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SIV Surveillance and Recent Fair Human Infections - Dr. Dave Pyburn, USDA, APHIS, VS, from the 2012 Allen D. Leman Swine Conference, September 15-18, St. Paul, Minnesota, USA.
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Safeguarding Animal Health
SIV Surveillance and Recent
Fair Human Infections
(“Spill Over”)
Dr. Dave Pyburn
USDA APHIS VS
1
Safeguarding Animal Health
Swine Influenza Virus
Surveillance
• Voluntary Program / Anonymous
• Objectives
Monitor genetic evolution and ecology
Provide isolates for research activities
Provide isolates for progressive development of
Diagnostic reagents
Diagnostic assays
Vaccines
2
Safeguarding Animal Health
Swine Influenza Virus
Surveillance
• Surveillance streams
Case compatible
accessions to diagnostic
laboratories
First point of contact or
commingling events
Swine linked to a human
case of SIV
3
Safeguarding Animal Health
SIV Surveillance Results
4
Safeguarding Animal Health
SIV Surveillance Results
5
Month
Number of accessions with each subtype present
Total Accessions
with H3N2
reported
Accessions with H3N2 Pandemic
Matrix
Accessions with H3N2 with North American
Matrix
H3N2 with Matrix family not yet reported H1N1 H1N2
Oct 2011 10 5 4 1 14 13
Nov 2011 15 9 3 3 21 11
Dec 2011 10 7 2 1 11 13
Jan 2012 9 9 0 0 11 11
Feb 2012 12 7 3 2 10 4
Mar 2012 3 3 1 1 13 4
Apr 2012 16 7 8 1 13 10
May 2012 11 2 8 1 14 7
Jun 2012 30 7 1 29 16 24
Jul 2012 22 1 0 21 18 25
Aug 2012 … … … … … …
Sep 2012 … … … … … …
FY 2012 YTD Total 138 57 30 60
141 122
Safeguarding Animal Health
SIV Surveillance Numbers
6
Safeguarding Animal Health
Human Infections• Recent H3N2v findings:
Humans linked to exposures through exhibitions
(county and state fairs) - Multiple states involved
>300 people (in 10 states) have documented
sickness; many were traced to exposure to swine
at exhibition events (state and county fairs)Most cases have occurred in pig exhibitors and have
occurred after very close contact with pigs over a
relatively long period of time
16 hospitalizations and one death associated with H3N2v
• Also human infections (4) with H1N2v linked
with swine exposure in one state (+H1N1v)
7
Safeguarding Animal Health
Human Infections
• Limited human-to-human transmission of
H3N2v virus is thought to have occurred in
the fall and winter of 2011
2012 H3N2v very similar to the H3N2v viruses
found in 2011
No sustained community transmission of this virus
taking place at this time but some human to
human looks likely
CDC is monitoring for changes in the virus and
potential person-to-person transmission of H3N2v
8
Safeguarding Animal Health
H3N2v
• Influenza A (H3N2) viruses with genes from
avian, swine, and human viruses that
normally circulate in swine
• When human infections with these viruses
occur, these viruses are called “variant”
viruses (thus the “v”)
• When these viruses are found in swine, they
are called swine influenza A (H3N2) viruses.
• M gene from 2009 pH1N1
9
Safeguarding Animal Health
H1N2v• Prolonged contact with pigs at a fair
First time this virus has been found in humans
• Two of the people had underlying health
conditions that placed them at high risk of
serious flu complications
One of the two people with high risk factors was
hospitalized
All recovered
• Susceptible to antiviral drugs oseltamivir
(Tamiflu®) and zanamivir (Relenza®)
• M gene from 2009 pH1N1
10
Safeguarding Animal Health
Public Guidance
• CDC recommends annual seasonal influenza
vaccination for all persons aged 6 months
and older to protect against seasonal
influenza viruses
Unlikely to protect against variant influenza
viruses
• For high risk persons (age and medical
factors) - avoiding or minimizing exposure to
pigs or pig barns at fairs
11
Safeguarding Animal Health
Public Guidance
12
Recently, CDC and 4-H issued a fact sheet titled “Influenza H3N2v: Key Facts
For People Exhibiting Pigs at Fairs .” (Available at
http://www.cdc.gov/flu/swineflu/h3n2v-key-facts-exhibiting-pigs-at-
fairs.htm.)
CDC and USDA have issued a fact sheet titled “Issues for Fair Organizers to
Consider When Planning Fairs.” (Available at
http://www.cdc.gov/flu/swineflu/h3n2v-fairs-planning.htm.)
Additionally, CDC has issued a fact sheet for fair goers entitled “Take Action
to Prevent the Spread of Flu Between People and Pigs at Fairs.” (Available at
http://www.cdc.gov/flu/swineflu/h3n2v-fairs-factsheet.htm.)
Safeguarding Animal Health
Take Home Thoughts • Influenza A viruses have been isolated from many
species including humans, pigs, horses, marine
mammals, and birds
• One notable commonality between
H1N2v, H1N1v, and H3N2v influenza viruses is that
all have the M gene from the 2009 pH1N1 virus
Does the M gene confer easier transmissibility to humans?
Between humans?
• Surveillance in swine can help to target surveillance
in humans – geographically and for a specific virus
Effective surveillance not possible without industry
willingness and participation
13