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Flu - H3N2v

What is H3N2v?
H3N2v is a non-human influenza virus that normally circulates in pigs and has infected humans. Viruses that normally circulate in pigs are “swine influenza viruses.” When these viruses infect humans, they are termed “variant” viruses.

In 2011, a specific H3N2 virus was detected. The virus was first identified in pigs in 2010 and was first detected in people in 2011. Nationwide, there were 12 human infections with this virus, termed H3N2v, in 2011; most were associated with exposure to pigs. In 2012, H3N2v outbreaks in humans associated with exposure to pigs began in July. Michigan saw its first case in August 2012. As of August 24, 2012, Michigan has reported five cases of this particular flu virus. Nationwide to date, there have been 277 cases, of which 236 were reported from Ohio and Indiana.

How can a person catch a flu virus from a pig?
Influenza viruses can spread from pigs to people and from people to pigs. Transmission from infected pigs to humans is thought to happen in the same way that seasonal influenza viruses spread between people; mainly through infected droplets created when an infected pig coughs or sneezes. If these droplets land in your nose or mouth, or you inhale them, you can be infected. There also is some evidence that you might get infected by touching something that has virus on it and then touching your own mouth or nose. A third possible way to get infected is to inhale dust containing influenza virus. Scientists aren’t really sure which of these ways of transmission is the most common. Most of the cases of H3N2v known to date have come through exposure to pigs at fair events or exhibitions. Of all these cases, three instances of likely person-to-person spread of H3N2v have been identified by the Centers for Disease Control (CDC).

What are the symptoms of H3N2v?
Symptoms of H3N2v have been consistent with seasonal influenza and include fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue. While influenza viruses can spread from people to pigs and pigs to people, however, they have not been shown to be transmissible to people through eating pork (pig meat).

Is the Branch-Hillsdale-St. Joseph Health Department concerned about H3N2v?
Yes. The Health Department is concerned about H3N2v for a few reasons:

  • Influenza viruses (including variant viruses like H3N2v) can sometimes cause severe disease, even in healthy people. Influenza can lead to complications (like pneumonia), to hospitalization, and can also lead to death.
  • H3N2v seems to spread more easily to humans from pigs than other swine influenza viruses.
  • Influenza viruses are always changing. It’s possible the H3N2v virus could change and begin spreading easily from person to person.
  • Studies conducted by CDC have indicated that children younger than 10 years old have little to no immunity against H3N2v virus. (Adults might have more immunity, perhaps because they might have been exposed to similar viruses in their longer lifetimes.)

Is H3N2v dangerous?
Currently, the severity of human illness associated with H3N2v resembles that of seasonal flu. But keep in mind that even seasonal influenza can be a serious disease. Sometimes seasonal influenza can lead to complications (like pneumonia). It also can lead to hospitalization and even death.

Is there a vaccine for H3N2v?
Early steps to make a vaccine against H3N2v have been taken, but no decision to mass produce such a vaccine has been made.

Will this season’s flu vaccine protect me against H3N2v?
YES. CDC recommends that everyone 6 months and older get a seasonal flu vaccine each year.

Is there treatment for H3N2v?
Yes. The same influenza antiviral drugs used to treat seasonal flu can treat H3N2v in children and adults. The currently recommended drugs – oseltamivir and zanamivir - are available by prescription from your doctor. Early treatment works better and may be especially important for people with a high risk condition. If you are prescribed antiviral drugs by your doctor, you should finish all of the medication, according to your doctor’s instructions.

Who is at high risk of serious H3N2v illness?
People who are at high risk of developing complications if they get seasonal flu include the following:

  • children younger than 5 years but especially those younger than 2 years;
  • people 65 years and older;
  • pregnant women; and
  • people with certain long-term health conditions (like
  • asthma, COPD, diabetes, heart disease weakened immune systems, liver or kidney disorders, cancer or AIDS and neurological or neurodevelopmental conditions).

These same groups of people are thought to be at high risk of developing serious complications from H3N2v infection.

Can I get H3N2v from eating pork?
No. Influenza viruses have not been shown to be transmissible to people through eating pork (pig meat).

When did H3N2v start? How many people have been infected?
The H3N2v virus was found in U.S. pigs in 2010 and in people in 2011. Between August and December 2011, 12 U.S. residents were found to be infected with H3N2v. In April 2012, a case of H3N2v was detected in a child. Beginning in July 2012, many more cases of H3N2v associated with swine exposure at agricultural fairs were reported to CDC by 10 different states.

Who has been infected by H3N2v?
Most H3N2v infections have occurred in children with exposure to swine; many have occurred at agricultural fairs.

What is CDC doing about this situation?
CDC is communicating regularly with states, and states have ramped up their surveillance and laboratory activities to detect human cases of H3N2v. CDC also is monitoring the situation closely. CDC’s Influenza Division is examining the genes of many of the H3N2v viruses that are shipped by state public health laboratories to CDC, to ensure that the virus is not changing in key ways. To date, no significant changes in the H3N2v virus have been detected.

What should I do if I am at an agricultural fair?
If you are at an agricultural fair, please follow these precautionary steps:

  • Don’t take food or drink into pig areas; don’t eat, drink or put anything in your mouth in pig areas.
  • Don’t take toys, pacifiers, cups, baby bottles, strollers, or similar items into pig areas.
  • Avoid close contact with pigs that look or act ill.
  • Take protective measures if you must come in contact with pigs that are known or suspected to be sick. This includes minimizing contact with pigs and wearing personal protective equipment like protective clothing and gloves and masks that cover your mouth and nose when contact is required.
  • Wash your hands often with soap and running water before and after exposure to pigs. If soap and water are not available, use an alcohol-based hand rub.
  • To further reduce the risk of infection, minimize contact with pigs and swine barns.
  • Watch your pig (if you have one) for illness. Call a veterinarian if you suspect illness.
  • Avoid contact with pigs if you have flu-like symptoms. Wait 7 days after your illness started or until you have been without fever for 24 hours without the use of fever reducing medications, whichever is longer. If you must have contact with pigs while you are sick, take the protective actions listed above.

In particular, if you are at high risk of serious flu complications, avoid pigs and swine barns at the fair this year.

Should I avoid agricultural fairs where swine are present?
It’s not necessary to avoid agricultural fairs where swine are present. However, you should take steps to protect yourself against H3N2v if you do attend agricultural fairs, particularly where swine are present. If you are at high risk of serious flu complications, avoid pigs and swine barns at the fair this year.

Are there things I should do, even if I’m not around pigs?
As always, take time to get a seasonal influenza vaccine as soon as flu vaccine becomes available in your community, to protect yourself from the seasonal influenza viruses that are most likely to circulate this season.

Can you tell if a pig has the flu?
Signs that a pig has the flu may include fever, depression, coughing (barking), discharge from the nose or eyes, sneezing, breathing difficulties, eye redness or inflammation, and going off feed. Some pigs infected with influenza, however, may have no symptoms at all.

Is H3N2v the same as the H3N2 flu virus that makes people sick each flu season?
No. H3N2v is different than the seasonal influenza A (H3N2) found in the human seasonal flu shot. H3N2v is a variant virus that is spreading in pigs and has infected some humans and is not included as of yet in the seasonal flu shot.

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