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Ahead of Print -Swine Influenza A(H3N2) Virus Infection in Immunocompromised Man, Italy, 2014 - Volume 21, Number 7—July 2015 - Emerging Infectious Disease journal - CDC


Ahead of Print -Swine Influenza A(H3N2) Virus Infection in Immunocompromised Man, Italy, 2014 - Volume 21, Number 7—July 2015 - Emerging Infectious Disease journal - CDC

CDC. Centers for Disease Control and Prevention. CDC 24/7: Saving Lives. Protecting People.

Volume 21, Number 7—July 2015


Swine Influenza A(H3N2) Virus Infection in Immunocompromised Man, Italy, 2014

Technical Appendicies


Antonio Piralla, Ana Moreno, Maria Ester Orlandi, Elena Percivalle, Chiara Chiapponi, Fausto Vezzoli, Fausto BaldantiComments to Author , and the Influenza Surveillance Study Group
Author affiliations: Fondazione Istituto Di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy (A. Piralla, M.E. Orlandi, E. Percivalle, F. Baldanti)Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Brescia, Italy (A. Moreno)Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Parma, Italy (C. Chiapponi)Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Lodi, Italy (F. Vezzoli)


Because swine influenza virus infection is seldom diagnosed in humans, its frequency might be underestimated. We report a immunocompromised hematologic patient with swine influenza A(H3N2) virus in 2014 in Italy. Local pigs were the source of this human infection.
Pigs are considered the “mixing vessel” in which avian, human, and swine influenza genetic material can be exchanged and result in new influenza viruses (1). Zoonotic influenza A infections in humans caused by swine influenza viruses (SIVs) have been infrequently reported in Europe (1,2), even though at least 19% of occupationally exposed humans, such as pig farmers, slaughterers, and veterinarians, have SIV antibodies (3). However, because the infection is clinically mild in most cases, its frequency might be underdiagnosed in humans (4).
Three influenza A subtypes (H1N1, H1N2, and H3N2) circulate in swine herds in Italy (1). We report a European swine A(H3N2) influenza virus that occurred in an immunocompromised man in Italy in 2014.
Dr. Piralla is a clinical virologist at the Molecular Virology Unit of the Fondazione IRCCS Policlinico San Matteo in Pavia, Italy. His main research interests include molecular epidemiology of respiratory viruses, the study of virus evolution and interaction with the host, and design of next-generation sequencing protocols to study virus evolution and new pathogen discovery.


Additional members of the Influenza Study Group who contributed data: Alessia Griello, Marta Premoli, Franscesca Rovida, Bianca Mariani (SS Virologia Molecolare, SC Microbiologia e Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy); Francesca Manola Adella (Dipartimento di Virologia, Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Brescia, Italy); Anna Maria Belloni (Azienda Sanitaria Locale); Maria Gramegna, Liliana Coppola, Alessandra Piatti, Laura Gemma Brenzoni (DG Sanità, Regione Lombardia, Milan, Italy); Mario Luini (Organizzazione Mondiale per la Salute degli Animali, Laboratorio di riferimento per l’Influenza Suina, Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Parma, Italy); Emanuela Foni and Laura Baioni (Istituto Zooprofilattico Sperimentale della Lombardia ed Emilia Romagna, Parma, Italy)
We thank the Direzione Generale Sanità, Regione Lombardia; the physicians and veterinarians of the Azienda Sanitaria Locale involved in case management; and all the collaborators in the case definition. We thank Daniela Sartori for manuscript editing and Laurene Kelly for English revision.
This study was supported by grants from the Ministero della Salute, Fondazione IRCCS Policlinico San Matteo, Ricerca Corrente (grant no. 80622), Progetto Cariplo 2011-0517, Milan, Italy, and by a grant from the Ministero della Salute, IZSLER PRC2012002.


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Technical Appendix

Suggested citation for this article: Piralla A, Moreno A, Orlandi ME, Percivalle E, Chiapponi C, Vezzoli F, et al. Swine influenza A(H3N2) virus infection in immunocompromised man, Italy, 2014. Emerg Infect Dis. 2015 Jul [date cited].
DOI: 10.3201/eid2107.140981
1Members of the Influenza Surveillance Study Group who contributed data are listed at the end of this article.

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