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Volume 18, Number 12—December 2012

Research

Outbreak of Influenza A (H3N2) Variant Virus Infection among Attendees of an Agricultural Fair, Pennsylvania, USA, 2011

Karen K. WongComments to Author , Adena Greenbaum, Maria E. Moll, James Lando, Erin L. Moore, Rahul Ganatra, Matthew Biggerstaff, Eugene Lam, Erica E. Smith, Aaron D. Storms, Jeffrey R. Miller, Virginia Dato, Kumar Nalluswami, Atmaram Nambiar, Sharon A. Silvestri, James R. Lute, Stephen Ostroff, Kathy Hancock, Alicia Branch, Susan C. Trock, Alexander Klimov, Bo Shu, Lynnette Brammer, Scott Epperson, Lyn Finelli, and Michael A. Jhung
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (K.K. Wong, A. Greenbaum, R. Ganatra, M. Biggerstaff, E. Lam, A.D. Storms, J.R. Miller, K. Hancock, A. Branch, S.C. Trock, A. Klimov, B. Shu, L. Brammer, S. Epperson, L. Finelli, M.A. Jhung); Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA (M.E. Moll, E.E. Smith, J.R. Miller, V. Dato, K. Nalluswami, A. Nambiar, J.R. Lute, S. Ostroff); Allegheny County Health Department, Pittsburgh, Pennsylvania (J. Lando, S.A. Silvestri); and Pennsylvania Department of Agriculture, Harrisburg (E.L. Moore)

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Table 1

Characteristics of case-patients with suspected, probable, or confirmed A(H3N2)v virus infection after attending agricultural Fair A, Pennsylvania, 2011*

Characteristic A(H3N2)v case status
Suspected, n = 82 Probable and confirmed, n = 7 All cases, N = 89
Sex

M

37 (45) 2 (29) 39 (44)

F

45 (55) 5 (71) 50 (56)
Age, y

Median (range)

13 (0.5–60) 3 (1–9) 12 (0.5–60)

<4

9 (11) 5 (71) 14 (16)

4–13

34 (41) 2 (29) 36 (40)

14–18

12 (15) 0 12 (13)

19–49

17 (21) 0 17 (19)

>50

10 (12) 0 10 (11)
Underlying medical condition† 17/80 (21) 1/7 (14) 18/87 (21)
Reported any prior influenza vaccination 49/73 (67) 5/5 (100) 54/78 (69)
No. days spent at fair, median (range) 7 (1–10) 4 (1–8) 6 (1–10)
Family owns swine 27/82 (33) 2/7 (29) 29/89 (33)
Reported swine exposure‡ 73/80 (91) 7/7 (100) 80/87 (92)
Signs/symptoms

Fever/feverish

74/82 (90) 7/7 (100) 81/89 (91)

Cough

58/80 (73) 6/7 (86) 64/87 (74)

Runny nose

38/77 (49) 3/7 (43) 41/84 (49)

Headache

58/72 (81) 0/4 58/76 (76)

Muscle aches

40/69 (58) 0/5 40/74 (54)

Sore throat

44/72 (61) 1/5 (20) 45/77 (58)

Shortness of breath

16/69 (23) 1/7 (14) 17/76 (22)

Vomiting

21/82 (26) 2/7 (29) 23/89 (26)

Diarrhea

27/82 (33) 2/7 (29) 29/89 (33)

Fatigue

55/57 (96) 3/3 (100) 58/60 (97)

Joint pain

18/53 (34) 0/1 18/54 (33)
Illness duration, median days (range) 7 (2–18)§ 6 (3–9)¶ 6 (2–18)**
Received medical attention 28/81 (35) 3/7 (43) 31/88 (35)
Hospitalized 0/81 1/7 (14) 1/88 (1)

*Data are no. (%) with characteristic or no. with characteristic/total no. case-patients with data (%) unless otherwise specified. A(H3N2)v, influenza A (H3N2) variant virus.
†Includes asthma, chronic lung disease, heart disease, diabetes or metabolic disease, kidney disease, liver disease, immunosuppressive condition, cancer, and neurologic or neurodevelopmental disorders.
‡Includes visiting swine exhibit, walking near swine exhibit, or touching swine at fair.
§Of 60 persons with known dates of illness onset and recovery.
¶Of 5 persons with known date of recovery.
**Of 65 persons with known date of recovery.

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