Prevalance of H3N2v among Children and Elderly Adults in the United States in 2011-2012

Ana Hernandez Ergel Cadilenia Joanne Gryn Lillian Crystal Reyes

Introduction of H3N2v
-Extent of Problem & Agent of Disease -Symptoms & Modes of Transmission -Mechanisms to Control the Spread of Disease & Host Factors -Environmental Factors that make People Vulnerable & Temporal Variation -Additional Epidemiologic Variables -Hypotheses -Gaps in Knowledge -Suggestions for Further Research

What is H3N2v?
-H3N2v is a variant of H3N2 influenza virus that infected 320 people in the United States
H3N2v is a non-human influenza virus that normally circulates in pigs and that has infected humans.

The virus was circulating in pigs in 2010 and was first detected in people in 2011.
-There were 12 human infections with this virus, termed H3N2v, in 2011; most were associated with exposure to pigs. -In 2012, H3N2v outbreaks in July

Extent of Problem
Influenza viruses can spread from pigs to people and from people to pigs. Mainly through infected droplets created when an infected pig coughs or sneezes. 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.

Agent of Disease

It is a virus Can be transmitted by droplets Pig to human contact Human to human Dirt particles

Signs & Symptoms

Runny or stuffy nose Fever Sore throat Cough Headaches Body aches Fatigue Diarrhea or vomiting Incubation Period: 3-7 days like the regular

Modes of Transmission

The flu can be extended to another individual by about 6 feet away from a person who has the flu. Experts think the flu is spread by droplets. Indirect mode transmission -when a person touches an object that contains the flu virus and then touches one self's mouth or nose.

Mechanisms for Control: CDC and H3N2v

State Surveillance
o

Human cases

Laboratory Activities
o

Genes of H3N2v ensure no significant

changes

Health Alert Network (HAN)

CDC's primary method of informing the public about urgent health incidents.

Health Alert Network (HAN) and H3N2v Connections

Public Health Care Providers

Factories harvesting animals

Public
HAN Recommends:

Washing hands frequently with soap after exposure to animals Avoid eating or drinking in animal areas Good hygiene

Health Care Providers

HAN Recommends:

Hospitals
o

report any H3N2v patient

Factories
HAN Recommends:

Vaccinate animals
Good hygiene

Proper ventilation system

Host Factors: Who is at risk?

Children (younger than 5 year of age)

Elderly (older than 65 years old)

Other Factors

Weak Immune System (AIDS/HIV) Agriculture Employment / Fairs Chronic Conditions

o

asthma, diabetes, heart disease, or neurological conditions endocrine, kidney, liver metabolic, morbidly obese

Disorders
o

Indiana and Ohio

(CDC 2012)

Environmental Factors
-People who work in the swine industry and who work outside -United States: Utah, Iowa, Indiana, Ohio, West Virginia, Pennsylvania, Maine -People attending fairs -Minimize contact with pigs and swine barns -Some evidence states that you might get infected by touching something that has virus on it and then touching your own mouth or nose- Wash hands -Monitor animals

(CDC 2012)

Temporal Variation of H3N2v

-Seasonal influenza is seen during the summer months; County fair season -Hot weather and viruses correlate
-May-August -Dr. Bresee stated "This is not a pandemic situation, but the CDC will continue to monitor what's going on (2012). -Growing problem that is continually being

Is H3N2v a Threat?
-1 death reported in Ohio August 2012 -older adult -multiple underlying health conditons -had direct exposure to pigs in a fair setting -majority of H3N2v cases have been in children -Some adults have been infected

Additional Epidemiologic Variables

Agent

H3N2v virus

Pig, children, elderly

Farms, pig industries, county fairs, dust particles, water droplets

Host

Environment

Current Hypotheses
This virus seems to spread more easily to humans from pigs than other swine influenza viruses. Influenza viruses are always changing. Its 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.)

It is hard to distinguish if a person has the H3N2v at first because it is similar to the regular flu No vaccine is available yet, therefore there is insufficient knowledge Creating a Vaccine to prevent H3N2v (manufacturers are in a position to produce a vaccine that protects against this strain should sustained human-to-human transmission of H3N2v occur.) www.flu.gov

Gaps in Knowledge

Proposed Policies Encourage vaccination with the 201213 flu vaccine for all persons 6 months of age as soon as it is available. o Although the 201213 vaccine is unlikely to provide protection against H3N2v for children, it might provide some protection for adults. Regulations aimed towards: Prevalent places o Fairs settings Factories harvesting pigs General public

Prevalent Places

Farm settings

Prevalent Places
Focus on Primary Prevention

Ohio counties
Butler (17)

Champaign (15)
Gallia (12)

Indiana counties

Factories Harvesting Pigs

Requirement:
o
o

vaccination ventilation

Hygiene
Biosecurity system Work with veterinarians

General Public

Primary prevention Hospitals Inform local public health department

Further Epidemiologic Research

-Provide vaccine that will protect not only some adults, but children too. -Possibly remove pigs from fairs -Vaccinate animals at County Fairs -If anyone shows signs of H3N2v then report it -Continue seasonal awareness

Conclusion
-H3N2v can spread to humans from infected pigs -Seasonal flu vaccine is not designed to protect against H3N2v -The CDC tracks cases of H3N2v in humans and reports them online. The USDA is responsible for tracking flu in pigs. -Symptoms similar to seasonal flu: fever, cough, runny nose, sore throat, and muscle aches. -Most cases occurred after direct or close contact to pigs and many of these exposures have been at county agricultural fairs. CDC continues to closely monitor human infections with H3N2v viruses.

References
OHIO- Ohio Department of Health Home. (2012, September 12). Ohio Department of Health Home. Retrieved December 1, 2012, from http://www.odh.ohio.gov/default.aspx CDC - Seasonal Influenza (Flu) - H3N2v and You. (2012, August 12). Centers for Disease Control and Prevention. Retrieved December 1, 2012, from http://www.cdc.gov/flu/swineflu/h3n2v-basics.htm H3N2v | Flu.gov. (n.d.). Home | Flu.gov. Retrieved December 1, 2012, from http://www.flu.gov/about_the_flu/h3n2v/# Health Alert Network (HAN) | Home. (2012, November 27). CDC Emergency Preparedness & Response Site. Retrieved December 1, 2012, from http://www.bt.cdc.gov/han/ Increase in A H3N2v detections in the United States. (2012, August 14). World Health Organization. Retrieved November 30, 2012, from http://www.euro.who.int/en/what-we-do/health-topics/communicablediseases/influenza/news/news/2012/8/increase-in-a-h3n2v-detections-in-theunited-states

CLASS ACTIVITY Quiz

1. True or False There is a vaccine available to directly prevent H3N2v?

Quiz
2. In which state did the only death due to H3N2v take place? a. California b. Ohio(correct) c. Massachusetts d. Texas

Quiz
3.List some signs and symptoms of H3N2v.

Quiz
4.Who is more at risk for contracting H3N2v? a. 21 year old b. 43 year old c. 68 year old d. 13 year old