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Zhang Z, Lei Z. The Alarming Situation of Highly Pathogenic Avian Influenza Viruses in 2019-2023. Glob Med Genet 2024; 11:200-213. [PMID: 38947761 PMCID: PMC11213626 DOI: 10.1055/s-0044-1788039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Avian influenza viruses (AIVs) have the potential to cause severe illness in wild birds, domestic poultry, and humans. The ongoing circulation of highly pathogenic avian influenza viruses (HPAIVs) has presented significant challenges to global poultry industry and public health in recent years. This study aimed to elucidate the circulation of HPAIVs during 2019 to 2023. Specifically, we assess the alarming global spread and continuous evolution of HPAIVs. Moreover, we discuss their transmission and prevention strategies to provide valuable references for future prevention and control measures against AIVs.
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Affiliation(s)
- Zhiwei Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian Province, People's Republic of China
- Department of Industrial & Systems Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Zhao Lei
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian Province, People's Republic of China
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Ma Y, Zhao Y, Ma Y. Kernel Bayesian nonlinear matrix factorization based on variational inference for human-virus protein-protein interaction prediction. Sci Rep 2024; 14:5693. [PMID: 38454139 PMCID: PMC10920681 DOI: 10.1038/s41598-024-56208-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 03/04/2024] [Indexed: 03/09/2024] Open
Abstract
Identification of potential human-virus protein-protein interactions (PPIs) contributes to the understanding of the mechanisms of viral infection and to the development of antiviral drugs. Existing computational models often have more hyperparameters that need to be adjusted manually, which limits their computational efficiency and generalization ability. Based on this, this study proposes a kernel Bayesian logistic matrix decomposition model with automatic rank determination, VKBNMF, for the prediction of human-virus PPIs. VKBNMF introduces auxiliary information into the logistic matrix decomposition and sets the prior probabilities of the latent variables to build a Bayesian framework for automatic parameter search. In addition, we construct the variational inference framework of VKBNMF to ensure the solution efficiency. The experimental results show that for the scenarios of paired PPIs, VKBNMF achieves an average AUPR of 0.9101, 0.9316, 0.8727, and 0.9517 on the four benchmark datasets, respectively, and for the scenarios of new human (viral) proteins, VKBNMF still achieves a higher hit rate. The case study also further demonstrated that VKBNMF can be used as an effective tool for the prediction of human-virus PPIs.
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Affiliation(s)
- Yingjun Ma
- School of Mathematics and Statistics, Xiamen University of Technology, Xiamen, China
| | - Yongbiao Zhao
- School of Computer, Central China Normal University, Wuhan, China
| | - Yuanyuan Ma
- School of Computer Engineering, Hubei University of Arts and Science, Xiangyang, China.
- Hubei Key Laboratory of Power System Design and Test for Electrical Vehicle, Hubei University of Arts and Science, Xiangyang, China.
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Chen X, Wang W, Wang Y, Lai S, Yang J, Cowling BJ, Horby PW, Uyeki TM, Yu H. Serological evidence of human infections with highly pathogenic avian influenza A(H5N1) virus: a systematic review and meta-analysis. BMC Med 2020; 18:377. [PMID: 33261599 PMCID: PMC7709391 DOI: 10.1186/s12916-020-01836-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/02/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Highly pathogenic avian influenza A(H5N1) virus poses a global public health threat given severe and fatal zoonotic infections since 1997 and ongoing A(H5N1) virus circulation among poultry in several countries. A comprehensive assessment of the seroprevalence of A(H5N1) virus antibodies remains a gap and limits understanding of the true risk of A(H5N1) virus infection. METHODS We conducted a systematic review and meta-analysis of published serosurveys to assess the risk of subclinical and clinically mild A(H5N1) virus infections. We assessed A(H5N1) virus antibody titers and changes in titers among populations with variable exposures to different A(H5N1) viruses. RESULTS Across studies using the World Health Organization-recommended seropositive definition, the point estimates of the seroprevalence of A(H5N1) virus-specific antibodies were higher in poultry-exposed populations (range 0-0.6%) and persons exposed to both human A(H5N1) cases and infected birds (range 0.4-1.8%) than in close contacts of A(H5N1) cases or the general population (none to very low frequencies). Seroprevalence was higher in persons exposed to A(H5N1) clade 0 virus (1.9%, range 0.7-3.2%) than in participants exposed to other clades of A(H5N1) virus (range 0-0.5%) (p < 0.05). Seroprevalence was higher in poultry-exposed populations (range 0-1.9%) if such studies utilized antigenically similar A(H5N1) virus antigens in assays to A(H5N1) viruses circulating among poultry. CONCLUSIONS These low seroprevalences suggest that subclinical and clinically mild human A(H5N1) virus infections are uncommon. Standardized serological survey and laboratory methods are needed to fully understand the extent and risk of human A(H5N1) virus infections.
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Affiliation(s)
- Xinhua Chen
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China
| | - Wei Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China
| | - Yan Wang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China
| | - Shengjie Lai
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China
- WorldPop, School of Geography and Environmental Science, University of Southampton, Southampton, SO17 1BJ, UK
| | - Juan Yang
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Peter W Horby
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, USA
| | - Hongjie Yu
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China.
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Evidence of exposure and human seroconversion during an outbreak of avian influenza A(H5N1) among poultry in Cameroon. Emerg Microbes Infect 2019; 8:186-196. [PMID: 30866772 PMCID: PMC6455145 DOI: 10.1080/22221751.2018.1564631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
From May 2016 to March 2017, 22 poultry outbreaks of avian influenza A(H5N1) were reported in Cameroon, mainly in poultry farms and live bird markets. No human cases were reported. In this study, we sought to describe the 2016 A(H5N1) outbreak strain and to investigate the risk of infection in exposed individuals. We find that highly pathogenic influenza subtype A(H5N1), clade 2.3.2.1c from Cameroon is closely related phylogenetically and antigenically to strains isolated in central and western Africa at the time. No molecular markers of increased human transmissibility were noted; however, seroconversion was detected in two poultry workers (1.5% of total screened). Therefore, the continued outbreaks of avian influenza in poultry and the risk of zoonotic human infection highlight the crucial need for continued and vigilant influenza surveillance and research in Africa, especially in areas of high poultry trade, such as Cameroon.
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Ryu S, Kim CK, Kim K, Woo SH, Chun BC. Serosurveillance of avian influenza A/H5N6 virus infection in poultry farmers, Gyeonggi Province, Republic of Korea, 2016-2017. Int J Infect Dis 2018; 75:49-51. [PMID: 30096358 DOI: 10.1016/j.ijid.2018.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 08/01/2018] [Accepted: 08/01/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Between November 20, 2016 and April 17, 2017, outbreaks of highly pathogenic avian influenza (HPAI) A/H5N6 occurred on poultry farms in Gyeonggi Province in the Republic of Korea. A serosurvey was conducted among poultry farmers to identify the transmission of HPAI A/H5N6 virus to humans. METHODS A descriptive study of 870 poultry farmers in Gyeonggi Province in Korea was conducted during the 2016-2017 outbreaks. Serological testing was performed using a microneutralization (MN) assay for antibodies against influenza A/duck/ES2/Korea/2016 virus, which has antigenic properties similar to those of the HPAI A/H5N6 virus that caused this poultry outbreak. RESULTS Overall, 523 exposed poultry farmers were assessed by serological testing. Consequently, all tested negative for HPAI A/H5N6 virus via MN assay. CONCLUSIONS Based on serological assays, no transmission of HPAI A/H5N6 to humans was identified in this study cohort. Additional studies should be conducted to determine the possibility of poultry-to-human transmission of HPAI A/H5N6.
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Affiliation(s)
- Sukhyun Ryu
- Division of Infectious Disease Control, Gyeonggi Provincial Government, Suwon, Republic of Korea; Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, Republic of Korea.
| | - Chi-Kyeong Kim
- Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
| | - Kisoon Kim
- Division of Viral Diseases Research, Center for Infectious Diseases Research, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
| | - Sang Hee Woo
- Division of Viral Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
| | - Byung Chul Chun
- Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, Republic of Korea; Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
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Carnero AM, Kitayama K, Diaz DA, Garvich M, Angulo N, Cama VA, Gilman RH, Bayer AM. Risk for interspecies transmission of zoonotic pathogens during poultry processing and pork production in Peru: A qualitative study. Zoonoses Public Health 2018; 65:528-539. [PMID: 29602269 DOI: 10.1111/zph.12463] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Indexed: 12/14/2022]
Abstract
Interspecies transmission of pathogens is an unfrequent but naturally occurring event and human activities may favour opportunities not previously reported. Reassortment of zoonotic pathogens like influenza A virus can result from these activities. Recently, swine and birds have played a central role as "mixing vessels" for epidemic and pandemic events related to strains like H1N1 and H5N1. Unsafe practices in poultry markets and swine farms can lead to interspecies transmission, favouring the emergence of novel strains. Thus, understanding practices that lead to interspecies interactions is crucial. This qualitative study aimed to evaluate poultry processing practices in formal and informal markets and the use of leftovers by swine farmers in three Peruvian cities: Lima (capital), Tumbes (coastal) and Tarapoto (jungle). We conducted 80 direct observations at formal and informal markets and interviewed 15 swine farmers. Processors slaughter and pluck chickens and vendors and/or processors eviscerate chickens. Food safety and hygiene practices were suboptimal or absent, although some heterogeneity was observed between cities and chicken vendors versus processors. Both vendors (76%) and processors (100%) sold the chicken viscera leftovers to swine farmers, representing the main source of chicken viscera for swine farms (53%). Swine farmers fed the chicken viscera to their swine. Chicken viscera cooking times varied widely and were insufficient in some cases. Non-abattoired poultry leads to the sale of poultry leftovers to small-scale swine farms, resulting in indirect but frequent interspecies contacts that can lead to interspecies transmission of bacterial pathogens or the reassortment of influenza A viruses. These interactions are exacerbated by suboptimal safety and hygiene conditions. People involved in these activities constitute an at-risk population who could play a central role in preventing the transmission of pathogens between species. Educational interventions on hygiene and food safety practices will be important for reducing the risk of interspecies influenza transmission.
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Affiliation(s)
- A M Carnero
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - K Kitayama
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - D A Diaz
- Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura (AB PRISMA), Lima, Peru
| | - M Garvich
- Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura (AB PRISMA), Lima, Peru
| | - N Angulo
- Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura (AB PRISMA), Lima, Peru
| | - V A Cama
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - R H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A M Bayer
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Evaluating interest in an influenza A(H5N1) vaccine among laboratory workers who work with highly-pathogenic avian influenza viruses in the United States. Vaccine 2018; 36:306-312. [PMID: 29199043 PMCID: PMC5759037 DOI: 10.1016/j.vaccine.2017.10.104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 09/20/2017] [Accepted: 10/31/2017] [Indexed: 11/23/2022]
Abstract
Highly pathogenic avian influenza viruses pose an occupational risk to laboratorians. The majority of survey respondents were interested in the Q-Pan H5N1 vaccine. Interest in vaccination varied by role in the laboratory and time spent with HPAI viruses. Q-Pan H5N1 vaccine could be used in tandem with current biosafety practices for HPAI laboratorians.
Background Highly pathogenic avian influenza A (HPAI) viruses found in poultry and wild birds occasionally infect humans and can cause serious disease. In 2014, the Advisory Committee on Immunization Practices (ACIP) reviewed data from one licensed ASO3-adjuvanted influenza A(H5N1) vaccine for consideration of use during inter-pandemic periods among persons with occupational exposure. To guide vaccine policy decisions, we conducted a survey of laboratory workers to assess demand for HPAI vaccination. Methods We designed an anonymous web survey (EpiInfo 7.0) to collect information on demographics, type of work and time spent with HPAI viruses, and interest in HPAI vaccination. Eligible participants were identified from 42 entities registered with United States Department of Agriculture’s Agricultural Select Agent program in 2016 and emailed electronic surveys. Personnel with Biosafety Level 3 enhanced (BSL-3E) laboratory access were surveyed. Descriptive analysis was performed. Results Overall, 131 responses were received from 33 principal investigators, 26 research scientists, 24 technicians, 15 postdoctoral fellows, 6 students, and 27 others. The estimated response rate was 15% among the laboratory personnel of responding principal investigators. One hundred respondents reported working in a BSL-3E area where HPAI experiments occurred with a mean time of 5.1–11.7 h per week. Overall, 49% were interested in receiving an A(H5N1) vaccine. By role, interest was highest among students (80%) and among those who spent >50% of their time in a BSL-3E area (64%). Most (61%) of those who said they might be or were not interested in vaccine believed it would not provide additional protection to current safety practices. Conclusions Half of responding laboratory workers was interested in receiving an influenza A(H5N1) vaccine. HPAI vaccination of laboratory workers at risk of occupational exposure could be used along with existing safety practices to protect this population.
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Agunos A, Pierson FW, Lungu B, Dunn PA, Tablante N. Review of Nonfoodborne Zoonotic and Potentially Zoonotic Poultry Diseases. Avian Dis 2017; 60:553-75. [PMID: 27610715 DOI: 10.1637/11413-032416-review.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Emerging and re-emerging diseases are continuously diagnosed in poultry species. A few of these diseases are known to cross the species barrier, thus posing a public health risk and an economic burden. We identified and synthesized global evidence for poultry nonfoodborne zoonoses to better understand these diseases in people who were exposed to different poultry-related characteristics (e.g., occupational or nonoccupational, operational types, poultry species, outbreak conditions, health status of flocks). This review builds on current knowledge on poultry zoonoses/potentially zoonotic agents transmitted via the nonfoodborne route. It also identifies research gaps and potential intervention points within the poultry industry to reduce zoonotic transmission by using various knowledge synthesis tools such as systematic review (SR) and qualitative (descriptive) and quantitative synthesis methods (i.e., meta-analysis). Overall, 1663 abstracts were screened and 156 relevant articles were selected for further review. Full articles (in English) were retrieved and critically appraised using routine SR methods. In total, eight known zoonotic diseases were reviewed: avian influenza (AI) virus (n = 85 articles), Newcastle disease virus (n = 8), West Nile virus (WNV, n = 2), avian Chlamydia (n = 24), Erysipelothrix rhusiopathiae (n = 3), methicillin-resistant Staphylococcus aureus (MRSA, n = 15), Ornithonyssus sylvarium (n = 4), and Microsporum gallinae (n = 3). In addition, articles on other viral poultry pathogens (n = 5) and poultry respiratory allergens derived from mites and fungi (n = 7) were reviewed. The level of investigations (e.g., exposure history, risk factor, clinical disease in epidemiologically linked poultry, molecular studies) to establish zoonotic linkages varied across disease agents and across studies. Based on the multiple outcome measures captured in this review, AI virus seems to be the poultry zoonotic pathogen that may have considerable and significant public health consequences; however, epidemiologic reports have only documented severe human cases clustered in Asia and not in North America. In contrast, avian Chlamydia and MRSA reports clustered mainly in Europe and less so in North America and other regions. Knowledge gaps in other zoonoses or other agents were identified, including potential direct (i.e., nonmosquito-borne) transmission of WNV from flocks to poultry workers, the public health and clinical significance of poultry-derived (livestock-associated) MRSA, the zoonotic significance of other viruses, and the role of poultry allergens in the pathophysiology of respiratory diseases of poultry workers. Across all pathogens reviewed, the use of personal protective equipment was commonly cited as the most important preventive measure to reduce the zoonotic spread of these diseases and the use of biosecurity measures to reduce horizontal transmission in flock populations. The studies also emphasized the need for flock monitoring and an integrated approach to prevention (i.e., veterinary-public health coordination with regard to diagnosis, and knowledge translation and education in the general population) to reduce zoonotic transmission.
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Affiliation(s)
- Agnes Agunos
- A Public Health Agency of Canada, Guelph, Ontario, Canada N1G5B2
| | - F William Pierson
- B Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061
| | - Bwalya Lungu
- C Department of Food Science and Technology, University of California, Davis, CA 95616
| | - Patricia A Dunn
- D Animal Diagnostic Laboratory (PADLS-PSU), Pennsylvania State University, University Park, PA 16802
| | - Nathaniel Tablante
- E Virginia-Maryland College of Veterinary Medicine, University of Maryland, College Park, MD 20740
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Ge Y, Yao QC, Wang XF, Fan ZQ, Deng GH, Chai HL, Chen HL, Hua YP. Epidemic of wild-origin H1NX avian influenza viruses in Anhui, China. Infect Dis Poverty 2017; 6:98. [PMID: 28669354 PMCID: PMC5494855 DOI: 10.1186/s40249-017-0304-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 04/13/2017] [Indexed: 01/21/2023] Open
Abstract
Background As the natural hosts of avian influenza viruses (AIVs), aquatic and migratory birds provide a gene pool for genetic transfer among species and across species, forming transient “genome constellations.” This work describes the phylogenetic dynamics of H1NX based on the complete molecular characterization of eight genes of viruses that were collected from 2014 to 2015 in Anhui Province, China. Methods Hemagglutination and hemagglutination inhibition tests were used to determine the hemagglutination (HA) activity of the HA subtypes. The entire genomes of the viruses were sequenced on an ABI PRISM 3500xl DNA Analyzer. The sequences were genetically analysed to study their genetic evolution using DNASTAR and MEGA 6. The pathogenic effects of the viruses were evaluated using mouse infection models. Results Seven strains of the H1 subtype avian influenza virus were isolated. Phylogenetic analysis indicated natural recombination of the H1 influenza viruses between the Eurasian lineage and the North American lineage. Some genes had high sequence identity with A/bean goose/Korea/220/2011(H9N2), which is a typical case involving viral reassortment between the Eurasian lineage and the North American lineage. The results of infection experiments in mice showed that the viruses could acquire the ability to multiply in mouse respiratory organs without adaptation. Conclusions These findings suggest that continued surveillance of wild birds, particularly migratory birds, is important to provide early warning of possible H1 influenza epidemics and to understand the ecology of the virus. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0304-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ye Ge
- College of Wildlife Resources, Northeast Forestry University, Harbin, 150040, Heilongjiang Province, China.,State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Harbin, China
| | - Qiu-Cheng Yao
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Harbin, China
| | - Xian-Fu Wang
- Natural Protection & Management Station of Forestry Department Centre of Anhui Province, Hefei, Anhui Province, China
| | - Zhi-Qiang Fan
- School of Life Sciences, Anqing Normal University, Anqing, Anhui Province, China
| | - Guo-Hua Deng
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Harbin, China.
| | - Hong-Liang Chai
- College of Wildlife Resources, Northeast Forestry University, Harbin, 150040, Heilongjiang Province, China.
| | - Hua-Lan Chen
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Harbin, China
| | - Yu-Ping Hua
- College of Wildlife Resources, Northeast Forestry University, Harbin, 150040, Heilongjiang Province, China.
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Klous G, Huss A, Heederik DJ, Coutinho RA. Human-livestock contacts and their relationship to transmission of zoonotic pathogens, a systematic review of literature. One Health 2016; 2:65-76. [PMID: 28616478 PMCID: PMC5462650 DOI: 10.1016/j.onehlt.2016.03.001] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 02/11/2016] [Accepted: 03/14/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Micro-organisms transmitted from vertebrate animals - including livestock - to humans account for an estimated 60% of human pathogens. Micro-organisms can be transmitted through inhalation, ingestion, via conjunctiva or physical contact. Close contact with animals is crucial for transmission. The role of intensity and type of contact patterns between livestock and humans for disease transmission is poorly understood. In this systematic review we aimed to summarise current knowledge regarding patterns of human-livestock contacts and their role in micro-organism transmission. METHODS We included peer-reviewed publications published between 1996 and 2014 in our systematic review if they reported on human-livestock contacts, human cases of livestock-related zoonotic diseases or serological epidemiology of zoonotic diseases in human samples. We extracted any information pertaining the type and intensity of human-livestock contacts and associated zoonoses. RESULTS 1522 papers were identified, 75 were included: 7 reported on incidental zoonoses after brief animal-human contacts (e.g. farm visits), 10 on environmental exposures and 15 on zoonoses in developing countries where backyard livestock keeping is still customary. 43 studies reported zoonotic risks in different occupations. Occupations at risk included veterinarians, culling personnel, slaughterhouse workers and farmers. For culling personnel, more hours exposed to livestock resulted in more frequent occurrence of transmission. Slaughterhouse workers in contact with live animals were more often positive for zoonotic micro-organisms compared to co-workers only exposed to carcasses. Overall, little information was available about the actual mode of micro-organism transmission. CONCLUSIONS Little is known about the intensity and type of contact patterns between livestock and humans that result in micro-organism transmission. Studies performed in occupational settings provide some, but limited evidence of exposure response-like relationships for livestock-human contact and micro-organism transmission. Better understanding of contact patterns driving micro-organism transmission from animals to humans is needed to provide options for prevention and thus deserves more attention.
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Affiliation(s)
- Gijs Klous
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
- Institute for Risk Assessment Sciences, division Environmental Epidemiology, Utrecht University, The Netherlands
| | - Anke Huss
- Institute for Risk Assessment Sciences, division Environmental Epidemiology, Utrecht University, The Netherlands
| | - Dick J.J. Heederik
- Institute for Risk Assessment Sciences, division Environmental Epidemiology, Utrecht University, The Netherlands
| | - Roel A. Coutinho
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
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Shimizu K, Wulandari L, Poetranto ED, Setyoningrum RA, Yudhawati R, Sholikhah A, Nastri AM, Poetranto AL, Candra AYR, Puruhito EF, Takahara Y, Yamagishi Y, Yamaoka M, Hotta H, Ustumi T, Lusida MI, Soetjipto, Shimizu YK, Soegiarto G, Mori Y. Seroevidence for a High Prevalence of Subclinical Infection With Avian Influenza A(H5N1) Virus Among Workers in a Live-Poultry Market in Indonesia. J Infect Dis 2016; 214:1929-1936. [PMID: 27923953 PMCID: PMC5142092 DOI: 10.1093/infdis/jiw478] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/03/2016] [Indexed: 02/02/2023] Open
Abstract
Background. In Indonesia, highly pathogenic avian influenza A(H5N1) virus has become endemic in poultry and has caused sporadic deadly infections in human. Since 2012, we have conducted fixed-point surveillance of avian influenza viruses at a live-poultry market in East Java, Indonesia. In this study, we examined the seroprevalence of avian influenza A(H5N1) virus infection among market workers. Methods. Sera were collected from 101 workers in early 2014 and examined for antibody activity against avian A(H5N1) Eurasian lineage virus by a hemagglutination-inhibition (HI) assay. Results. By the HI assay, 84% of the sera tested positive for antibody activity against the avian virus. Further analysis revealed that the average HI titer in 2014 was 2.9-fold higher than in 2012 and that seroconversion occurred in 44% of paired sera (11 of 25) between 2012 and 2014. A medical history survey was performed in 2016; responses to questionnaires indicated that none of workers had had severe acute respiratory illness during 2013. Conclusions. This study provides evidence of a high prevalence of avian A(H5N1) virus infection in 2013 among workers at a live-poultry market. However, because no instances of hospitalizations were reported, we can conclude the virus did not manifest any clinical symptoms in workers.
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Affiliation(s)
- Kazufumi Shimizu
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Laksmi Wulandari
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Department of Pulmonology and Respiratory Medicine
| | - Emmanuel D Poetranto
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Department of Clinical Science, Faculty of Veterinary Medicine, Airlangga University, Surabaya, Indonesia
| | - Retno A Setyoningrum
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Department of Pediatrics
| | - Resti Yudhawati
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Department of Pulmonology and Respiratory Medicine
| | - Amelia Sholikhah
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Department of Pediatrics
| | - Aldise M Nastri
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease
| | - Anna L Poetranto
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease
| | - Adithya Y R Candra
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease
| | - Edith F Puruhito
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease
| | - Yusuke Takahara
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Yoshiaki Yamagishi
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Masaoki Yamaoka
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Hak Hotta
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Takako Ustumi
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Maria I Lusida
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease
| | - Soetjipto
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease
| | - Yohko K Shimizu
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
| | - Gatot Soegiarto
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.,Department of Internal Medicine, Faculty of Medicine
| | - Yasuko Mori
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan
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13
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Estimating the sensitivity of passive surveillance for HPAI H5N1 in Bayelsa state, Nigeria. Prev Vet Med 2016; 129:58-66. [DOI: 10.1016/j.prevetmed.2016.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 05/05/2016] [Accepted: 05/06/2016] [Indexed: 11/20/2022]
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14
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Nasreen S, Khan SU, Luby SP, Gurley ES, Abedin J, Zaman RU, Sohel BM, Rahman M, Hancock K, Levine MZ, Veguilla V, Wang D, Holiday C, Gillis E, Sturm-Ramirez K, Bresee JS, Rahman M, Uyeki TM, Katz JM, Azziz-Baumgartner E. Highly pathogenic Avian Influenza A(H5N1) virus infection among workers at live bird markets, Bangladesh, 2009-2010. Emerg Infect Dis 2015; 21:629-37. [PMID: 25811942 PMCID: PMC4378465 DOI: 10.3201/eid2104.141281] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Evidence of infection was low despite frequent exposure to infected poultry and low use of personal protective equipment. The risk for influenza A(H5N1) virus infection is unclear among poultry workers in countries where the virus is endemic. To assess H5N1 seroprevalence and seroconversion among workers at live bird markets (LBMs) in Bangladesh, we followed a cohort of workers from 12 LBMs with existing avian influenza surveillance. Serum samples from workers were tested for H5N1 antibodies at the end of the study or when LBM samples first had H5N1 virus–positive test results. Of 404 workers, 9 (2%) were seropositive at baseline. Of 284 workers who completed the study and were seronegative at baseline, 6 (2%) seroconverted (7 cases/100 poultry worker–years). Workers who frequently fed poultry, cleaned feces from pens, cleaned food/water containers, and did not wash hands after touching sick poultry had a 7.6 times higher risk for infection compared with workers who infrequently performed these behaviors. Despite frequent exposure to H5N1 virus, LBM workers showed evidence of only sporadic infection.
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15
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Chen S, Li Z, Hu M, Guo S, Wu J, Wang B, Hu W, Sun Y, Li H, Liu M, Moore JB, Chen H. Knowledge, Attitudes, and Practices (KAP) Relating to Avian Influenza (H10N8) among Farmers' Markets Workers in Nanchang, China. PLoS One 2015; 10:e0127120. [PMID: 25993111 PMCID: PMC4436285 DOI: 10.1371/journal.pone.0127120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 04/10/2015] [Indexed: 12/02/2022] Open
Abstract
Three cases of avian influenza virus H10N8 were reported in Nanchang, China, as of April 2014. To identify the knowledge, attitudes, and practices (KAP) related to H10N8 among farmers’ market workers, a cross-sectional survey was conducted in 63 farmers’ markets in Nanchang. Using the resulting data, characteristics of poultry and non-poultry workers’ knowledge, attitudes, and practice were described. Results suggest that interventions targeting high-risk workers should be developed and implemented by public health agencies to prevent the spread of H10N8. Additionally policies that encourage farmers’ market workers to receive influenza vaccine should be developed, adopted, and enforced.
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Affiliation(s)
- Shengen Chen
- Nanchang Centre for Disease Control and Prevention, Nanchang, Jiangxi Province, The People’s Republic of China
| | - Zifen Li
- Nanchang Centre for Disease Control and Prevention, Nanchang, Jiangxi Province, The People’s Republic of China
- School of Public Health, Medical College of Nanchang University, Nanchang, Jiangxi Province, The People’s Republic of China
| | - Maohong Hu
- Nanchang Centre for Disease Control and Prevention, Nanchang, Jiangxi Province, The People’s Republic of China
| | - Shuangli Guo
- Nanchang Centre for Disease Control and Prevention, Nanchang, Jiangxi Province, The People’s Republic of China
| | - Jingwen Wu
- Nanchang Centre for Disease Control and Prevention, Nanchang, Jiangxi Province, The People’s Republic of China
| | - Bin Wang
- Nanchang Centre for Disease Control and Prevention, Nanchang, Jiangxi Province, The People’s Republic of China
| | - Wei Hu
- Nanchang Centre for Disease Control and Prevention, Nanchang, Jiangxi Province, The People’s Republic of China
| | - Yanshuang Sun
- Nanchang Centre for Disease Control and Prevention, Nanchang, Jiangxi Province, The People’s Republic of China
| | - Hui Li
- Nanchang Centre for Disease Control and Prevention, Nanchang, Jiangxi Province, The People’s Republic of China
| | - Mingbin Liu
- Nanchang Centre for Disease Control and Prevention, Nanchang, Jiangxi Province, The People’s Republic of China
| | - Justin B. Moore
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Haiying Chen
- Nanchang Centre for Disease Control and Prevention, Nanchang, Jiangxi Province, The People’s Republic of China
- * E-mail:
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16
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Abstract
Each year, influenza causes substantial mortality and morbidity worldwide. It is important to understand influenza in the tropics because of the significant burden in the region and its relevance to global influenza circulation. In this review, influenza burden, transmission dynamics, and their determinants in the tropics are discussed. Environmental, cultural, and social conditions in the tropics are very diverse and often differ from those of temperate regions. Theories that account for and predict influenza dynamics in temperate regions do not fully explain influenza epidemic patterns observed in the tropics. Routine surveillance and household studies have been useful in understanding influenza dynamics in the tropics, but these studies have been limited to only some regions; there is still a lack of information regarding influenza burden and transmission dynamics in many tropical countries. Further studies in the tropics will provide useful insight on many questions that remain.
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Affiliation(s)
- Sophia Ng
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109 USA
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109 USA
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17
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Brown M, Moore L, McMahon B, Powell D, LaBute M, Hyman JM, Rivas A, Jankowski M, Berendzen J, Loeppky J, Manore C, Fair J. Constructing rigorous and broad biosurveillance networks for detecting emerging zoonotic outbreaks. PLoS One 2015; 10:e0124037. [PMID: 25946164 PMCID: PMC4422680 DOI: 10.1371/journal.pone.0124037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 03/10/2015] [Indexed: 11/19/2022] Open
Abstract
Determining optimal surveillance networks for an emerging pathogen is difficult since it is not known beforehand what the characteristics of a pathogen will be or where it will emerge. The resources for surveillance of infectious diseases in animals and wildlife are often limited and mathematical modeling can play a supporting role in examining a wide range of scenarios of pathogen spread. We demonstrate how a hierarchy of mathematical and statistical tools can be used in surveillance planning help guide successful surveillance and mitigation policies for a wide range of zoonotic pathogens. The model forecasts can help clarify the complexities of potential scenarios, and optimize biosurveillance programs for rapidly detecting infectious diseases. Using the highly pathogenic zoonotic H5N1 avian influenza 2006-2007 epidemic in Nigeria as an example, we determined the risk for infection for localized areas in an outbreak and designed biosurveillance stations that are effective for different pathogen strains and a range of possible outbreak locations. We created a general multi-scale, multi-host stochastic SEIR epidemiological network model, with both short and long-range movement, to simulate the spread of an infectious disease through Nigerian human, poultry, backyard duck, and wild bird populations. We chose parameter ranges specific to avian influenza (but not to a particular strain) and used a Latin hypercube sample experimental design to investigate epidemic predictions in a thousand simulations. We ranked the risk of local regions by the number of times they became infected in the ensemble of simulations. These spatial statistics were then complied into a potential risk map of infection. Finally, we validated the results with a known outbreak, using spatial analysis of all the simulation runs to show the progression matched closely with the observed location of the farms infected in the 2006-2007 epidemic.
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Affiliation(s)
- Mac Brown
- University of California-Santa Barbara, Department of Economics, Santa Barbara, California, 93111, United States of America
| | - Leslie Moore
- Statistical Sciences, Los Alamos National Laboratory, Los Alamos, New Mexico, 87545, United States of America
| | - Benjamin McMahon
- Los Alamos National Laboratory, Theoretical Biology and Biophysics, Los Alamos, New Mexico, 87545, United States of America
| | - Dennis Powell
- Energy and Infrastructure Analysis, Los Alamos National Laboratory, Los Alamos, New Mexico, 87545, United States of America
| | - Montiago LaBute
- Lawrence Livermore National Laboratory, Applied Statistics Group—Computational Engineering Division, Mailstop L-174, 7000 East Ave. Livermore, California, 94550, United States of America
| | - James M. Hyman
- Department of Mathematics, Tulane University, New Orleans, Louisiana, 70118, United States of America
| | - Ariel Rivas
- Center for Global Health, Health Sciences Center, University of New Mexico, Albuquerque, New Mexico, 87131, United States of America
| | - Mark Jankowski
- Minnesota Pollution Control Agency, Environmental Analysis & Outcomes Division, St. Paul, Minnesota, 55155, United States of America
| | - Joel Berendzen
- Los Alamos National Laboratory, Applied Modern Physics, Mailstop D454, Los Alamos, New Mexico, 87545, United States of America
| | - Jason Loeppky
- University of British Columbia, Okanagan, 3333 University Way, Kelowna, B.C. V1V 1V7, Canada
| | - Carrie Manore
- Center for Computational Science, Tulane University, New Orleans, Louisiana, 70118, United States of America
| | - Jeanne Fair
- Los Alamos National Laboratory, Environmental Stewardship, K404, Los Alamos, New Mexico, 87545, United States of America
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18
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Reed C, Bruden D, Byrd KK, Veguilla V, Bruce M, Hurlburt D, Wang D, Holiday C, Hancock K, Ortiz JR, Klejka J, Katz JM, Uyeki TM. Characterizing wild bird contact and seropositivity to highly pathogenic avian influenza A (H5N1) virus in Alaskan residents. Influenza Other Respir Viruses 2014; 8:516-23. [PMID: 24828535 PMCID: PMC4181814 DOI: 10.1111/irv.12253] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Highly pathogenic avian influenza A (HPAI) H5N1 viruses have infected poultry and wild birds on three continents with more than 600 reported human cases (59% mortality) since 2003. Wild aquatic birds are the natural reservoir for avian influenza A viruses, and migratory birds have been documented with HPAI H5N1 virus infection. Since 2005, clade 2.2 HPAI H5N1 viruses have spread from Asia to many countries. OBJECTIVES We conducted a cross-sectional seroepidemiological survey in Anchorage and western Alaska to identify possible behaviors associated with migratory bird exposure and measure seropositivity to HPAI H5N1. METHODS We enrolled rural subsistence bird hunters and their families, urban sport hunters, wildlife biologists, and a comparison group without bird contact. We interviewed participants regarding their exposures to wild birds and collected blood to perform serologic testing for antibodies against a clade 2.2 HPAI H5N1 virus strain. RESULTS Hunters and wildlife biologists reported exposures to wild migratory birds that may confer risk of infection with avian influenza A viruses, although none of the 916 participants had evidence of seropositivity to HPAI H5N1. CONCLUSIONS We characterized wild bird contact among Alaskans and behaviors that may influence risk of infection with avian influenza A viruses. Such knowledge can inform surveillance and risk communication surrounding HPAI H5N1 and other influenza viruses in a population with exposure to wild birds at a crossroads of intercontinental migratory flyways.
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Affiliation(s)
- Carrie Reed
- Epidemic Intelligence Service, Centers for Disease Control and PreventionAtlanta, GA, USA
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
| | - Dana Bruden
- Arctic Investigations Program, Centers for Disease Control and PreventionAnchorage, AK, USA
| | - Kathy K Byrd
- Epidemic Intelligence Service, Centers for Disease Control and PreventionAtlanta, GA, USA
- Arctic Investigations Program, Centers for Disease Control and PreventionAnchorage, AK, USA
| | - Vic Veguilla
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
| | - Michael Bruce
- Arctic Investigations Program, Centers for Disease Control and PreventionAnchorage, AK, USA
| | - Debby Hurlburt
- Arctic Investigations Program, Centers for Disease Control and PreventionAnchorage, AK, USA
| | - David Wang
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
| | - Crystal Holiday
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
| | - Kathy Hancock
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
| | - Justin R Ortiz
- Epidemic Intelligence Service, Centers for Disease Control and PreventionAtlanta, GA, USA
- Departments of Medicine and Global Health, University of WashingtonSeattle, WA, USA
| | - Joe Klejka
- Yukon Kuskokwim Health CorporationBethel, AK, USA
| | - Jacqueline M Katz
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
| | - Timothy M Uyeki
- Influenza Division, Centers for Disease Control and PreventionAtlanta, GA, USA
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19
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20
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Nguku P, Oyemakinde A, Sabitu K, Olayinka A, Ajayi I, Fawole O, Babirye R, Gitta S, Mukanga D, Waziri N, Gidado S, Biya O, Gana C, Ajumobi O, Abubakar A, Sani-Gwarzo N, Ngobua S, Oleribe O, Poggensee G, Nsubuga P, Nyager J, Nasidi A. Training and service in public health, Nigeria Field Epidemiology and Laboratory Training, 2008 - 2014. Pan Afr Med J 2014; 18 Suppl 1:2. [PMID: 25328621 PMCID: PMC4199351 DOI: 10.11694/pamj.supp.2014.18.1.4930] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 07/09/2014] [Indexed: 11/06/2022] Open
Abstract
The health workforce is one of the key building blocks for strengthening health systems. There is an alarming shortage of curative and preventive health care workers in developing countries many of which are in Africa. Africa resultantly records appalling health indices as a consequence of endemic and emerging health issues that are exacerbated by a lack of a public health workforce. In low-income countries, efforts to build public health surveillance and response systems have stalled, due in part, to the lack of epidemiologists and well-trained laboratorians. To strengthen public health systems in Africa, especially for disease surveillance and response, a number of countries have adopted a competency-based approach of training - Field Epidemiology and Laboratory Training Program (FELTP). The Nigeria FELTP was established in October 2008 as an inservice training program in field epidemiology, veterinary epidemiology and public health laboratory epidemiology and management. The first cohort of NFELTP residents began their training on 20th October 2008 and completed their training in December 2010. The program was scaled up in 2011 and it admitted 39 residents in its third cohort. The program has admitted residents in six annual cohorts since its inception admitting a total of 207 residents as of 2014 covering all the States. In addition the program has trained 595 health care workers in short courses. Since its inception, the program has responded to 133 suspected outbreaks ranging from environmental related outbreaks, vaccine preventable diseases, water and food borne, zoonoses, (including suspected viral hemorrhagic fevers) as well as neglected tropical diseases. With its emphasis on one health approach of solving public health issues the program has recruited physicians, veterinarians and laboratorians to work jointly on human, animal and environmental health issues. Residents have worked to identify risk factors of disease at the human animal interface for influenza, brucellosis, tick-borne relapsing fever, rabies, leptospirosis and zoonotic helminthic infections. The program has been involved in polio eradication efforts through its National Stop Transmission of Polio (NSTOP). The commencement of NFELTP was a novel approach to building sustainable epidemiological capacity to strengthen public health systems especially surveillance and response systems in Nigeria. Training and capacity building efforts should be tied to specific system strengthening and not viewed as an end to them. The approach of linking training and service provision may be an innovative approach towards addressing the numerous health challenges.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Joseph Nyager
- Federal Ministry of Agriculture and Rural Development, Nigeria
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21
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Van Kerkhove MD. Brief literature review for the WHO global influenza research agenda--highly pathogenic avian influenza H5N1 risk in humans. Influenza Other Respir Viruses 2014; 7 Suppl 2:26-33. [PMID: 24034480 DOI: 10.1111/irv.12077] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Highly pathogenic avian influenza A H5N1 viruses remain a significant health threat to humans given the continued rare occurrence of human cases with a high case fatality rate. This brief literature review summarizes available evidence of risk factors for H5N1 infection in humans and updates a recent systematic review published in early 2011. Several epidemiologic studies have been published to evaluate the risk factors for H5N1 infection in humans, including contact with poultry and poultry products and non-poultry-related contact such as from H5N1-contaminated water. While most H5N1 cases are attributed to exposure to sick poultry, it is unclear how many may be due to human-to-human transmission. The collective results of published literature suggest that transmission risk of H5N1 from poultry to humans may be highest among individuals who may have been in contact with the highest potential concentrations of virus shed by poultry. This suggests that there may be a threshold of virus concentration needed for effective transmission and that circulating H5N1 strains have not yet mutated to transmit readily from either poultry to human or from human to human. However, the mode of potential transmission can be quite varied throughout different countries and by study with exposures ranging from visiting a wet market, preparing infected poultry for consumption, to swimming or bathing in ponds frequented by poultry. Several important data gaps remain in the understanding of the epidemiology of H5N1 in humans and limit our ability to interpret the results of the available H5N1 seroepidemiologic studies.
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Affiliation(s)
- Maria D Van Kerkhove
- MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
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22
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Li LH, Yu Z, Chen WS, Liu SL, Lu Y, Zhang YJ, Chen EF, Lin JF. Evidence for H5 avian influenza infection in Zhejiang province, China, 2010-2012: a cross-sectional study. J Thorac Dis 2014; 5:790-6. [PMID: 24409357 DOI: 10.3978/j.issn.2072-1439.2013.12.45] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 12/25/2013] [Indexed: 11/14/2022]
Abstract
BACKGROUND The first outbreak of H5N1 highly-pathogenic avian influenza (HPAI) virus associated with several human deaths occurred in 1997 in Hong-Kong, China. While H5N1 virus infection in poultry workers has been studied in some detail, little is known about the environmental risk factors of the H5 avian influenza virus infection in China. METHODS A cross-sectional study was performed to evaluate the environmental load of H5 viruses in poultry-contaminated environments and to explore potential risk factors associated with infection in poultry workers between October 2010 and March 2012. Serum and environmental samples were collected in Zhejiang province, China. The hemagglutination inhibition (HI) assay was used to analyze human sera for antibodies against H5N1 virus [A/Hubei/1/2010 (H5N1) and A/Anhui/1/2005 (H5N1)]. All participants were interviewed with a standardized questionnaire to collect information on exposure to poultry. H5 Avian influenza virus in the environmental samples was detected by real time RT-PCR. RESULTS One hundred and five of 3,453 environmental samples (3.0%) tested positive for H5 avian influenza virus. Fifty-five of 1,169 subjects (4.7%) tested seropositive for anti-H5N1 antibodies. A statistically significant difference in H5 virus detection rate was found among the different environments sampled (<0.001), with the highest showed in live bird markets (68.6%). Detection rate varied according to the source of samples, sewage (9.5%), drinking water (19.0%), feces (19.0%), cage surface (25.7%), and slaughtering chopping boards (15.2%), respectively. Direct or close contact with poultry (OR =5.20, 95% CI, 1.53-17.74) and breeding numerous poultry (OR =3.77, 95% CI, 1.72-8.73) were significantly associated with seroprevalence of antibodies to avian influenza virus A (H5N1). CONCLUSIONS The number of birds bred more than 1,000 and direct or close contact with poultry in the workplace or the environment would be a potential risk of H5N1 infection.
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Affiliation(s)
- Lian-Hong Li
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Zhao Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Wen-Sen Chen
- First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - She-Lan Liu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Ye Lu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Yan-Jun Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - En-Fu Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Jun-Fen Lin
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
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23
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Nasreen S, Uddin Khan S, Azziz-Baumgartner E, Hancock K, Veguilla V, Wang D, Rahman M, Alamgir ASM, Sturm-Ramirez K, Gurley ES, Luby SP, Katz JM, Uyeki TM. Seroprevalence of antibodies against highly pathogenic avian influenza A (H5N1) virus among poultry workers in Bangladesh, 2009. PLoS One 2013; 8:e73200. [PMID: 24039887 PMCID: PMC3764173 DOI: 10.1371/journal.pone.0073200] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 07/17/2013] [Indexed: 01/09/2023] Open
Abstract
We conducted a cross-sectional study in 2009 to determine the seroprevalence and risk factors for highly pathogenic avian influenza A (H5N1) [HPAI H5N1] virus antibodies among poultry workers at farms and live bird markets with confirmed/suspected poultry outbreaks during 2009 in Bangladesh. We tested sera by microneutralization assay using A/Bangladesh/207095/2008 (H5N1; clade 2.2.2) virus with confirmation by horse red blood cell hemagglutination inhibition and H5-specific Western blot assays. We enrolled 212 workers from 87 farms and 210 workers from three live bird markets. One hundred and two farm workers (48%) culled poultry. One hundred and ninety-three farm workers (91%) and 178 market workers (85%) reported direct contact with poultry that died during a laboratory confirmed HPAI H5N1 poultry farm outbreak or market poultry die-offs from suspected HPAI H5N1. Despite exposure to sick poultry, no farm or market poultry workers were seropositive for HPAI H5N1 virus antibodies (95% confidence interval 0-1%).
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Affiliation(s)
- Sharifa Nasreen
- Center for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- * E-mail:
| | - Salah Uddin Khan
- Center for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | | | - Kathy Hancock
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Vic Veguilla
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - David Wang
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research, Government of Bangladesh, Dhaka, Bangladesh
| | - A. S. M. Alamgir
- Institute of Epidemiology, Disease Control and Research, Government of Bangladesh, Dhaka, Bangladesh
| | - Katharine Sturm-Ramirez
- Center for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Emily S. Gurley
- Center for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Stephen P. Luby
- Center for Communicable Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jacqueline M. Katz
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Timothy M. Uyeki
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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24
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Liao Q, Bai T, Zhou L, Vong S, Guo J, Lv W, Dong L, Xiang N, Li Z, Huai Y, Zhou J, Li X, Chen RY, Xu Z, Uyeki TM, Shu Y, Yu H. Seroprevalence of antibodies to highly pathogenic avian influenza A (H5N1) virus among close contacts exposed to H5N1 cases, China, 2005-2008. PLoS One 2013; 8:e71765. [PMID: 23967241 PMCID: PMC3742513 DOI: 10.1371/journal.pone.0071765] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 07/03/2013] [Indexed: 11/18/2022] Open
Abstract
To assess the extent of highly pathogenic avian influenza (HPAI) A (H5N1) virus transmission, we conducted sero-epidemiologic studies among close contacts exposed to H5N1 cases in mainland China during 2005-2008. Blood specimens were collected from 87 household members and 332 social contacts of 23 H5N1 index cases for HPAI H5N1 serological testing by modified horse red-blood-cell hemagglutinin inhibition and microneutralization assays. All participants were interviewed with a standardized questionnaire to collect information about the use of personal protective equipment, illness symptoms, exposure to an H5N1 case during the infectious period, and poultry exposures. Two (2.3%) household contacts tested positive for HPAI H5N1 virus antibody, and all social contacts tested negative. Both seropositive cases had prolonged, unprotected, close contact with a different H5N1 index case, including days of bed-care or sleeping together during the index case's infectious period, and did not develop any illness. None of the 419 close contacts used appropriate personal protective equipment including 17% who reported providing bedside care or having physical contact with an H5N1 case for at least 12 hours. Our findings suggest that HPAI H5N1 viruses that circulated among poultry in mainland China from 2005-2008 were not easily transmitted to close contacts of H5N1 cases.
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Affiliation(s)
- Qiaohong Liao
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Tian Bai
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Lei Zhou
- Public Health Emergency Center, China CDC, Beijing, China
| | - Sirenda Vong
- World Health Organization (WHO) Beijing Office, Beijing, China
| | - Junqiao Guo
- Liaoning Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Wei Lv
- Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Libo Dong
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Nijuan Xiang
- Public Health Emergency Center, China CDC, Beijing, China
| | - Zi Li
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Yang Huai
- US Centers for Disease Control and Prevention’s International Emerging Infections Program, Beijing, China
| | - Jianfang Zhou
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Xiaodan Li
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
| | - Ray Y. Chen
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Zhen Xu
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Timothy M. Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Yuelong Shu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Key Laboratory for Medical Virology, National Health and Family Planning Commission, Beijing, China
- * E-mail: (HJY); (YLS)
| | - Hongjie Yu
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- * E-mail: (HJY); (YLS)
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Di Trani L, Porru S, Bonfanti L, Cordioli P, Cesana BM, Boni A, Di Carlo AS, Arici C, Donatelli I, Tomao P, Vonesch N, De Marco MA. Serosurvey against H5 and H7 avian influenza viruses in Italian poultry workers. Avian Dis 2013; 56:1068-71. [PMID: 23402138 DOI: 10.1637/10184-041012-resnote.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Highly pathogenic (HP) and low pathogenic (LP) avian influenza viruses (AIVs) belonging to H5 and H7 subtypes have been found to be associated with human infection as the result of direct transmission from infected poultry. Human infections by AIVs can cause mild or subclinical disease, and serosurveys are believed to represent an important tool to identify risk of zoonotic transmission. Therefore, we sought to examine Italian poultry workers exposed during LPAI and HPAI outbreaks with the aim of assessing serologic evidence of infection with H5 and H7 AIVs. From December 2008 to June 2010 serum samples were collected from 188 poultry workers and 379 nonexposed controls in Northern Italy. The hemagglutination inhibition (HI) assay using horse red blood cells (RBCs) and a microneutralization (MN)-enzyme-linked immunosorbent assay test were used to analyze human sera for antibodies against the following H5 and H7 LPAI viruses: A/Dk/It/4445/07(H5N2); A/Ty/It/2369/09(H5N7); A/Ty/It/218-193/ 10; A/Ck/It/3775/99(H7N1); A/Ty/It/214845/03(H7N3); and A/Dk/It/332145/09(H7N3). Since previous studies identified low antibody titer to AIVs in people exposed to infected poultry, a cutoff titer of > or = 1:10 was chosen for both serologic assays. Only HI-positive results confirmed by MN assay were considered positive for presence of specific antibodies. The Fisher exact test was used to analyze differences in seroprevalence between poultry workers and control groups, with the significance level set at P < 0.05. MN results showed a proportion of H7-seropositive poultry workers (6/188, i.e., 3.2%), significantly higher than that of controls (0/379), whereas no MN-positive result was obtained against three H5 LPAI subtypes recently identified in Italy. In conclusion, the survey indicated that assessing seroprevalence can be an important tool in risk assessment and health,surveillance of poultry workers.
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Affiliation(s)
- L Di Trani
- Department of Veterinary Public Health and Food Safety, Istituto Superiore di Sanità, V.le Regina Elena 299, 00161 Rome, Italy
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Okoye J, Eze D, Krueger WS, Heil GL, Friary JA, Gray GC. Serologic evidence of avian influenza virus infections among Nigerian agricultural workers. J Med Virol 2013; 85:670-6. [DOI: 10.1002/jmv.23520] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2012] [Indexed: 11/08/2022]
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Toner ES, Adalja AA, Nuzzo JB, Inglesby TV, Henderson DA, Burke DS. Assessment of serosurveys for H5N1. Clin Infect Dis 2013; 56:1206-12. [PMID: 23386633 DOI: 10.1093/cid/cit047] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND It has been suggested that the true case-fatality rate of human H5N1 influenza infection is appreciably less than the figure of approximately 60% that is based on official World Health Organization (WHO)-confirmed case reports because asymptomatic cases may have been missed. A number of seroepidemiologic studies have been conducted in an attempt to identify such missed cases. METHODS We conducted a comprehensive literature review of all English-language H5N1 human serology surveys with detailed attention to laboratory methodology used (including whether investigators used criteria set by the WHO to define positive cases), laboratory controls used, and the clades/genotypes involved. RESULTS Twenty-nine studies were included in the analysis. Few reported using unexposed control groups and one-third did not apply WHO criteria. Of studies that used WHO criteria, only 4 found any seropositive results to clades/genotypes of H5N1 that are currently circulating. No studies reported seropositive results to the clade 2/genotype Z viruses that have spread throughout Eurasia and Africa. CONCLUSIONS This review suggests that the frequency of positive H5 serology results is likely to be low; therefore, it is essential that future studies adhere to WHO criteria and include unexposed controls in their laboratory assays to limit the likelihood of false-positive results.
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Affiliation(s)
- Eric S Toner
- Center for Biosecurity, University of Pittsburgh Medical Center, Baltimore, MD 21202, USA.
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Kwon D, Lee JY, Choi W, Choi JH, Chung YS, Lee NJ, Cheong HM, Katz JM, Oh HB, Cho H, Kang C. Avian influenza a (H5N1) virus antibodies in poultry cullers, South Korea, 2003-2004. Emerg Infect Dis 2012; 18:986-8. [PMID: 22607722 PMCID: PMC3358159 DOI: 10.3201/eid1806.111631] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Transmission of influenza (H5N1) virus from birds to humans is a serious public health threat. In South Korea, serologic investigation among 2,512 poultry workers exposed during December 2003-March 2004 to poultry with confirmed or suspected influenza (H5N1) virus infection found antibodies in 9. Frequency of bird-to-human transmission was low.
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Affiliation(s)
- Donghyok Kwon
- Korea Centers for Disease Control and Prevention, Osong, South Korea
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29
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Feikin DR, Ope MO, Aura B, Fuller JA, Gikunju S, Vulule J, Ng'ang'a Z, Njenga MK, Breiman RF, Katz M. The population-based burden of influenza-associated hospitalization in rural western Kenya, 2007-2009. Bull World Health Organ 2012; 90:256-263A. [PMID: 22511821 DOI: 10.2471/blt.11.094326] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 12/08/2011] [Accepted: 12/09/2011] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To estimate the burden and age-specific rates of influenza-associated hospitalization in rural western Kenya. METHODS All 3924 patients with respiratory illness (defined as acute cough, difficulty in breathing or pleuritic chest pain) who were hospitalized between June 2007 and May 2009 in any inpatient health facility in the Kenyan district of Bondo were enrolled. Nasopharyngeal and oropharyngeal swabs were collected and tested for influenza viruses using real-time reverse transcriptase polymerase chain reaction (RT-PCR). In the calculation of annual rates, adjustments were made for enrolled patients who did not have swabs tested for influenza virus. FINDINGS Of the 2079 patients with tested swabs, infection with influenza virus was confirmed in 204 (10%); 176, 27 and 1 were found to be RT-PCR-positive for influenza A virus only, influenza B virus only, and both influenza A and B viruses, respectively. Among those tested for influenza virus, 6.8% of the children aged < 5 years and 14.0% of the patients aged ≥ 5 years were found positive. The case-fatality rate among admitted patients with PCR-confirmed infection with influenza virus was 2.0%. The annual rate of hospitalization (per 100,000 population) was 699.8 among patients with respiratory illness and 56.2 among patients with influenza (with 143.7, 18.8, 55.2, 65.1 and 57.3 hospitalized patients with influenza virus per 100,000 people aged < 5, 5-19, 20-34, 35-49 and ≥ 50 years, respectively). CONCLUSION In a rural district of western Kenya, the rate of influenza-associated hospitalization was highest among children aged less than 5 years.
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Affiliation(s)
- Daniel R Feikin
- Centers for Disease Control and Prevention, PO Box 1578, Kisumu, Kenya.
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Parsons LM, Somoskovi A, Lee E, Paramasivan CN, Schneidman M, Birx D, Roscigno G, Nkengasong J. Global health: Integrating national laboratory health systems and services in resource-limited settings. Afr J Lab Med 2012; 1:11. [PMID: 29062731 PMCID: PMC5644514 DOI: 10.4102/ajlm.v1i1.11] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Accepted: 01/19/2012] [Indexed: 11/01/2022] Open
Abstract
Laboratory systems worldwide are challenged not only by the need to compete for scarce resources with other sections of national health care programmes, but also with the lack of understanding of the critical role that laboratories play in the accurate diagnosis and monitoring of patients suffering from high-burdens of disease. An effective approach to establishing cost-effective laboratory systems that provide rapid and accurate test results for optimal impact on patient care is to move away from disease-specific programmes and establish integrated laboratory services. An integrated laboratory network provides all primary diagnostic services needed for care and treatment without requiring patients to go to different laboratory facilities for specific tests. Such a network focuses on providing quality-assured basic laboratory testing through the use of common specimen collection, reporting and diagnostic platforms that can be used across diseases. An integrated laboratory system also provides specimen transport to specialised laboratories and an environment conducive to the introduction and use of new and more complex technologies that would benefit the patient population and public health systems as a whole. As such, this article described various strategies for, and practical examples of, the successful integration of laboratory services.
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Affiliation(s)
- Linda M Parsons
- Global AIDS Program, US Centers for Disease Control and Prevention, Atlanta, USA
| | - Akos Somoskovi
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Evan Lee
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | | | | | - Deborah Birx
- Global AIDS Program, US Centers for Disease Control and Prevention, Atlanta, USA
| | | | - John Nkengasong
- Global AIDS Program, US Centers for Disease Control and Prevention, Atlanta, USA
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Huo X, Zu R, Qi X, Qin Y, Li L, Tang F, Hu Z, Zhu F. Seroprevalence of avian influenza A (H5N1) virus among poultry workers in Jiangsu Province, China: an observational study. BMC Infect Dis 2012; 12:93. [PMID: 22512873 PMCID: PMC3348011 DOI: 10.1186/1471-2334-12-93] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 04/18/2012] [Indexed: 11/23/2022] Open
Abstract
Background Since 2003 to 06 Jan 2012, the number of laboratory confirmed human cases of infection with avian influenza in China was 41 and 27 were fatal. However, the official estimate of the H5N1 case-fatality rate has been described by some as an over estimation since there may be numerous undetected asymptomatic/mild cases of H5N1 infection. This study was conducted to better understand the real infection rate and evaluate the potential risk factors for the zoonotic spread of H5N1 viruses to humans. Methods A seroepidemiological survey was conducted in poultry workers, a group expected to have the highest level of exposure to H5N1-infected birds, from 3 counties with habitat lakes of wildfowl in Jiangsu province, China. Serum specimens were collected from 306 participants for H5N1 serological test. All participants were interviewed to collect information about poultry exposures. Results The overall seropositive rate was 2.61% for H5N1 antibodies. The poultry number was found associated with a 2.39-fold significantly increased subclinical infection risk after adjusted with age and gender. Conclusions Avian-to -human transmission of avian H5N1 virus remained low. Workers associated with raising larger poultry flocks have a higher risk on seroconversion.
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Affiliation(s)
- Xiang Huo
- Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu Rd, 172#, Nanjing 210009, China
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Abstract
The prevalence of avian H5N1 influenza A infections in humans has not been definitively determined. Cases of H5N1 infection in humans confirmed by the World Health Organization (WHO) are fewer than 600 in number, with an overall case fatality rate of >50%. We hypothesize that the stringent criteria for confirmation of a human case of H5N1 by WHO do not account for a majority of infections but rather the select few hospitalized cases that are more likely to be severe and result in poor clinical outcome. Meta-analysis shows that 1 to 2% of more than 12,500 study participants from 20 studies had seroevidence for prior H5N1 infection.
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Affiliation(s)
- Taia T. Wang
- Department of Microbiology, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Michael K. Parides
- Mount Sinai Center for Biostatistics and Department of Health Evidence and Policy, Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Peter Palese
- Department of Microbiology, Mount Sinai School of Medicine, New York, NY 10029, USA
- Department of Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA
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Abstract
Medicine for Policymakers is a Journal column that provides decision makers with brief explanations of the meaning and implications for biosecurity of clinical issues. The articles describe, for a nonmedical audience, hospital practices, medical challenges, healthcare delivery issues, and other topics of current interest. Readers may submit ideas to the column's editor, Amesh A. Adalja, MD, through the Journal's editorial office at jfox@upmc-biosecurity.org .
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Affiliation(s)
- Eric S Toner
- Center for Biosecurity of UPMC, 621 E. Pratt St., Ste. 210, Baltimore, MD 21202, USA
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Abstract
Two recently submitted (but as yet unpublished) studies describe success in creating mutant isolates of H5N1 influenza A virus that can be transmitted via the respiratory route between ferrets; concern has been raised regarding human-to-human transmissibility of these or similar laboratory-generated influenza viruses. Furthermore, the potential release of methods used in these studies has engendered a great deal of controversy around publishing potential dual-use data and also has served as a catalyst for debates around the true case-fatality rate of H5N1 influenza and the capability of influenza vaccines and antivirals to impact any future unintentional or intentional release of H5N1 virus. In this report, we review available seroepidemiology data for H5N1 infection and discuss how case-finding strategies may influence the overall case-fatality rate reported by the WHO. We also provide information supporting the position that if an H5N1 influenza pandemic occurred, available medical countermeasures would have limited impact on the associated morbidity and mortality.
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Luong HM, Wang SF, Trao VT, Chen M, Huang JC, Cam PD, Lin YT, Chen YMA. Retrospective survey of avian influenza H5N1 infection in Northern Vietnam by using a combinational serologic assay. Health (London) 2012. [DOI: 10.4236/health.2012.430149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ekong PS, Ducheyne E, Carpenter TE, Owolodun OA, Oladokun AT, Lombin LH, Berkvens D. Spatio-temporal epidemiology of highly pathogenic avian influenza (H5N1) outbreaks in Nigeria, 2006-2008. Prev Vet Med 2011; 103:170-7. [PMID: 22079423 DOI: 10.1016/j.prevetmed.2011.10.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Revised: 09/11/2011] [Accepted: 10/01/2011] [Indexed: 10/15/2022]
Abstract
From 2006 to 2008, outbreaks of highly pathogenic avian influenza A (HPAI) virus of the H5N1 subtype occurred among poultry in Nigeria. We described the spatio-temporal patterns of the HPAI H5N1 outbreaks in Nigeria. Data of suspected and laboratory confirmed outbreaks maintained at the National Veterinary Research Institute Vom was analyzed using descriptive and exploratory analyses, GIS mapping, global and local spatial statistical analyses using the Cuzick-Edwards' (C-E) test and SaTScan Space-Time Scan Statistic. A total of 1654 suspected outbreaks were reported from 32 of the 36 States and the Federal Capital Territory (FCT), 299 were confirmed HPAI H5N1 positive from 27 states and FCT. The outbreaks occurred as three distinct epidemic waves with peak periods of January-March mainly in the North-West, North-Central and North-East regions during 2006 and 2007 and July-September in the South-West and South-South regions in 2007. Three spatio-temporal clusters were identified extending across States and international borders, consistent with disease transmission occurring through local and long-distance spread. This calls for enhanced strategies by the states and regional authorities to improve surveillance, prevention and control measures at the states, national and international levels.
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Affiliation(s)
- Pius S Ekong
- Epidemiology Unit, National Veterinary Research Institute, Vom, Plateau State, Nigeria.
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Kayali G, Barbour E, Dbaibo G, Tabet C, Saade M, Shaib HA, Debeauchamp J, Webby RJ. Evidence of infection with H4 and H11 avian influenza viruses among Lebanese chicken growers. PLoS One 2011; 6:e26818. [PMID: 22046370 PMCID: PMC3203926 DOI: 10.1371/journal.pone.0026818] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 10/05/2011] [Indexed: 12/11/2022] Open
Abstract
Human infections with H5, H7, and H9 avian influenza viruses are well documented. Exposure to poultry is the most important risk factor for humans becoming infected with these viruses. Data on human infection with other low pathogenicity avian influenza viruses is sparse but suggests that such infections may occur. Lebanon is a Mediterranean country lying under two major migratory birds flyways and is home to many wild and domestic bird species. Previous reports from this country demonstrated that low pathogenicity avian influenza viruses are in circulation but highly pathogenic H5N1 viruses were not reported. In order to study the extent of human infection with avian influenza viruses in Lebanon, we carried out a seroprevalence cross-sectional study into which 200 poultry-exposed individuals and 50 non-exposed controls were enrolled. We obtained their sera and tested it for the presence of antibodies against avian influenza viruses types H4 through H16 and used a questionnaire to collect exposure data. Our microneutralization assay results suggested that backyard poultry growers may have been previously infected with H4 and H11 avian influenza viruses. We confirmed these results by using a horse red blood cells hemagglutination inhibition assay. Our data also showed that farmers with antibodies against each virus type clustered in a small geographic area suggesting that unrecognized outbreaks among birds may have led to these human infections. In conclusion, this study suggests that occupational exposure to chicken is a risk factor for infection with avian influenza especially among backyard growers and that H4 and H11 influenza viruses may possess the ability to cross the species barrier to infect humans.
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Affiliation(s)
- Ghazi Kayali
- Division of Virology, Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, Tennessee, United States of America.
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Leibler JH, Silbergeld EK, Pekosz A, Gray GC. No evidence of infection with avian influenza viruses among US poultry workers in the Delmarva Peninsula, Maryland and Virginia, USA. J Agromedicine 2011; 16:52-7. [PMID: 21213164 DOI: 10.1080/1059924x.2011.533612] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Industrial poultry workers may be at elevated risk of avian influenza infection due to intense occupational contact with live poultry. Serum samples from poultry workers and community members in the Delmarva Peninsula, one of the densest regions of poultry production in the United States, were analyzed for antibodies to strains of five avian influenza subtypes using microneutralization assays. No evidence of infection was found, suggesting inefficient transmission to humans or the absence of virus in these premises. Continued serological surveillance of workers in industrial food animal facilities is necessary to prevent the transmission of influenza A viruses.
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Affiliation(s)
- Jessica H Leibler
- Department of Environmental and Occupational Health, George Washington University School of Public Health and Health Services, Washington, DC, USA.
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Gray GC, Ferguson DD, Lowther PE, Heil GL, Friary JA. A national study of US bird banders for evidence of avian influenza virus infections. J Clin Virol 2011; 51:132-5. [PMID: 21530384 DOI: 10.1016/j.jcv.2011.03.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Revised: 03/22/2011] [Accepted: 03/26/2011] [Indexed: 01/25/2023]
Abstract
BACKGROUND Previously we have found that Midwestern US wildlife biologists, poultry farmers, veterinarians, and duck hunters have had evidence of avian influenza virus infections (AIVs). OBJECTIVES We sought to evaluate a national sample of US bird banders for previous evidence of AIV infection. STUDY DESIGN Controlled, cross-sectional serological survey. RESULTS In 2009 and 2010 we enrolled 157 registered bird banders from 40 US states and compared their enrollment data and serological results with 78 adult age-group matched controls from Iowa. On average, the bird banders had 15 years of wild bird exposure, banded 20 days per year, worked chiefly in 1 of the 4 North American flyways, and banded 300 individual birds of 5 different species per season. While handling birds, only 15% of banders reported wearing gloves. Three bird banders and 1 control had evidence of previous infection (1 AIV each) with A/BWTE/Ohio/07/495762-6(H7N3), A/Ty/MN/38391-6/95(H9N2) or A/CK/NJ/7290-2/95(H11N3) by microneutralization assay. There was no evidence of previous infection with a representative sample of H4, H5, H6, H8, or H10 AIVs. Participants were followed for influenza-like-illness for a median of 7 months and 4 (3 bird banders) submitted self-collected eye, nasal, and throat influenza-like-illness swab specimens, 1 of which collected in November of 2009, yielded a pandemic H1N1 influenza A virus. CONCLUSION Despite reports of conjunctivitis and upper respiratory symptoms while bird banding, we found sparse evidence that US bird banders had infections with AIVs.
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Affiliation(s)
- Gregory C Gray
- Emerging Pathogens Institute and College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
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Ortiz JR, Lafond KE, Wong TA, Uyeki TM. Pandemic influenza in Africa, lessons learned from 1968: a systematic review of the literature. Influenza Other Respir Viruses 2011; 6:11-24. [PMID: 21668669 PMCID: PMC3175329 DOI: 10.1111/j.1750-2659.2011.00257.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Please cite this paper as: Ortiz et al. (2012) Pandemic influenza in Africa, lessons learned from 1968: a systematic review of the literature. Influenza and Other Respiratory Viruses 6(1), 11–24. Background To help understand the potential impact of the 2009 H1N1 pandemic in Africa, we reviewed published data from Africa of the two previous influenza pandemics. Methods We conducted a systematic search of three biomedical databases for articles in any language on 1957 H2N2 or 1968 H3N2 pandemic influenza virus infection in Africa published from January 1950 through August 2008. Results We identified 1327 potentially relevant articles, and 298 warranted further review. Fourteen studies on 1968 H3N2 influenza met inclusion criteria, while two studies identified describing 1957 H2N2 were excluded for data limitations. Among these 14 studies, community attack rates for symptomatic infection during all 1968 pandemic waves were around 20%. However, the proportion infected in communities ranged from 6% in isolated communities to 100% in enclosed populations. A total of 22–64% of sampled clinic patients and 8–72% of hospitalized patients had evidence of 1968 H3N2 virus infection. After the second pandemic wave, up to 41–75% of persons tested had serological evidence of 1968 H3N2 virus infection. Conclusion The 1968 H3N2 influenza pandemic, generally regarded as mild worldwide, appears to have had a substantial impact upon public health in Africa. Without more epidemiologic data the impact of the 2009 H1N1 pandemic in Africa cannot be assumed to have been mild. Assessment of the burden of 2009 H1N1 virus and future influenza pandemics in Africa should attempt to assess disease impact by a variety of methods, including substudies among specific populations.
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Affiliation(s)
- Justin R Ortiz
- Department of Medicine, University of Washington, Seattle, USA.
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Van Kerkhove MD, Mumford E, Mounts AW, Bresee J, Ly S, Bridges CB, Otte J. Highly pathogenic avian influenza (H5N1): pathways of exposure at the animal-human interface, a systematic review. PLoS One 2011; 6:e14582. [PMID: 21283678 PMCID: PMC3025925 DOI: 10.1371/journal.pone.0014582] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Accepted: 10/21/2010] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The threat posed by highly pathogenic avian influenza A H5N1 viruses to humans remains significant, given the continued occurrence of sporadic human cases (499 human cases in 15 countries) with a high case fatality rate (approximately 60%), the endemicity in poultry populations in several countries, and the potential for reassortment with the newly emerging 2009 H1N1 pandemic strain. Therefore, we review risk factors for H5N1 infection in humans. METHODS AND FINDINGS Several epidemiologic studies have evaluated the risk factors associated with increased risk of H5N1 infection among humans who were exposed to H5N1 viruses. Our review shows that most H5N1 cases are attributed to exposure to sick poultry. Most cases are sporadic, while occasional limited human-to-human transmission occurs. The most commonly identified factors associated with H5N1 virus infection included exposure through contact with infected blood or bodily fluids of infected poultry via food preparation practices; touching and caring for infected poultry; [corrected] exposure to H5N1 via swimming or bathing in potentially virus laden ponds; and exposure to H5N1 at live bird markets. CONCLUSIONS Research has demonstrated that despite frequent and widespread contact with poultry, transmission of the H5N1 virus from poultry to humans is rare. Available research has identified several risk factors that may be associated with infection including close direct contact with poultry and transmission via the environment. However, several important data gaps remain that limit our understanding of the epidemiology of H5N1 in humans. Although infection in humans with H5N1 remains rare, human cases continue to be reported and H5N1 is now considered endemic among poultry in parts of Asia and in Egypt, providing opportunities for additional human infections and for the acquisition of virus mutations that may lead to more efficient spread among humans and other mammalian species. Collaboration between human and animal health sectors for surveillance, case investigation, virus sharing, and risk assessment is essential to monitor for potential changes in circulating H5N1 viruses and in the epidemiology of H5N1 in order to provide the best possible chance for effective mitigation of the impact of H5N1 in both poultry and humans. DISCLAIMER The opinions expressed in this article are those of the authors and do not necessarily reflect those of the institutions or organizations with which they are affiliated.
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Affiliation(s)
- Maria D Van Kerkhove
- MRC Centre for Outbreak Analysis and Modelling, Imperial College London, London, United Kingdom.
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Suptawiwat O, Tantilipikorn P, Boonarkart C, Lumyongsatien J, Uiprasertkul M, Puthavathana P, Auewarakul P. Enhanced susceptibility of nasal polyp tissues to avian and human influenza viruses. PLoS One 2010; 5:e12973. [PMID: 20885984 PMCID: PMC2945772 DOI: 10.1371/journal.pone.0012973] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Accepted: 08/16/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Influenza viruses bind and infect respiratory epithelial cells through sialic acid on cell surface. Differential preference to sialic acid types contributes to host- and tissue-tropism of avian and seasonal influenza viruses. Although the highly pathogenic avian influenza virus H5N1 can infect and cause severe diseases in humans, it is not efficient in infecting human upper respiratory tract. This is because of the scarcity of its receptor, α2,3-linked sialic acid, in human upper airway. Expression of sialic acid can be influenced by various factors including inflammatory process. Allergic rhinitis and nasal polyp are common inflammatory conditions of nasal mucosa and may affect expression of the sialic acid and susceptibility to influenza infection. METHODOLOGY/PRINCIPAL FINDING To test this hypothesis, we detected α2,3- and α2,6-linked sialic acid in human nasal polyp and normal nasal mucosal tissues by lectin staining and infected explants of those tissues with avian influenza viruses H5N1 and seasonal influenza viruses. We show here that mucosal surface of nasal polyp expressed higher level of α2,3- and α2,6-linked sialic acid than normal nasal mucosa. Accordingly, both H5N1 avian influenza viruses and seasonal influenza viruses replicated more efficiently in nasal polyp tissues explants. CONCLUSIONS/SIGNIFICANCE Our data suggest a role of nasal inflammatory conditions in susceptibility to influenza infection, especially by avian influenza viruses, which is generally inefficient in infecting human upper airway. The increased receptor expression may contribute to increased susceptibility in some individuals. This may contribute to the gradual adaptation of the virus to human population.
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MESH Headings
- Disease Susceptibility
- Humans
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H1N1 Subtype/physiology
- Influenza A Virus, H5N1 Subtype/genetics
- Influenza A Virus, H5N1 Subtype/isolation & purification
- Influenza A Virus, H5N1 Subtype/physiology
- Influenza, Human/metabolism
- Influenza, Human/virology
- N-Acetylneuraminic Acid/metabolism
- Nasal Mucosa/metabolism
- Nasal Mucosa/virology
- Nasal Polyps/genetics
- Nasal Polyps/metabolism
- Nasal Polyps/virology
- Receptors, Virus/genetics
- Receptors, Virus/metabolism
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Affiliation(s)
- Ornpreya Suptawiwat
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pongsakorn Tantilipikorn
- Department of Oto-Rhino-Laryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chompunuch Boonarkart
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jate Lumyongsatien
- Department of Oto-Rhino-Laryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Mongkol Uiprasertkul
- Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pilaipan Puthavathana
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Prasert Auewarakul
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- * E-mail:
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Buchy P, Vong S, Chu S, Garcia JM, Hien TT, Hien VM, Channa M, Ha DQ, Chau NVV, Simmons C, Farrar JJ, Peiris M, de Jong MD. Kinetics of neutralizing antibodies in patients naturally infected by H5N1 virus. PLoS One 2010; 5:e10864. [PMID: 20532246 PMCID: PMC2879427 DOI: 10.1371/journal.pone.0010864] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 05/02/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Little is known about the kinetics of anti-H5 neutralizing antibodies in naturally H5N1-infected patients with severe clinical illness or asymptomatic infection. METHODS Using H5N1 microneutralisation (MN) and H5-pseudotype particle-based microneutralisation assays (H5pp) we analyzed sera sequentially obtained from 11 severely ill patients diagnosed by RT-PCR (follow-up range 1-139 weeks of disease onset) and 31 asymptomatically infected individuals detected in a sero-epidemiological study after exposure to H5N1 virus (follow-up range: 1-2 month-11 months after exposure). RESULTS Of 44 sera from 11 patients with H5N1 disease, 70% tested positive by MN (antibody titre > or = 80) after 2 weeks and 100% were positive by 3 weeks after disease onset. The geometric mean MN titers in severely ill patients were 540 at 1-2 months and 173 at 10-12 months and thus were higher than the titers from asymptomatic individuals (149 at 1-2 months, 62.2 at 10-12 months). Fractional polynomial regression analysis demonstrated that in all severely ill patients, positive titers persisted beyond 2 years of disease onset, while 10 of 23 sera collected 10-11 months after exposure in asymptomatically infected individuals tested negative. CONCLUSIONS Our results indicate that people with asymptomatic H5N1 infection have lower H5N1 antibody titres compared to those with severe illness and that in many asymptomatically infected patients the antibody titer decreased to levels below the threshold of positivity within one year. These data are essential for the design and interpretation of sero-epidemiological studies.
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What is the evidence of a role for host genetics in susceptibility to influenza A/H5N1? Epidemiol Infect 2010; 138:1550-8. [PMID: 20236573 DOI: 10.1017/s0950268810000518] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The apparent family clustering of avian influenza A/H5N1 has led several groups to postulate the existence of a host genetic influence on susceptibility to A/H5N1, yet the role of host factors on the risk of A/H5N1 disease has received remarkably little attention compared to the efforts focused on viral factors. We examined the epidemiological patterns of human A/H5N1 cases, their possible explanations, and the plausibility of a host genetic effect on susceptibility to A/H5N1 infection. The preponderance of familial clustering of cases and the relative lack of non-familial clusters, the occurrence of related cases separated by time and place, and the paucity of cases in some highly exposed groups such as poultry cullers, are consistent with a host genetic effect. Animal models support the biological plausibility of genetic susceptibility to A/H5N1. Although the evidence is circumstantial, host genetic factors are a parsimonious explanation for the unusual epidemiology of human A/H5N1 cases and warrant further investigation.
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Serosurveillance study on transmission of H5N1 virus during a 2006 avian influenza epidemic. Epidemiol Infect 2010; 138:1274-80. [DOI: 10.1017/s095026880999166x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
SUMMARYIn 2006 an outbreak of avian influenza A(H5N1) in Turkey caused 12 human infections, including four deaths. We conducted a serological survey to determine the extent of subclinical infection caused by the outbreak. Single serum samples were collected from five individuals with avian influenza whose nasopharyngeal swabs tested positive for H5 RNA by polymerase chain reaction, 28 family contacts of the cases, 95 poultry cullers, 75 individuals known to have had contact with diseased chickens and 81 individuals living in the region with no known contact with infected chickens and/or patients. Paired serum samples were collected from 97 healthcare workers. All sera were tested for the presence of neutralizing antibodies by enzyme-linked immunoassay, haemagglutination inhibition and microneutralization assays. Only one serum sample, from a parent of an avian influenza patient, tested positive for H5N1 by microneutralization assay. This survey shows that there was minimal subclinical H5N1 infection among contacts of human cases and infected poultry in Turkey in 2006. Further, the low rate of subclinical infection following contact with diseased poultry gave further support to the reported low infectivity of the virus.
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Schultsz C, Nguyen VD, Hai LT, Do QH, Peiris JSM, Lim W, Garcia JM, Nguyen DT, Nguyen THL, Huynh HT, Phan XT, van Doorn HR, Nguyen VVC, Farrar J, de Jong MD. Prevalence of antibodies against avian influenza A (H5N1) virus among Cullers and poultry workers in Ho Chi Minh City, 2005. PLoS One 2009; 4:e7948. [PMID: 19956765 PMCID: PMC2776305 DOI: 10.1371/journal.pone.0007948] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Accepted: 10/28/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Between 2003 and 2005, highly pathogenic avian influenza A (H5N1) viruses caused large scale outbreaks in poultry in the Ho Chi Minh City area in Vietnam. We studied the prevalence of antibodies against H5N1 in poultry workers and cullers who were active in the program in Ho Chi Minh City in 2004 and 2005. METHODOLOGY/PRINCIPAL FINDINGS Single sera from 500 poultry workers and poultry cullers exposed to infected birds were tested for antibodies to avian influenza H5N1, using microneutralization assays and hemagglutination inhibition assay with horse blood. All sera tested negative using microneutralization tests. Three samples showed a 1ratio80 titer in the hemagglutination inhibition assay. CONCLUSIONS/SIGNIFICANCE This study provides additional support for the low transmissibility of clade 1 H5N1 to humans, but limited transmission to highly exposed persons cannot be excluded given the presence of low antibody titers in some individuals.
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Affiliation(s)
- Constance Schultsz
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
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Hassantoufighi A, Zhang H, Sandbulte M, Gao J, Manischewitz J, King L, Golding H, Straight TM, Eichelberger MC. A practical influenza neutralization assay to simultaneously quantify hemagglutinin and neuraminidase-inhibiting antibody responses. Vaccine 2009; 28:790-7. [PMID: 19887135 DOI: 10.1016/j.vaccine.2009.10.066] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2009] [Revised: 09/05/2009] [Accepted: 10/13/2009] [Indexed: 11/16/2022]
Abstract
Influenza vaccine immunogenicity is commonly assessed by determining hemagglutination inhibition (HAI) titers in serum samples. HAI titers have been used to predict vaccine efficacy, but this often fails when live attenuated vaccines are evaluated, because it does not encompass all immune mediators of protection. Although antibodies that inhibit viral neuraminidase (NA) also contribute to protection against disease, there is currently no routine assessment of NA inhibition titers. A serological method with the capacity to measure functional inhibition of both HA and NA would be valuable. We developed a high-throughput virus neutralization assay that uses viral NA activity to quantify influenza replication (the AVINA assay), and showed its capacity to identify antivirals with a broad range of target specificities. In this report we demonstrate that antibodies with specificity for either HA or NA are detected in this assay, whereas a commonly used virus neutralization assay only detects those with HA-specificity. We also compared human responses to seasonal influenza vaccines measured by HAI, micro-neutralization, NA inhibition and AVINA assays. The response rates to both trivalent inactivated and live attenuated vaccines were greater when measured by the AVINA than the other assays, reflecting the dual antigen reactivity and increased sensitivity of the assay. The potential of this single assay to predict protection against influenza-induced tachypnea was demonstrated in vaccinated cotton rats. The AVINA assay is therefore a practical, comprehensive method to determine influenza vaccine immunogenicity and potential efficacy.
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Affiliation(s)
- Arash Hassantoufighi
- Division of Viral Products, Office of Vaccine Research and Review, Center for Biologics Evaluation and Research, FDA, Bethesda, MD 20892, USA
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Dejpichai R, Laosiritaworn Y, Phuthavathana P, Uyeki TM, O'Reilly M, Yampikulsakul N, Phurahong S, Poorak P, Prasertsopon J, Kularb R, Nateerom K, Sawanpanyalert N, Jiraphongsa C. Seroprevalence of antibodies to avian influenza virus A (H5N1) among residents of villages with human cases, Thailand, 2005. Emerg Infect Dis 2009; 15:756-60. [PMID: 19402962 PMCID: PMC2687002 DOI: 10.3201/eid1505.080316] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
No evidence of influenza virus A (H5N1) neutralizing antibodies was found in residents of 4 villages where human cases had occurred the previous year. In 2005, we assessed the seroprevalence of neutralizing antibodies to avian influenza virus A (H5N1) among 901 residents of 4 villages in Thailand where at least 1 confirmed human case of influenza (H5N1) had occurred during 2004. Although 68.1% of survey participants (median age 40 years) were exposed to backyard poultry and 25.7% were exposed to sick or dead chickens, all participants were seronegative for influenza virus (H5N1).
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49
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Zhou L, Liao Q, Dong L, Huai Y, Bai T, Xiang N, Shu Y, Liu W, Wang S, Qin P, Wang M, Xing X, Lv J, Chen RY, Feng Z, Yang W, Uyeki TM, Yu H. Risk factors for human illness with avian influenza A (H5N1) virus infection in China. J Infect Dis 2009; 199:1726-34. [PMID: 19416076 PMCID: PMC2759027 DOI: 10.1086/599206] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND In China, 30 human cases of avian influenza A (H5N1) virus infection were identified through July 2008. We conducted a retrospective case-control study to identify risk factors for influenza H5N1 disease in China. METHODS A questionnaire about potential influenza H5N1 exposures was administered to 28 patients with influenza H5N1 and to 134 randomly selected control subjects matched by age, sex, and location or to proxies. Conditional logistic regression analyses were performed. RESULTS Before their illness, patients living in urban areas had visited wet poultry markets, and patients living in rural areas had exposure to sick or dead backyard poultry. In multivariable analyses, independent risk factors for influenza H5N1 were direct contact with sick or dead poultry (odds ratio [OR], 506.6 [95% confidence interval {CI}, 15.7-16319.6]; P<.001), indirect exposure to sick or dead poultry (OR, 56.9 [95% CI, 4.3-745.6]; P=.002), and visiting a wet poultry market (OR, 15.4 [95% CI, 3.0-80.2]; P=.001). CONCLUSIONS To prevent human influenza H5N1 in China, the level of education about avoiding direct or close exposures to sick or dead poultry should be increased, and interventions to prevent the spread of influenza H5N1 at live poultry markets should be implemented.
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Affiliation(s)
- Lei Zhou
- Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Qiaohong Liao
- Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Libo Dong
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Yang Huai
- Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Tian Bai
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Nijuan Xiang
- Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Yuelong Shu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Wei Liu
- Wuhan Center for Disease Control and Prevention, Wuhan, China
| | - Shiwen Wang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Pengzhe Qin
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Min Wang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Xuesen Xing
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Ray Y. Chen
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA; Based at the U.S. Embassy, Beijing
| | - Zijian Feng
- Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Weizhong Yang
- Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Timothy M. Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Hongjie Yu
- Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
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Gray GC, McCarthy T, Capuano AW, Setterquist SF, Alavanja MC, Lynch CF. Evidence for avian influenza A infections among Iowa's agricultural workers. Influenza Other Respir Viruses 2009; 2:61-9. [PMID: 18941621 PMCID: PMC2568886 DOI: 10.1111/j.1750-2659.2008.00041.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Identifying risk factors for zoonotic influenza transmission may aid public health officials in pandemic influenza planning. OBJECTIVES We sought to evaluate rural Iowan agriculture workers exposed to poultry for previous evidence of avian influenza virus infection. METHODS In 2004 we enrolled 803 rural adult Iowans in a 2-year prospective study of zoonotic influenza transmission. Their enrollment data and sera were compared with those from 66 adult controls enrolled at the University of Iowa in 2006 by proportional odds modeling. RESULTS The 803 participants were 58.8% male with a mean age of 55.6 yrs. Forty-eight percent reported previous poultry exposure. Sera were studied by microneutralization techniques for antibodies against avian H4, H5, H6, H7, and H9 viruses. Touching live birds was associated (OR = 1.2; 95% CI 1.02-1.8) with increased antibody titer against H5 virus. Similarly, participants who reported hunting wild birds had increased antibody titers against H7 virus (OR = 2.8; 95%CI = 1.2-6.5) and subjects who reported recent work with poultry had increased antibody titers against H6 (OR = 3.4; 95% CI 1.4-8.5) and H7 viruses (OR = 2.5, 95% CI = 1.1-5.7). There was no evidence of elevated antibody against avian H4 or H9 viruses. CONCLUSIONS These data suggest that hunting and exposure to poultry may be important risk factors for avian influenza virus infection among rural US populations. Agriculture workers should be included in influenza pandemic plans.
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Affiliation(s)
- Gregory C Gray
- Center for Emerging Infectious Diseases, Department of Epidemiology at the University of Iowa's College of Public Health, Iowa City, IA 52242, USA.
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