UPDATED Sept. 20 at 5:20 p.m.

Baltimore, MD – The Maryland Department of Health has presumptively identified the influenza virus strain H3N2v (variant flu) in seven Maryland residents who had close contact with pigs at the Charles County Fair. None of the infected individuals has developed serious illness or been hospitalized.

Influenza is an infection caused by the influenza virus which can affect people and other animals, including pigs and birds. Symptoms for the H3N2v strain are the same as seasonal flu and include fever and respiratory symptoms, such as sore throat and cough. Historically, there is limited human to human transmission from this strain of variant flu. The treatment recommendations for this strain of influenza are the same as for seasonal flu.

Health officials recommend that people with influenza-like illness contact their healthcare provider and inform them if they have had pig contact within the past seven days. Providers are advised to contact their local health departments if they suspect variant flu in their patients to coordinate appropriate testing with their local health department. The Charles County Health Department can be reached at 301-609-6900 ext. 6025 and the St. Mary’s County Health Department can be reached at 301-475-4330.

Twenty other cases of variant flu have been detected in other states this year. Of those, 18 were also the virus strain H3N2v. Illnesses associated with these variant flu infections have been mostly mild with symptoms similar to those of seasonal flu. In 2012, 13 individuals developed influenza after direct contact with sick pigs at the Queen Anne’s County fair in Maryland.

Certain people are at higher risk for complications of influenza, including children under five, the elderly, pregnant women, and those with chronic heart, lung, liver, kidney and neurologic conditions or immunosuppression. The spread of influenza, including the possible spread of H3N2v, between humans can be prevented by:
Avoiding close contact with sick people;
Limiting contact with others as much as possible if you are sick to keep from infecting them and staying home from work or school if you are sick until you are fever free for 24 hours without fever reducing medicines;
Covering your nose and mouth with a tissue when you cough or sneeze and dispose of the tissue immediately after use;
Washing your hands often with soap and water or alcohol-based hand rub if soap and water are not available;
Avoiding touching your eyes, nose and mouth;
Cleaning and disinfecting surfaces and objects that may be contaminated with germs like the flu; and
Getting the seasonal influenza vaccine when it becomes available. Although it is not effective against H3N2v, it is protective against other common strains of influenza.
The spread of influenza between pigs and humans can be prevented by:
Washing your hands frequently with soap and running water before and after exposure to pigs;
Never eating, drinking or putting things in your mouth in pig areas;
Considering avoiding exposure to pigs and swine barns this summer, especially if sick pigs have been identified and if you are high risk of complications from influenza;
Watching your pig for signs of illness and calling a veterinarian if you suspect they might be sick;
Avoiding close contact with pigs that look or act ill; and
Avoiding contact with pigs if you are experiencing flu-like symptoms.
Additional information from the Centers for Disease Control and Prevention regarding Swine Influenza/Variant Influenza Viruses is available here.

LEONARDTOWN, MD (September 20, 2017) – The Maryland Department of Health, Maryland Department of Agriculture, and the health departments in Charles County and St. Mary’s County are investigating five cases of influenza in pigs recently exhibited at the Charles County Fair. Preliminary tests show that the pigs are infected with influenza A, but it is not yet known if this strain is potentially transmissible to humans. Additional testing and investigation is underway by the Department of Agriculture.

It is rare for influenza viruses that normally infect pigs – often called “swine flu” – to spread to people, but it is possible. Most commonly, human infections with swine flu occur in people who have been exposed to infected pigs (e.g., children handling pigs at agricultural fairs or workers in the swine industry). Limited human-to-human spread of swine flu has been detected previously, but no sustained or community spread has been identified. There have been 421 human cases of swine flu in the United States since 2005. Twenty cases have occurred in 2017, all in states other than Maryland.

The symptoms of swine flu in humans are similar to non-swine influenza and can include fever, cough and sore throat. Prescription influenza antiviral drugs can treat swine flu infections in people, especially when started early. Health officials recommend that people with influenza-like illness contact their healthcare provider and inform them if they have had pig contact within the past seven days. Providers are advised to contact their local health departments if they suspect swine flu in their patients to coordinate appropriate testing with their local health department. The Charles County Health Department can be reached at 301-609-6025 and the St. Mary’s County Health Department can be reached at 301-475-4330.

All swine at the Charles County fairgrounds are under a quarantine order from the Department of  Agriculture and will not be released until seven days after the last pig shows signs of influenza illness. Swine exhibits at the upcoming St. Mary’s County and Calvert County fairs have been cancelled by order of the Secretary of Agriculture. To report sick pigs, or if you have questions about pigs and influenza, please call the Department of Agriculture at 410-841-5810 or after hours at 410-841-5971.

Tips to protect yourself and others from the flu
The flu vaccine protects against many types of influenza. The Centers for Disease Control (CDC) recommends that all people over age 6 months get the flu vaccine every year. Other important steps people can take to protect themselves and others from all types of influenza include: 
• Avoiding close contact with sick people;
• Limiting contact with others as much as possible if you are sick to keep from infecting them and stay home for at least 24 hours after your fever is gone, except to get medical care or for other necessities;
• Covering your nose and mouth with a tissue when you cough or sneeze and dispose of the tissue immediately after use;
• Washing your hands often with soap and water or alcohol-based hand rub if soap and water are not available;
• Avoiding touching your eyes, nose and mouth; and
• Cleaning and disinfecting surfaces and objects that may be contaminated with germs like the flu.

People who are at high risk of serious flu complications, including children younger than 5 years, people 65 years and older, pregnant women, and people with certain long-term health conditions (like asthma and other lung disease, diabetes, heart disease, weakened immune systems, and neurological or neurodevelopmental conditions) should avoid pigs and swine barns. Other people who may have exposure to pigs, such as through an agricultural fair, should take the following protective measures:
• Do not eat, drink or put anything in your mouth in pig areas;
• Do not take toys, pacifiers, cups, baby bottles, strollers, or similar items into pig areas;
• Avoid close contact with pigs that look or act ill;
• Wear personal protective equipment if you are required to have contact with a pig that is known or suspected to be sick;
• Wash your hands often with soap and running water or alcohol-based hand rub before and after Exposure to pigs;
• Minimize contact with pigs in the pig barn and arenas;
• If you have a pig, watch it for signs of illness and call a veterinarian if you suspect illness; and
• Avoid contact with pigs if you have flu symptoms.

Additional Resources:
1. Health overview of flu facts, the Maryland 2016-2017 Influenza Plan, and other flu-related resources: https://phpa.health.maryland.gov/OIDEOR/IMMUN/Pages/influenza.aspx
2. USDA APHIS swine disease information: https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/animal-disease-information/swine-disease-information
3. CDC information about swine flu, including key facts and details on past cases: https://www.cdc.gov/flu/swineflu/index.htm.
4. CDC guidance for people attending agricultural fairs or other settings where swine might be present: http://www.cdc.gov/flu/swineflu/variant/preventspreadfactsheet.htm.
5. CDC information about influenza, including prevention recommendations, surveillance data, and other facts: https://www.cdc.gov/flu/index.htm.
6. World Animal Health Organization (OIE) information: http://www.oie.int/fileadmin/Home/eng/Media_Center/docs/pdf/Disease_cards/SI-EN.pdf
7. Maryland Secretary of Agriculture Order to Prevent the Spread of Swine Influenza: http://mda.maryland.gov/AnimalHealth/Documents/2017SwineFluOrder.pdf