Swine influenza virus infections. Transmission from ill pigs to humans at a Wisconsin agricultural fair and subsequent probable person-to-person transmission.

In September 1988, a previously healthy 32-year-old pregnant woman was hospitalized for pneumonia and died 8 days later. The only pathogen detected was an influenza virus antigenically related to the swine influenza virus (SIV). Four days before illness onset, the patient visited a county fair swine exhibition where there was widespread influenzalike illness among the swine. To detect other persons who were possibly infected by contact with the ill swine, we measured serum SIV hemagglutination-inhibition antibody titer in 25 swine exhibitors who were 9 to 19 years old. Nineteen (76%) had SIV hemagglutination-inhibition titers of 20 or greater. Antibody was undetectable in serum samples from 25 swine exhibitors from a neighboring county. Additional studies suggest that one to three health care personnel who had contact with the patient developed influenzalike illnesses with laboratory evidence of SIV infection. An outbreak of apparent SIV infection in swine resulted in multiple human infections, and, although no recognized community outbreak resulted, there was evidence of virus transmission from the patient to health care personnel.