REPORT FROM THE DEPARTMENT OF HEALTH – Local and federal officials are investigating the cause of a confirmed variant flu case on Maui. The Hawaii State Department of Health (DOH) is working with federal and state partners, including the Centers for Disease Control and Prevention (CDC), the U.S. Department of Agriculture, and the Hawaii State Department of Agriculture (HDOA) to find the source of how a Maui resident adult contracted the virus, known as H3N2v virus.

The resident sought medical attention after experiencing symptoms consistent with the regular flu, including fever, cough, and body aches. Because the patient’s primary care doctor is a participant in DOH’s influenza-like illness sentinel network (ILINet), a respiratory specimen was sent to the State Laboratories Division for testing.  Lab results for H3N2v virus were confirmed by CDC late last week. The resident has since fully recovered without need for hospitalization.

“Fortunately, we have a robust surveillance network and our State Laboratory detected this variant virus and conferred with federal partners,” stated Health Director Loretta Fuddy. “Thanks to the excellent cooperation of Hawaii’s healthcare providers, participation in our sentinel network exceeds CDC recommendations.  In addition to our state laboratory’s ability to identify unusual flu strains, sentinel physicians contribute to our ability to catch incidents such as this, which might otherwise fall below the radar.”

The H3N2v virus identified in this case shares genetic similarities to variant flu viruses which have been identified in several other states in the past year.  The H3N2v virus has rarely infected humans and has caused only limited human-to-human infection.  The small number of previous infections has occurred mostly among children and those who work closely with pigs (e.g., livestock farmers).  In this case, preliminary DOH findings suggest the latter exposure, although the investigation is ongoing in collaboration with HDOA.

“The virus seems to be behaving as previously observed in other cases, with illness similar to seasonal flu and with no sustained community transmission,” noted State Epidemiologist Dr. Sarah Park. “Still, anyone who develops flu-like illness within a week after close contact with domestic pigs should see their healthcare provider.”

Additionally, children, pregnant women, elderly, and those with compromised immune systems should be especially careful around pigs and practice good hand washing habits; those who work closely with pigs should take appropriate protective measures, including hand hygiene, personal protective equipment, and regular influenza vaccination.

“This particular virus is mainly transmitted through exposure to infected swine and is not transmitted through properly cooked pork,” said HDOA state veterinarian Dr. James Foppoli.  “HDOA veterinarians will be taking samples to investigate the status of swine herds potentially associated with this case.  The total number of human cases of swine derived influenza virus suggests that viral transmission from swine to humans is extremely uncommon.  However, as in the past, we continue to emphasize that pig farmers and others having close contact with live swine practice good hygienic measures, such as frequent hand washing.”

Animal samples taken by HDOA will be tested by the DOH State Laboratory as part of their work as a member of the National Animal Health Laboratory Network.

Additional information about H3N2v virus can be found at http://www.cdc.gov/flu/swineflu/influenza-variant-viruses-h3n2v.htm. Information is also available from DOH Disease Outbreak Control Division at http://hawaii.gov/health/DIB/index.html, and from HDOA Animal Disease Control Branch at http://hawaii.gov/hdoa/ai/ldc/ai_ldc.

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