title: Dual infection of novel influenza viruses A/H1N1 and A/H3N2 in a cluster of Cambodian patients.
abstract: During the early months of 2009, a novel influenza A/H1N1 virus (pH1N1) emerged in Mexico and quickly spread across the globe. In October 2009, a 23-year-old male residing in central Cambodia was diagnosed with pH1N1. Subsequently, a cluster of four influenza-like illness cases developed involving three children who resided in his home and the children's school teacher. Base composition analysis of internal genes using reverse transcriptase polymerase chain reaction and electrospray ionization mass spectrometry revealed that specimens from two of the secondary victims were coinfected with influenza A/H3N2 and pH1N1. Phylogenetic analysis of the hemagglutinin genes from these isolated viruses showed that they were closely related to existing pH1N1 and A/H3N2 viruses circulating in the region. Genetic recombination was not evident within plaque-purified viral isolates on full genome sequencing. This incident confirms dual influenza virus infections and highlights the risk of zoonotic and seasonal influenza viruses to coinfect and possibly, reassort where they cocirculate.
authors: Naval Health Research Center, San Diego, California, USA. Chris.Myers2@med.navy.mil
authors: Christopher A
authors: CA
authors: Myers
authors: Matthew R
authors: MR
authors: Kasper
authors: Chadwick Y
authors: CY
authors: Yasuda
authors: Chin
authors: C
authors: Savuth
authors: David J
authors: DJ
authors: Spiro
authors: Rebecca
authors: R
authors: Halpin
authors: Dennis J
authors: DJ
authors: Faix
authors: Robert
authors: R
authors: Coon
authors: Shannon D
authors: SD
authors: Putnam
authors: Thomas F
authors: TF
authors: Wierzba
authors: Patrick J
authors: PJ
authors: Blair
mesh_terms: D000293:Adolescent; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D016000:Cluster Analysis; D004196:Disease Outbreaks; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D053122:Influenza A Virus, H3N2 Subtype; D007251:Influenza, Human / Q000453:epidemiology* / Q000821:virology*; D008297:Male; D055815:Young Adult