Swine Flu Count Up to 3 in Pennsylvania

The Centers for Disease Control and Prevention (CDC) has confirmed three cases of human infection with swine origin influenza A (H3) viruses in Pennsylvania, as of Sept. 6. According to the Pennsylvania Department of Health, all three infected children under age 10 attended the Washington County Agricultural Fair the week of Aug. 13-20.

“It′s pretty rare to see human infections with swine flu viruses. CDC gets reports of about 5 cases of human infections with swine flu viruses each year,” said Lyn Finelli, chief outbreak investigator for CDC′s Influenza Division. “Most of the time, these cases occur after close contact with pigs and seldom spread onward from the first person infected.”

The viruses isolated in Pennsylvania are a little different from previously seen swine origin influenza A (H3) viruses in that all have acquired a gene from the human 2009 H1N1 viruses, the CDC said.

The investigation in Pennsylvania will continue to determine if more people are sick or if there is ongoing spread of this virus in the community.

“Fortunately,” Finelli said, “it does not look like there is current spread in the community and so far, illness associated with these viruses has not been especially severe. Two of the patients are fully recovered and the third is recovering.”

Finelli said that although this season’s flu vaccines will not protect against an infection with a swine origin virus, the antiviral drugs oseltamivir and zanamivir, which are used to treat infection with human seasonal viruses, also show activity against these viruses.

For Medicare beneficiaries, oseltamivir and zanamivir are for use in a Medicare-approved demonstration project, and reported with the appropriate HCPCS Level II code:

G9018 Zanamivir, inhalation powder, administered through inhaler, generic, per 10 mg
G9019 Oseltamivir phosphate, oral, generic, per 75 mg
G9034 Zanamivir, inhalation powder, administered through inhaler, brand name, per 10 mg
G9035 Oseltamivir phosphate, oral, brand name, per 75 mg

“If [clinicians] see influenza like illness and suspect influenza and there is a history of swine exposure, [they] should consider treating their patients with influenza antiviral medications, even before they get a positive influenza test result. This is especially true if there is little seasonal influenza activity, which is the case in most of the United States at this time,” Finelli said.

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