Avian influenza A(H7N9) and (H5N1) infections among poultry and swine workers and the general population in Beijing, China, 2013–2015

Yang, Peng; Ma, Caiyun; Cui, Shujuan; Zhang, Daitao; Shi, Weixian; Pan, Yang; Sun, Yingxian; Lu, Guilan; Peng, Xiaomin; Zhao, Jiachen; Liu, Yimeng; Wang, Quanyi

doi:10.1038/srep33877

Cited by 16 publications

(8 citation statements)

References 27 publications

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“…Although most of those exposures may correspond to LPM visits, other opportunities for contact with poultry along the production and value chain also exist. For example, poultry workers in Beijing were shown to be at a higher risk for H7N9 infection than the remaining population of the city ( 24 ). Poultry may become a reservoir when the circulation of avian influenza viruses through the production and value chains cannot be prevented; poultry-related variables were found to be key predictors of H7N9 risk in several previously published studies ( 20 , 23 , 25 , 26 ).…”

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confidence: 99%

Changing Geographic Patterns and Risk Factors for Avian Influenza A(H7N9) Infections in Humans, China

Artois¹,

Jiang²,

Wang³

et al. 2018

Emerg. Infect. Dis.

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The fifth epidemic wave of avian influenza A(H7N9) virus in China during 2016–2017 demonstrated a geographic range expansion and caused more human cases than any previous wave. The factors that may explain the recent range expansion and surge in incidence remain unknown. We investigated the effect of anthropogenic, poultry, and wetland variables on all epidemic waves. Poultry predictor variables became much more important in the last 2 epidemic waves than they were previously, supporting the assumption of much wider H7N9 transmission in the chicken reservoir. We show that the future range expansion of H7N9 to northern China may increase the risk of H7N9 epidemic peaks coinciding in time and space with those of seasonal influenza, leading to a higher risk of reassortments than before, although the risk is still low so far.

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confidence: 99%

Changing Geographic Patterns and Risk Factors for Avian Influenza A(H7N9) Infections in Humans, China

Artois¹,

Jiang²,

Wang³

et al. 2018

Emerg. Infect. Dis.

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“…In that study, the absence of confirmed infections or severe illnesses in poultry workers with serological evidence of recent infection is also consistent with most infections being mild. A study in Beijing estimated very low risks of H7N9 in poultry workers in Beijing, and did not identify any infections in 1300 person-years of exposure among the general population from 2013 to 2015 [15]. …”

Section: Discussionmentioning

confidence: 99%

Population seroprevalence of antibody to influenza A(H7N9) virus, Guangzhou, China

et al. 2016

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BackgroundSince the identification in early 2013 of severe disease caused by influenza A(H7N9) virus infection, there have been few attempts to characterize the full severity profile of human infections. Our objective was to estimate the number and severity of H7N9 infections in Guangzhou, using a serological study.MethodsWe collected residual sera from patients of all ages admitted to a hospital in the city of Guangzhou in southern China in 2013 and 2014. We screened the sera using a haemagglutination inhibition assay against a pseudovirus containing the H7 and N9 of A/Anhui/1/2013(H7N9), and samples with a screening titer ≥10 were further tested by standard hemagglutination-inhibition and virus neutralization assays for influenza A(H7N9). We used a statistical model to interpret the information on antibody titers in the residual sera, assuming that the residual sera provided a representative picture of A(H7N9) infections in the general population, accounting for potential cross-reactions.ResultsWe collected a total of 5360 residual sera from December 2013 to April 2014 and from October 2014 to December 2014, and found two specimens that tested positive for H7N9 antibody at haemagglutination inhibition titer ≥40 and a neutralization titer ≥40. Based on this, we estimated that 64,000 (95 % credibility interval: 7300, 190,000) human infections with influenza A(H7N9) virus occurred in Guangzhou in early 2014, with an infection-fatality risk of 3.6 deaths (95 % credibility interval: 0.47, 15) per 10,000 infections.ConclusionsOur study suggested that the number of influenza A(H7N9) virus infections in Guangzhou substantially exceeded the number of laboratory-confirmed cases there, albeit with considerable imprecision. Our study was limited by the small number of positive specimens identified, and larger serologic studies would be valuable. Our analytic framework would be useful if larger serologic studies are done.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1983-3) contains supplementary material, which is available to authorized users.

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“…The incidence density rate for H9N2 viral infections (from 2013 to 2015, 3.08 per 1000 person‐months) among all the study participants was found to be higher than those for H7N9 (0.4 per 1000 person‐months) and H5N1 (1.3 per 1000 person‐months) infections observed in the same period with the same population (HI assay; HI cutoff titer, 80). Another study conducted in Guangdong Province, China, also revealed that the seroprevalence of anti‐H9N2 antibodies (6.79%) was higher than for H7N9 (3.95%), H5N1 (1.36%), and even avian‐like canine H3N2 (1.85%) (HI assay; HI cutoff titer, 40).…”

Section: Discussionmentioning

confidence: 66%

Avian influenza A (H9N2) virus infections among poultry workers, swine workers, and the general population in Beijing, China, 2013‐2016: A serological cohort study

Cui

Sun

et al. 2019

Influenza Resp Viruses

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Background Few studies have reported on the seroprevalence of antibodies against avian influenza A (H9N2) virus and the incidence of these infections in the northern China and among swine workers. Methods We conducted a serological cohort study among people working with poultry or swine or the general population in Beijing, China. It comprised four cross‐sectional serological surveys in November 2013, April 2014, April 2015, and April 2016. Blood samples collected from the participants were tested for anti‐H9N2 antibodies using a hemagglutination‐inhibition (HI) assay. Multivariable Poisson regression model was then used to compare the person‐month incidence rates for H9N2 viral infections among the three groups, assessed by incidence rate ratio (IRR). Results In the four cross‐sectional surveys, the highest seroprevalence of anti‐H9N2 antibodies (HI titer ≥ 80) was recorded in the poultry workers (2.77%, 19/685) in April 2016, while the lowest was recorded in the general population (0.09%, 1/1135) in April 2015. The highest incidence density rate for H9N2 infections across the whole study period was recorded among the poultry workers (3.75/1000 person‐months), followed by the swine workers (1.94/1000 person‐months) and the general population (1.78/1000 person‐months). Multivariable analysis showed that the poultry workers were at higher risk (IRR: 2.42, 95% CI: 1.07‐5.48; P = 0.034) of contracting H9N2 virus than the general population. Conclusions Although the seroprevalence of H9N2 antibodies was low in Beijing, the poultry workers were at higher risk of contracting H9N2 viral infections than the general population. Closer monitoring and strengthened protection measures for poultry workers are warranted.

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Avian influenza A(H7N9) and (H5N1) infections among poultry and swine workers and the general population in Beijing, China, 2013–2015

Cited by 16 publications

References 27 publications

Changing Geographic Patterns and Risk Factors for Avian Influenza A(H7N9) Infections in Humans, China

Changing Geographic Patterns and Risk Factors for Avian Influenza A(H7N9) Infections in Humans, China

Population seroprevalence of antibody to influenza A(H7N9) virus, Guangzhou, China

Avian influenza A (H9N2) virus infections among poultry workers, swine workers, and the general population in Beijing, China, 2013‐2016: A serological cohort study

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