Swine-Origin Novel Influenza A Case in Maine: Maine CDC Recommendations for Healthcare Providers

Maine Center for Disease Control and Prevention (Maine CDC) is investigating a human case of novel influenza virus of swine origin. Federal CDC confirmed the novel strain in a child from Cumberland County earlier this week. A primary care provider evaluated the child, and provided treatment. The child was not hospitalized, and is recovering from the illness. Maine CDC has not identified any additional human cases. A joint investigation with the Maine Department of Agriculture and federal CDC is ongoing.

Influenza viruses are commonly found in humans, swine, birds, and other animals. The type of influenza identified in the Maine case is similar to previous, rare human infections with swineorigin H3N2 viruses, that also contains a genetic component of the pandemic H1N1 virus. This virus is genetically similar to four previous cases identified in the United States this year, three in Pennsylvania and one in Indiana, all of which had exposure to swine.

This child became ill in early October 2011 with symptoms similar to seasonal influenza including fever, cough, headache, sore throat and myalgia. Prior to illness, the child had exposure to swine including time spent in a closed setting at an agricultural fair. Maine CDC and the Department of Agriculture are currently investigating exposures. Presently this is an isolated event and Maine CDC has not confirmed any person to person transmission.

Maine CDC recommends the following for healthcare providers:

  • Maintain a heightened awareness for influenza-like illness (ILI) defined as fever greater than 100° with cough or sore throat, in the absence of another known cause.
  • Consider influenza testing by PCR for:
  • patients with ILI with recent exposure to pigs.
  • patients with ILI who are hospitalized,
  • patients with ILI who have died,
  • patients where a diagnosis of influenza would affect clinical care, infection control, or management of contacts.
  • Consider use of antivirals to quickly limit potential human transmission
  • Vaccinate patients and healthcare workers as a primary strategy to prevent influenza

Maine CDC reminds residents to take every day preventive measures against influenza. Maine CDC’s “No Flu 4 You” campaign provides 4 steps to help prevent flu:

  • Wash your hands
  • Cover your cough
  • Stay home when ill
  • Get vaccinated

Please report any cases of laboratory positive influenza to Maine CDC by fax (1-800-293-7534) or by phone through our 24 hour Disease Reporting and Consultation Hotline (1-800-821-5821). All influenza A rapid positive tests should be confirmed by PCR.

More information on swine-origin influenza viruses is available at http://www.cdc.gov/flu/swineflu/variant.htm.

Information on seasonal influenza is available at www.maineflu.gov.

Reprinted with permission.