#17,784
Although we see sporadic cases every summer here in the United States - and many more likely go undetected - spillovers of swine variant influenza viruses (typically H1N1v, H1N2v, H3N2v) are followed closely by health authorities because of their (currently low) potential to spark an epidemic or pandemic.
It isn't just the United States, of course. Swine variant viruses have been reported in Canada, Taiwan, Brazil, Italy, Denmark, France and Germany . . . to name a few. Most countries, however, do not test for the virus, and so its actual incidence isn't known.
Most of the time, people diagnosed with swine variant influenza had recent contact with pigs, but we've seen some cases where no such exposure was found, suggesting possible limited human-to-human spread.
Today the UK's Health Security Agency is reporting their first confirmed case. While this is likely a isolated case, this is reportedly a unique clade (1b.1.1) which differs from previous H1N2v strains, and this person's exposure has not been determined.
This individual only had mild illness, and has recovered. The UKHSA is following up with close contacts, but thus far, no additional cases have been identified. The UKHSA press release follows:
UKHSA detects human case of influenza A(H1N2)v
The UK Health Security Agency (UKHSA) has detected a single confirmed human case of influenza A(H1N2)v.
From:UK Health Security Agency Published27 November 2023
Influenza A(H1N2)v is similar to flu viruses currently circulating in pigs in the UK. This is the first detection of this strain of flu in a human in the UK.
As is usual early in emerging infection events, UKHSA is working closely with partners to determine the characteristics of the pathogen and assess the risk to human health.
The case was detected as part of routine national flu surveillance undertaken by UKHSA and the Royal College of General Practitioners (RCGP). The individual was tested by their GP after experiencing respiratory symptoms. Influenza A(H1N2)v virus was detected by UKHSA using polymerase chain reaction (PCR) testing and characterised using genome sequencing.
The individual concerned experienced a mild illness and has fully recovered. The source of their infection has not yet been ascertained and remains under investigation.
Close contacts of the case are being followed up by UKHSA and partner organisations. Any contacts will be offered testing as necessary and advised on any necessary further care if they have symptoms or test positive.
People with any respiratory symptoms should continue to follow the existing guidance; avoid contact with other people while symptoms persist, particularly if the people they are coming into contact with are elderly or have existing medical conditions.
UKHSA is monitoring the situation closely and is taking steps to increase surveillance within existing programmes involving GP surgeries and hospitals in parts of North Yorkshire. To assist in the detection of cases and assessment of transmission, those people who are contacted and asked to test are encouraged to do so.
Meera Chand, Incident Director at UKHSA, said:
It is thanks to routine flu surveillance and genome sequencing that we have been able to detect this virus. This is the first time we have detected this virus in humans in the UK, though it is very similar to viruses that have been detected in pigs.
We are working rapidly to trace close contacts and reduce any potential spread. In accordance with established protocols, investigations are underway to learn how the individual acquired the infection and to assess whether there are any further associated cases.
Chief Veterinary Officer, Christine Middlemiss, said:
We know that some diseases of animals can be transferred to humans – which is why high standards of animal health, welfare and biosecurity are so important.
Through our animal and human surveillance systems we work together to protect everyone. In this case we are providing specialist veterinary and scientific knowledge to support the UKHSA investigation. Pig keepers must also report any suspicion of swine flu in their herds to their local vet immediately.
Background on influenza viruses
Influenza A(H1) viruses are enzootic in swine populations in most regions of the world. When an influenza virus that normally circulates in swine is detected in a person, it is called a ‘variant influenza virus’.
H1N1, H1N2 and H3N2 are major subtypes of swine influenza A viruses in pigs and occasionally infect humans, usually after direct or indirect exposure to pigs or contaminated environments.
There have been a total of 50 human cases of influenza A(H1N2)v reported globally since 2005; none of them related genetically to this strain. Influenza A(H1N2)v has not previously been detected in humans in the UK. Human infections with swine influenza viruses occur sporadically.
Based on early information, the infection detected in the UK is a distinct clade (1b.1.1), which is different from recent human cases of influenza A(H1N2) elsewhere in the world but is similar to viruses in UK swine.
In 2009, there was a pandemic in humans caused by an influenza virus (influenza A H1N1(pdm09)) commonly referred to as ‘swine flu’. That virus contained genetic material from viruses that were circulating in pigs, birds and humans in the 1990s and 2000s.
Influenza A H1N1(pdm09) is now circulating in humans seasonally and is no longer referred to as swine flu. It is distinct from the viruses currently circulating in pigs.
