Swine Flu Update

Dear Providers: The attached CDC Alert contains an Update on H3N2 variant virus (or "H3N2v") and CDC's updated case definitions and recommendations.

Summer is here and this means it is fair time!  Please be aware of the possibility of novel influenza viruses in patients who are exhibiting symptoms of influenza.  Last year the H3N2v virus caused a multi-state outbreak that resulted in 306 cases, including 16 hospitalizations and 1 fatality. So far this year there have been 12 cases identified in the midwest, all associated with contact with swine at county fairs. Our local Northwest Washington Fair will be held this year August 12-17th.

The Washington State Dept of Health Public Health Lab is willing to test specimens for us, so please call to report any suspect cases so that we can facilitate testing for you. The following guidance should be used for reporting:

Case Under Investigation: Illness compatible with influenza2 in a patient meeting at least one of the epidemiologic criteria below for whom laboratory confirmation is not known or pending, or for whom test results do not provide a sufficient level of detail to confirm influenza A (H3N2)v virus (e.g., a positive rapid influenza diagnostic test).

Recent close contact3 (within 7 days of illness onset) with confirmed cases of influenza A (H3N2)v virus infection

Recent contact (within 7 days of illness onset) with swine or recent attendance at an event (such as an agricultural fair) where swine were present. Contact with swine may be direct contact (i.e., touching or handling a pig) or indirect contact (coming within about 6 feet (2 meters) of a pig without known direct contact).

For more information on case definitions see: http://www.cdc.gov/flu/swineflu/case-definitions.htm

Clinicians who suspect influenza in persons with recent exposure to swine should obtain a nasopharyngeal swab or aspirate from the patient, place the swab or aspirate in viral transport medium, and contact their local health department to arrange transport and request a timely diagnosis at the state public health laboratory.

For more information on testing see: http://www.cdc.gov/flu/swineflu/h3n2v-surveillance.htm

(Note: Commercial testing may not detect this virus)

Please check with the CDC website for timely updates.  If you have questions, please call. Thank you.