautions for people attending fairs where swine are present
August 8: Indiana Health Officials reported late this afternoon the cases of H3N2v have increased ten fold with 113 new cases reported. Ohio officials have also reported an increase in cases this last week. Contact with swine remains significant in the transmission of the disease. There is no cause for alarm at this point. Stay informed and take precautions when in contact with swine. Children and those with health issues remain most at risk for infection. (Distributed to EDEN Delegates August 9)
From CDC press release August 3, 2012
CDC reports 12 additional human infections with influenza A (H3N2) variant* virus in 3 states, Ohio (10), Hawaii (1), and Indiana (1) The H3N2v virus contains the M gene from the human influenza A(H1N1)pdm09 (2009 H1N1) virus, as have the previous 17 cases detected since July 2011. All of this week’s reported cases occurred in people who had direct or indirect contact with swine prior to their illness. The 10 cases in Ohio were associated with attendance at a fair where reportedly ill swine were present. The H3N2v case reported by Indiana also occurred in a person who attended a fair where swine were present. CDC continues to recommend preventive actions people can take to make their fair experience a safe and healthy one.
The number of cases of infection with H3N2v viruses with the M gene from the 2009 H1N1 virus detected in the United States since July 2011 now totals 29 [Hawaii (1), Indiana (7), Iowa (3), Ohio (10), Maine (2), Pennsylvania (3), Utah (1), and West Virginia (2)]. Twenty-three of these cases reported swine contact prior to illness onset. Among those 29 cases, 19 cases were associated with fairs where swine were present. Most human illness with H3N2v virus infection has resulted in signs and symptoms of influenza (fever, cough, runny nose, sore throat, muscle aches); 3 hospitalizations have occurred. All of the people hospitalized had high risk conditions. (See "people who are at greater risk of serious influenza-related complications" below.) All H3N2v virus cases have recovered fully.
According to USDA, swine influenza surveillance, this swine H3N2 virus with the pandemic M gene has been detected in swine in a number of U.S. states. This virus may be circulating widely in U.S. swine at this time. It should be noted, however, that influenza viruses have not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs.
It is possible that acquisition of the M gene from the 2009 H1N1 virus may allow H3N2v viruses to be more transmissible from pigs to people and from person-to-person."
Fall 2011 CDC issued new alerts urging public health departments, hospitals, and clinicians engaged in influenza surveillance to consider the possibility of the H3N2 virus in patients presenting with influenza-like illness. The influenza A virus involves a variant of the A(H3N2) virus that circulates among pigs. It contains the M gene from the pandemic 2009 influenza A(H1N1) virus that codes for matrix proteins found in the viral shell. The M gene plays a role in influenza virus infection. CDC, the World Health Organization, and the World Organisation for Animal Health have named it A(H3N2)v. The "v," which stands for "variant," distinguishes the novel virus from the seasonal A(H3N2) virus.
In December 2011, an influenza A (H1N1) virus known to circulate in U.S. swine but not humans has been detected in an adult in the state of Wisconsin. The patient reported work related exposure with swine prior to illness onset. CDC laboratory testing has confirmed that this is a new reassortant influenza A H1N1 virus as it has acquired the matrix [M] gene from the 2009 H1N1 pandemic virus. No human-to-human transmission with this virus has been identified.
Talking points for 2012 Outbreak of Human Cases of Swine Influenza
New Mexico State University
In 2009 U.S. Secretary of Agriculture Tom Vilsack announced the USDA's National Veterinary Services Laboratories (NVSL) confirmed the presence of 2009 pandemic H1N1 influenza virus in a pig sample collected at the Minnesota State Fair. The samples collected at the Minnesota State Fair were part of a University of Iowa and University of Minnesota cooperative agreement research project funded by the U.S. Centers for Disease Control and Prevention, which documents influenza viruses where humans and pigs interact, such as at fairs. The swine tested showed no signs of illness. Since the initial confirmation, five additional pigs have tested positive for 2009 H1N1.
Routine surveillance has also detected 2009 H1N1 in a commercial swine herd in Indiana. The swine and caretakers have all recovered from the virus. This finding is not a food safety issue nor a public health threat. This finding is however an important reminder of the need for biosecurity measures, especially with increasing numbers of human cases of 2009 H1N1. For USDA 2009 H1N1 testing results click -- USDA.
The Centers for Disease Control has issued Interim Guidelines for Workers Employed at Commercial Swine Farms to Prevent the Spread of Influenza A and H1N1 viruses.
Comparison of Strains -- The additional testing revealed the virus found in the pig is genetically compatible with the 2009 pandemic H1N1. However, no connection has been established between the pig testing positive for 2009 H1N1 and the outbreak of 2009 H1N1 among 4-Hers housed at and participating in the Minnesota State Fair. And in fact on the positive tests came from a swab sample taken as the pig was unloaded at the Fair.
Safety of Pork -- Swine influenza is a respiratory disease, thus you cannot contract the disease from consuming pork or pork products. Properly handled and cooked pork and pork products are safe to eat. Cooking pork to an internal temperature of 160°F kills bacteria and viruses. January 20, 2010 USDA reported on a study by their scientists, that reaffirms the safety of pork for consumption by the general public. In their study they found meat and tissue taken from swine exposed to two strains of the 2009 virus was free of the virus.
Secretary Vilsack reminded U.S. trade partners, there is no scientific reason to restrict imports as a result of 2009 H1N1 positive test in the initial or subsequent samples.
Swine Influenza and 2009 H1N1
Swine Influenza is a respiratory disease of pigs caused by Influenza A viruses. Swine influenza viruses circulate among swine throughout the year, but most outbreaks occur during the late fall and winter months similar to influenza outbreaks in humans. The classical swine flu virus Influenza A H1N1 was first isolated from a pig in 1930 and was the primary cause of swine influenza until 1998.
Pigs can be infected by avian influenza, human influenza, and swine influenza viruses. When influenza viruses from different species infect pigs, the viruses can reassort (swap genes) and new viruses that are a mix of swine, human and/or avian influenza viruses can emerge. Pigs are often referred to as "mixing vessels" because of this process. The multiple strains and subtypes of triple reassortant swine influenza viruses containing combinations of avian, human and swine influenza virus gene segments have emerged and become predominant among North American pigs since 1998.
Four main Influenza A virus subtypes have been isolated in pigs: H1N1, H1N2, H3N2, and H3N1. The H3N2 viruses initially were introduced into the pig population from humans. The current swine flu H3N2 viruses are closely related to human H3N2 viruses. Most of the recently isolated influenza viruses from pigs have been H1N1 viruses and these are genetically different from the 2009 H1N1 influenza virus, which is also a triple reassortant virus. The MN State Fair pig is the first U.S. pig to test positive for 2009 H1N1. The 2009 H1N1 virus has also been found in swine in Canada, Norway, Ireland , Japan, Iceland, China, and Australia.
The 2009 H1N1 virus has also been detected in turkeys in Chile and most recently turkeys in Ontario, Canada. Thus at this time humans, swine, and poultry have all been reported to be infected with genetically compatible strains of the 2009 H1N1 virus.
November 17, 2009 US Department of Agriculture researchers reported 2009 H1N1 virus does not easily infect poultry or spread among them. The researchers inoculated chickens, turkeys, ducks, and quail with the virus and found most of the birds showed no sign of infection; some quail were infected but did not pass the virus to other quail. The authors note that two turkey flocks in Chile were infected earlier this year, but those may have been isolated event
Influenza viruses can be directly transmitted from pigs to people and from people to pigs. Human infection with flu viruses from pigs are most likely to occur when people are in close contact with infected pigs. The infection of humans, swine and poultry with 2009 H1N1 is an indication of how these viruses can be shared and reassortant occur for the development of new viruses that may be a combination of human, swine and/or avian influenza viruses.
The 2009 H1N1 virus is a triple reassortant virus for which there is little or no immunity, there is sustained human-to-human transmission, and rapid worldwide spread. June 2009, the World Health Organization (WHO) declared 2009 H1N1 a pandemic influenza.
Influenza C viruses infect both humans and pigs, but do not infect birds. Transmission between pigs and humans have occurred in the past, but transmission is rare. Unlike Influenza A, Influenza C does not cause pandemics in humans, simply due to its lack genetic diversity and limited host potential.
In addition, all types of birds and several non-ruminant mammals (dogs, ferrets, pigs, and horses) are susceptible to influenza viruses. Cases of H1N1 influenza virus infection “spilling over” into these animals may occur if they come into close contact with an H1N1-infected human. On October 9, 2009, an USDA laboratory confirmed 2009 H1N1 infection in a ferret. The ferret's owner had previously been ill. November 4, 2009 another case of 2009 H1N1 was confirmed in a pet ferret in Nebraska. Also reported the same day by the Iowa State Department of Health was a confirmed case of 2009 H1N1 in a domestic (indoor) cat. In both of these cases the owners has been ill. Reports continue of infected dogs, ferrets, cats, and pet birds.
The best advice is to always follow common sense guidelines when dealing with animals (eg, washing your hands). In addition, it's more important than ever that pet owners keep a good eye on their pet's health and consult a veterinarian if their pet is showing any signs of illness. Keeping your pets healthy reduces their risk of becoming ill. Companion animals including , pot-bellied pigs, and birds should be monitored closely for signs of flu-like illness. Just like in people, treatment by your veterinarian will include efforts to treat the symptoms and/or prevent secondary bacterial pneumonia. It is unknown at this time whether an infected pet will harbor enough virus to spread the infection to a cage mate or uninfected humans. See the American Veterinary Association FAQs for more information.
Swine Influenza Symptoms and Treatment
Pigs with swine influenza can be subclinical (no symptoms) to acutely ill. The Minnesota State Fair pigs exhibited no signs of the illness. An acute outbreak of swine influenza is characterized by sudden onset and rapid spread through the herd, typically in 1-3 days. The main signs are depression, fever (to 108°F [42°C]), anorexia, coughing, dyspnea, weakness, prostration, and a mucous discharge from the eyes and nose. The course of the disease is usually 3-7 days in uncomplicated infections. Some pigs may become chronically affected. In herds that are in good condition, the principal economic loss is from stunting and delays in reaching market weight.
There is no effective treatment for swine influenza. Antimicrobials may reduce secondary bacterial infection and expectorants may help relieve signs in severely affected herds. Vaccination and strict import controls are the only specific preventive measures. Good management practices and freedom from stress, particularly due to crowding and dust, help reduce losses. The adoption of strict biosecurity management practices will reduce the risk of introducing and/or controlling influenza the herd.
The United States Department of Agriculture (USDA) has a Swine Influenza Virus (SIV) surveillance program. Surveillance is aimed to identify the H1N1 strain as well as other non-typical strains of SIV in swine. The immediate goals of the surveillance program are to:
- Determine if the H1N1 virus strain currently exists in U.S. swine;
- If the H1N1 strain is present, determine the distribution to inform further policy decisions;
- Detect other novel influenza virus strains in swine in a timely manner; and
- Determine genetic characteristics of novel viruses necessary for vaccine and diagnostics development
For more information – USDA SIV Surveillance Plan
The American Association of Swine Veterinarians offers the following recommendations:
- Swine workers should be vaccinated against the seasonal influenza viruses and receive priority for vaccination against any novel influenza viruses.
- Producers should emphasize good on-farm biosecurity practices.
- Continue current swine influenza vaccinations to control clinical signs of disease in pigs and utilize vaccines against the novel H1N1 if shown to reduce viral shedding and the risk of transmission to pork production personnel.
Support the USDA SIV Surveillance Plan designed to detect novel influenza virus including the pandemic H1N1. The association encourages its members to submit samples from pigs exhibiting influenza-like illness (lethargy, inappetence, fever, nasal/ocular discharge, sneezing, and coughing) to a veterinary diagnostic laboratory for differential testing. Also, pigs exhibiting clinical signs of illness should not be shipped to slaughter until the clinical signs have resolved. The USDA SIV surveillance testing is done at no charge to the producer/submitter.
The US swine industry has been proactive in implementing biosecurity measures to reduce the risk of disease in herds, small and large. The United States Department of Agriculture Animal and Plant Health Inspection Service (APHIS) has a detailed biosecurity plan for swine producers. Also see the EDEN Agrosecurity Topic Page – Protecting Farms – Agrosecurity Principles. See also the National Pork Board for additional biosecurity plans for swine producers.
The Centers for Disease Control (CDC) issued interim guidelines for people in contact with swine in a non-commercial setting, such as fairs, auctions, hobby farms and people who may have pet pigs. These guidelines were issued to reduce the risk of transmission of 2009 H1N1 from people to pigs.
The University of Minnesota also has an excellent resource for pork producers -- Be Prepared for H1N1.