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Mahadevan C, Mikkilineni R, Vyas N, Karabasanavar N. Assessment of Knowledge and Biosecurity Practices Related to Avian Influenza Among Poultry Workers in a District of South India. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024:00124784-990000000-00223. [PMID: 38489542 DOI: 10.1097/phh.0000000000001914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
CONTEXT Avian influenza, commonly known as bird flu, is a contagious disease that affects both animals and humans, posing a significant threat to public health, animal welfare, and the economy. This study aims to evaluate the knowledge of avian influenza among poultry farmworkers and evaluate the biosecurity practices implemented on their farms. OBJECTIVE The study's primary objective was to assess the knowledge regarding avian influenza among poultry farmworkers and the biosecurity practices they follow at the farm. DESIGN Cross-sectional study. SETTING The study was conducted in a district of South India. PARTICIPANTS This study included 105 poultry farmworkers across 70 poultry farms in the district. MAIN OUTCOME MEASURES Assessment of the participants' knowledge related to avian influenza, and the association between knowledge levels, demographic, and farm-related factors such as working experience in the poultry farm, type of poultry farm, type of poultry reared, and biosecurity practices. RESULTS In the study, 90% of participants were aware of avian influenza, with 36% correctly identifying the virus as its cause, whereas 5% wrongly cited it to be a bacteria. Although 90% knew avian influenza was infectious, only 18% recognized its potential transmission to humans; however, 82% understood prevention methods. Participants with an education level beyond high school displayed significantly higher awareness (P < .05), emphasizing importance of the education. CONCLUSIONS The study showed diverse awareness levels among poultry farmworkers regarding avian influenza, emphasizing gaps in the knowledge, particularly about its transmission to humans. This underscores the need for targeted awareness campaigns focusing on zoonotic risks to improve the level of understanding and implement effective preventive measures against avian influenza.
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Affiliation(s)
- Chandan Mahadevan
- Author affiliations: Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India (Dr Mahadevan, Dr Mikkilineni, and Dr Vyas); and Department of Veterinary Public Health and Epidemiology, Veterinary College, Vidyanagar, Hassan, Karnataka, India (Dr Karabasanavar)
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Brindle HE, Nadjm B, Choisy M, Christley R, Griffiths M, Baker S, Bryant JE, Campbell JI, Nguyen VVC, Nguyen TND, Vu TTH, Nguyen VH, Hoang BL, Le XL, Pham HM, Ta TDN, Ho DTN, Tran TN, Nguyen THN, Tran MP, Pham THP, Le VT, Nguyen DT, Hau TTT, Nguyen NV, Wertheim HFL, Thwaites GE, van Doorn HR. Aetiology and Potential Animal Exposure in Central Nervous System Infections in Vietnam. ECOHEALTH 2022; 19:463-474. [PMID: 36227390 PMCID: PMC9558024 DOI: 10.1007/s10393-022-01611-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 05/20/2022] [Indexed: 06/16/2023]
Abstract
An estimated 73% of emerging infections are zoonotic in origin, with animal contact and encroachment on their habitats increasing the risk of spill-over events. In Vietnam, close exposure to a wide range of animals and animal products can lead to acquisition of zoonotic pathogens, a number of which cause central nervous system (CNS) infections. However, studies show the aetiology of CNS infections remains unknown in around half of cases. We used samples and data from hospitalised patients with CNS infections, enrolled into the Vietnam Initiative on Zoonotic Infections multicentre study, to determine the association between aetiology and animal contact including those in whom the cause was unknown. Among 933 patients, a pathogen or an antibody response to it was identified in 291 (31.2%, 95% CI 28.3-34.3%). The most common pathogens were Streptococcus suis (n = 91 (9.8%, 8.0-11.9%)) and Japanese encephalitis virus (JEV) (n = 72 (7.7%, 6.1-9.7%)). Commonly reported animal contact included keeping, raising or handling (n = 364 (39.0%, 35.9-42.2%)) and handling, cooking or consuming raw meat, blood or viscera in the 2 weeks prior to symptom onset (n = 371 (39.8%, 36.6-43.0%)), with the latter most commonly from pigs (n = 343 (36.9%, 33.8-40.1%). There was no association between an unknown aetiology and exposure to animals in a multivariate logistic regression. Further testing for unknown or undetected pathogens may increase diagnostic yield, however, given the high proportion of zoonotic pathogens and the presence of risk factors, increasing public awareness about zoonoses and preventive measures can be considered.
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Affiliation(s)
- Hannah E Brindle
- Oxford University Clinical Research Unit, Hanoi, Vietnam.
- Institute of Infection and Global Health and National Institute, University of Liverpool, Liverpool, UK.
| | - Behzad Nadjm
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Atlantic Boulevard, Serekunda, The Gambia
| | - Marc Choisy
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | - Rob Christley
- Institute of Infection and Global Health and National Institute, University of Liverpool, Liverpool, UK
| | - Michael Griffiths
- Institute of Infection and Global Health and National Institute, University of Liverpool, Liverpool, UK
| | - Stephen Baker
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Department of Medicine, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Juliet E Bryant
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - James I Campbell
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | | | - Ty Thi Hang Vu
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Bao Long Hoang
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Hanoi Medical University, Hanoi, Vietnam
| | - Xuan Luat Le
- National Hospital for Tropical Diseases, Hanoi, Vietnam
| | - Ha My Pham
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Wellcome Trust Sanger Institute, Hinxton, UK
| | | | | | | | | | - My Phuc Tran
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Van Tan Le
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Thi Thu Trang Hau
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Research Group 2, AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | | | - Heiman F L Wertheim
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- RadboudUMC, Nijmegen, The Netherlands
| | - Guy E Thwaites
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - H Rogier van Doorn
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Ahmad S, Koh KY, Lee JI, Suh GH, Lee CM. Interpolation of Point Prevalence Rate of the Highly Pathogenic Avian Influenza Subtype H5N8 Second Phase Epidemic in South Korea. Vet Sci 2022; 9:vetsci9030139. [PMID: 35324867 PMCID: PMC8954420 DOI: 10.3390/vetsci9030139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 11/29/2022] Open
Abstract
Humans and animals are both susceptible to highly pathogenic avian influenza (HPAI) viruses. In the future, HPAI has the potential to be a source of zoonoses and pandemic disease drivers. It is necessary to identify areas of high risk that are more vulnerable to HPAI infections. In this study, we applied unbiased predictions based on known information to find points of localities with a high probability of point prevalence rate. To carry out such predictions, we utilized the inverse distance weighting (IDW) and kriging method, with the help of the R statistical computing program. The provinces of Jeollanam-do, Gyeonggi-do, Chungcheongbuk-do and Ulsan have high anticipated risk. This research might aid in the management of avian influenza threats associated with various potential risks.
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Affiliation(s)
- Saleem Ahmad
- Veterinary Public Health Lab, College of Veterinary Medicine, Chonnam National University, Gwangju 61186, Korea; (S.A.); (K.-Y.K.); (J.-i.L.)
| | - Kye-Young Koh
- Veterinary Public Health Lab, College of Veterinary Medicine, Chonnam National University, Gwangju 61186, Korea; (S.A.); (K.-Y.K.); (J.-i.L.)
| | - Jae-il Lee
- Veterinary Public Health Lab, College of Veterinary Medicine, Chonnam National University, Gwangju 61186, Korea; (S.A.); (K.-Y.K.); (J.-i.L.)
| | - Guk-Hyun Suh
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR Program, Chonnam National University, Gwangju 61186, Korea;
| | - Chang-Min Lee
- Department of Veterinary Internal Medicine, College of Veterinary Medicine and BK21 FOUR Program, Chonnam National University, Gwangju 61186, Korea;
- Correspondence:
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Bandou R, Hirose R, Nakaya T, Miyazaki H, Watanabe N, Yoshida T, Daidoji T, Itoh Y, Ikegaya H. Higher Viral Stability and Ethanol Resistance of Avian Influenza A(H5N1) Virus on Human Skin. Emerg Infect Dis 2022; 28:639-649. [PMID: 35202523 PMCID: PMC8888214 DOI: 10.3201/eid2803.211752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Evaluating the stability of highly pathogenic avian influenza viruses on human skin and measuring the effectiveness of disinfectants are crucial for preventing contact disease transmission. We constructed an evaluation model using autopsy skin samples and evaluated factors that affect the stability and disinfectant effectiveness for various subtypes. The survival time of the avian influenza A(H5N1) virus on plastic surfaces was ≈26 hours and on skin surfaces ≈4.5 hours, >2.5-fold longer than other subtypes. The effectiveness of a relatively low ethanol concentration (32%–36% wt/wt) against the H5N1 subtype was substantially reduced compared with other subtypes. Moreover, recombinant viruses with the neuraminidase gene of H5N1 survived longer on plastic and skin surfaces than other recombinant viruses and were resistant to ethanol. Our results imply that the H5N1 subtype poses a higher contact transmission risk because of its higher stability and ethanol resistance, which might depend on the neuraminidase protein.
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Din A. The stochastic bifurcation analysis and stochastic delayed optimal control for epidemic model with general incidence function. CHAOS (WOODBURY, N.Y.) 2021; 31:123101. [PMID: 34972335 DOI: 10.1063/5.0063050] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 11/15/2021] [Indexed: 06/14/2023]
Abstract
In the history of the world, contagious diseases have been proved to pose serious threats to humanity that needs uttermost research in the field and its prompt implementations. With this motive, an attempt has been made to investigate the spread of such contagion by using a delayed stochastic epidemic model with general incidence rate, time-delay transmission, and the concept of cross immunity. It is proved that the system is mathematically and biologically well-posed by showing that there exist a positive and bounded global solution of the model. Necessary conditions are derived, which guarantees the permanence as well as extinction of the disease. The model is further investigated for the existence of an ergodic stationary distribution and established sufficient conditions. The non-zero periodic solution of the stochastic model is analyzed quantitatively. The analysis of optimality and time delay is used, and a proper strategy was presented for prevention of the disease. A scheme for the numerical simulations is developed and implemented in MATLAB, which reflects the long term behavior of the model. Simulation suggests that the noises play a vital role in controlling the spread of an epidemic following the proposed flow, and the case of disease extinction is directly proportional to the magnitude of the white noises. Since time delay reflects the dynamics of recurring epidemics, therefore, it is believed that this study will provide a robust basis for studying the behavior and mechanism of chronic infections.
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Affiliation(s)
- Anwarud Din
- Department of Mathematics, Sun Yat-sen University, Guangzhou 510275, People's Republic of China
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Risk Factors of Influenza-Associated Respiratory Illnesses Reported to a Sentinel Hospital of Lahore, Pakistan: 2015-2016. ACTA ACUST UNITED AC 2021; 2021:2460553. [PMID: 34745395 PMCID: PMC8566087 DOI: 10.1155/2021/2460553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/10/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022]
Abstract
Epidemiological data about determinants of influenza A virus (IAV) in the Pakistani population is scarce. We aimed to conduct a prospective hospital-based active surveillance study from October 2015 to May 2016 to identify potential risk factors associated with IAV infection among patients with influenza-like illness (ILI) and severe acute respiratory illness (SARI). Surveillance was conducted in Lahore General Hospital, selected as a sentinel site in Lahore District, Pakistan. Nasal/throat samples were collected along with epidemiological and clinical data from enrolled patients. Real-time reverse-transcription polymerase chain reaction (rRT-PCR) was performed to identify IAV and its subtypes (H1N1pdm09, H3N2). Data were analyzed to determine risk factors and risk markers associated with IAV infections. A total of 311 suspected ILI and SARI cases were enrolled in the study, and among these 50 were IAV-positive. Of these 50 confirmed cases of IAV, 14 were subtyped as H1N1pdm09 and 15 were H3N2; the remaining 21 were untyped. A final multivariable model identified four independent risk factors/markers for IAV infection: exposure history to ILI patients within last 7 days and gender being male were identified as risk factors of IAV infection, while use of antibiotics prior to hospital consultation and presence of fever were identified as risk markers. We concluded that adopting nonpharmaceutical interventions like hand hygiene, masks, social distancing, and where possible, avoiding identified risk factors could decrease the risk of IAV infection and may prevent imminent outbreaks of IAV in the community.
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Nomoto H, Ishikane M, Lee S, Komiya N, Maeki T, Matsui T, Morita K, Oshitani H, Saijo M, Yamagishi T, Yamamoto T, Ohmagari N. Facilitating the deployment of Japanese human resources for responding global outbreaks of emerging and Re-emerging infectious diseases: A cross-sectional study. J Infect Chemother 2021; 28:41-46. [PMID: 34635449 DOI: 10.1016/j.jiac.2021.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/13/2021] [Accepted: 09/26/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In response to global outbreaks of infectious diseases, the need for support from organizations such as the World Health Organization Global Outbreak Alert and Response Network (GOARN) is increasing. Identifying the obstacles and support needs for applicants could increase GOARN deployments from Japan. METHODS This cross-sectional study involved a web-based, self-administered questionnaire survey targeting Japanese participants in the GOARN Tier 1.5 training workshop, held in Tokyo in December 2019. RESULTS All 47 Japanese participants in the workshop responded to the survey. Most responders were male and in their 30s and 40s. Participants specialized in case management (42.6%), infection prevention and control (25.6%), epidemiology and surveillance (19.1%). Only two participants (4.6%) had experienced a GOARN deployment. Their motivations for joining the GOARN training workshop were "Desire to be part of an international emerging infectious disease response team" (44.6%), "Interest in making an international contribution" (19.1%), and "Interest in working for the Japanese government in the field of international infectious diseases" (14.9%). Obstacles to GOARN deployments were "Making time for deployments" (45.7%) and "Lack of required professional skills and knowledge" (40.4%). The support needs for GOARN deployments constituted "Periodic simulation training" (51.1%), "Financial support during deployments" (44.7%), and "Technical support for deployments" (40.4%). CONCLUSIONS Our study revealed the obstacles and support needs of Japanese candidates for GOARN deployment. Making time and upskilling for GOARN deployment were the main obstacles. More practical training (like GOARN Tier 2.0) with other supports are needed. The national framework is desirable to realize these supports.
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Affiliation(s)
- Hidetoshi Nomoto
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, Japan; Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan; WHO Collaborating Centre for Prevention, Preparedness and Response to Emerging Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, Japan; WHO Collaborating Centre for Prevention, Preparedness and Response to Emerging Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, Japan.
| | - Sangnim Lee
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, Japan; WHO Collaborating Centre for Prevention, Preparedness and Response to Emerging Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, Japan; Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, 3-1-24, Matsuyama Kiyose, Tokyo, Japan
| | - Nobuhiro Komiya
- Department of Infectious Diseases, Japanese Red Cross Wakayama Medical Center, 4-20, Komatsubaradori, Wakayama City, Wakayama, Japan
| | - Takahiro Maeki
- Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Tamano Matsui
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku, Tokyo, Japan
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, Japan
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Masayuki Saijo
- Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan
| | - Takuya Yamagishi
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku, Tokyo, Japan
| | - Taro Yamamoto
- Department of International Health and Medical Anthropology, Institute of Tropical Medicine, Nagasaki University, 1-12-4, Sakamoto, Nagasaki City, Nagasaki, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, Japan; Emerging and Reemerging Infectious Diseases, Graduate School of Medicine, Tohoku University, 2-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi, Japan; WHO Collaborating Centre for Prevention, Preparedness and Response to Emerging Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku, Tokyo, Japan
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Capacity and use of diagnostics and treatment for patients with severe acute respiratory infections in the pre-COVID-19 era in district and provincial hospitals in Viet Nam. Western Pac Surveill Response J 2021; 12:1-9. [PMID: 35251746 PMCID: PMC8873919 DOI: 10.5365/wpsar.2021.12.4.835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Objective To describe the burden of severe acute respiratory infection (SARI) and the infrastructure and current practices of SARI management in hospitals in Viet Nam. Methods We conducted a short observational study at critical care units (CCUs) in 32 district hospitals and 16 provincial hospitals in five provinces in Viet Nam from March to July 2019. We collected data on hospital equipment and medicines used in SARI management. At the patient level, data were collected for 14 consecutive days on all patients presenting to CCUs, including information on demographics, intervention and treatment within 24 hours of CCU admission and 7-day outcome. Results There were significant differences between district and provincial hospitals in the availability of microbial culture, rapid influenza diagnostic tests, inflammatory markers and mechanical ventilation. Among 1722 eligible patients admitted to CCUs, there were 395 (22.9%) patients with SARI. The median age of SARI patients was 74 (interquartile range: 58–84) years; 49.1% were male. Although systemic antibiotics were available in all hospitals and were empirically given to 93.4% of patients, oseltamivir was available in 25% of hospitals, and only 0.5% of patients received empiric oseltamivir within 24 hours of admission. The 7-day mortality was 6.6% (26/395). Independent factors associated with 7-day mortality were septic shock and requiring respiratory support within 24 hours of admission. Discussion SARI is a major burden on CCUs in Viet Nam. Barriers to delivering quality care include the limited availability of diagnostics and medication and non-protocolized management of SARI in CCUs.
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El-Shesheny R, Kandeil A, Mostafa A, Ali MA, Webby RJ. H5 Influenza Viruses in Egypt. Cold Spring Harb Perspect Med 2021; 11:cshperspect.a038745. [PMID: 32122919 DOI: 10.1101/cshperspect.a038745] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
For almost a decade, Egypt has been endemic for highly pathogenic avian influenza (HPAI) A(H5N1) viruses. In addition to being catastrophic for poultry production, A(H5N1) has also caused 359 human infections in the country (∼40% of global cases), with 120 being fatal. From 2017, A(H5N1) viruses have been gradually replaced by HPAI A(H5N8) viruses seeded from Southeast Asia through Europe; no human cases have been reported since. This lack of human cases is not a consequence of fewer H5 infections in poultry. Despite governmental outbreak control, the number of avian influenza outbreaks has increased since 2006 partially fueled by noncompliance with preventive measures and suboptimal vaccination programs. Adherence to control measures is low because of social norms, especially among women and children-the main caretakers of household flocks in rural areas-and declining public awareness in the community. Egypt has thus become an epicenter for A(H5) virus evolution, with no clear resolution in sight.
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Affiliation(s)
- Rabeh El-Shesheny
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-3678, USA.,Center of Scientific Excellence for Influenza Viruses, National Research Centre, Giza 12622, Egypt
| | - Ahmed Kandeil
- Center of Scientific Excellence for Influenza Viruses, National Research Centre, Giza 12622, Egypt
| | - Ahmed Mostafa
- Center of Scientific Excellence for Influenza Viruses, National Research Centre, Giza 12622, Egypt
| | - Mohamed A Ali
- Center of Scientific Excellence for Influenza Viruses, National Research Centre, Giza 12622, Egypt
| | - Richard J Webby
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-3678, USA
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Tao Y, Probert WJM, Shea K, Runge MC, Lafferty K, Tildesley M, Ferrari M. Causes of delayed outbreak responses and their impacts on epidemic spread. J R Soc Interface 2021; 18:20200933. [PMID: 33653111 PMCID: PMC8086880 DOI: 10.1098/rsif.2020.0933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Livestock diseases have devastating consequences economically, socially and politically across the globe. In certain systems, pathogens remain viable after host death, which enables residual transmissions from infected carcasses. Rapid culling and carcass disposal are well-established strategies for stamping out an outbreak and limiting its impact; however, wait-times for these procedures, i.e. response delays, are typically farm-specific and time-varying due to logistical constraints. Failing to incorporate variable response delays in epidemiological models may understate outbreak projections and mislead management decisions. We revisited the 2001 foot-and-mouth epidemic in the United Kingdom and sought to understand how misrepresented response delays can influence model predictions. Survival analysis identified farm size and control demand as key factors that impeded timely culling and disposal activities on individual farms. Using these factors in the context of an existing policy to predict local variation in response times significantly affected predictions at the national scale. Models that assumed fixed, timely responses grossly underestimated epidemic severity and its long-term consequences. As a result, this study demonstrates how general inclusion of response dynamics and recognition of partial controllability of interventions can help inform management priorities during epidemics of livestock diseases.
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Affiliation(s)
- Yun Tao
- Intelligence Community Postdoctoral Research Fellowship Program, Oak Ridge, TN, USA.,Department of Ecology, Evolution and Marine Biology, University of California, Santa Barbara, CA, USA
| | - William J M Probert
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Katriona Shea
- Department of Biology, 208 Mueller Laboratory, Pennsylvania State University, University Park, PA, USA.,The Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA, USA
| | - Michael C Runge
- US Geological Survey, Patuxent Wildlife Research Center, Laurel, MD, USA
| | - Kevin Lafferty
- US Geological Survey, Western Ecological Research Center at Marine Science Institute, University of California, Santa Barbara, CA, USA
| | - Michael Tildesley
- The Zeeman Institute for Systems Biology and Infectious Disease Epidemiology Research, School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, West Midlands, UK
| | - Matthew Ferrari
- Department of Biology, 208 Mueller Laboratory, Pennsylvania State University, University Park, PA, USA.,The Center for Infectious Disease Dynamics, Pennsylvania State University, University Park, PA, USA
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Abstract
Highly pathogenic avian influenza H5N1 viruses have become endemic in global poultry populations over the past 25 years and pose an ongoing public health threat. Although the incidence of human cases has declined, viruses from the H5N1 lineage can now be found in poultry throughout Asia, the Middle East and Africa, in addition to causing outbreaks in Europe and the Americas. The recent emergence and spread of reassortant H5Nx viruses, resulting in regional poultry outbreaks, has increased the risk for further evolution of these viruses and possible avian-to-human transmission. Ongoing surveillance and pandemic preparedness for H5N1 and other avian influenza viruses of public health concern are warranted.
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Yitayih Y, Mekonen S, Zeynudin A, Mengistie E, Ambelu A. Mental health of healthcare professionals during the early stage of the COVID-19 pandemic in Ethiopia. BJPsych Open 2020; 7:e1. [PMID: 33256883 PMCID: PMC7844150 DOI: 10.1192/bjo.2020.130] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The coronavirus (COVID-19) pandemic causes healthcare professionals to suffer mental health problems such as psychological distress, anxiety, depression, denial and fear. However, studies are lacking related to Ethiopia and to Africa in general. AIMS To study the mental health of healthcare professionals during the COVID-19 pandemic in Ethiopia. METHOD A hospital-based cross-sectional study was conducted at Jimma University Medical Center among 249 healthcare professionals. The data were collected using self-administered questionnaires between 22 and 28 March 2020. The psychological impact was assessed using the Impact of Event Scale - Revised (IES-R) and symptoms of insomnia were measured using the Insomnia Severity Index (ISI). Social support was evaluated using the three-item Oslo Social Support Scale. Data were analysed using logistic regression to examine mutually adjusted associations, expressed as adjusted odds ratios. The psychosocial status of the healthcare professionals was predicted using a classification tree model supported by the genetic search method. RESULTS The prevalence of psychological distress among healthcare professionals was 78.3%. The mean IES-R score was 34.2 (s.d. = 19.4). The ISI score indicated that the prevalence of insomnia was 50.2%. Higher psychological distress was associated with younger age, having insomnia, not having a daily update on COVID-19, and feeling stigmatised and rejected in the neighbourhood because of hospital work. CONCLUSIONS This study indicates that, in Ethiopia, the prevalence of psychological distress among healthcare professionals is high and associated with specific sociodemographic risks.
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Affiliation(s)
| | - Seblework Mekonen
- Department of Environmental Health Science and Technology, Jimma University, Ethiopia
| | - Ahmed Zeynudin
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Ethiopia
| | - Embialle Mengistie
- Department of Environmental Health Science and Technology, Jimma University, Ethiopia
| | - Argaw Ambelu
- Department of Environmental Health Science and Technology, Jimma University, Ethiopia
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13
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Sensitive detection of virus with broad dynamic range based on highly bright quantum dot-embedded nanoprobe and magnetic beads. J IND ENG CHEM 2020. [DOI: 10.1016/j.jiec.2020.07.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Islam SS, Akwar H, Hossain MM, Sufian MA, Hasan MZ, Chakma S, Meeyam T, Chaisowwong W, Punyapornwithaya V, Debnath NC, Brum E, Pichpol D. Qualitative risk assessment of transmission pathways of highly pathogenic avian influenza (HPAI) virus at live poultry markets in Dhaka city, Bangladesh. Zoonoses Public Health 2020; 67:658-672. [PMID: 32558220 DOI: 10.1111/zph.12746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 05/14/2020] [Accepted: 05/21/2020] [Indexed: 11/30/2022]
Abstract
Analysis of environmental samples obtained from the Live Poultry Markets (LPMs) of Dhaka City, Bangladesh, has revealed that the highest degree of prevalence of highly pathogenic avian influenza A (HPAI, H5N1), besides other subtypes of the LPAI virus, poses the plausible risk of transmission of these viruses between human and poultry species. The present study was conducted using the OIE risk analysis framework to assess the risk level of each pathway successively. The estimated risk parameters were integrated towards to obtain the overall risk level for each specific HPAI transmission pathway using the matrix adapted by Cristobel Zepeda accompanying other expert consultations. The relevant data obtained from published and unpublished sources, together with survey data of field observations, were used to formulate and confirm the risk pathways and their associated risks. The results revealed that the risk of the release of the HPAI virus was medium when exposure was high. Additionally, the consequence would be considered very high with a medium degree of uncertainty for all parameters. Ultimately, the overall risk for transmission was estimated as medium with a medium degree of uncertainty. The findings of this study reveal that there is a significant threat that HPAI virus transmission could occur among poultry and humans and effectively sustain within the environment of the LPMs. Our findings are primarily focused on public health considerations, the hygienic slaughter of poultry and the relevant cleaning and sanitation practices conducted in the LPMs to support evidence-based decision-making processes. The findings of the study have the potential to be used to formulate effective risk reduction measures and can be further adapted in low-resource settings without major infrastructural changes required of the LPMs. All of which would reduce the risk of HPAI virus release and further lessen the degree of exposure and transmission in established LPMs.
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Affiliation(s)
- Sk Shaheenur Islam
- Department of Livestock Services, Krishi Khamar Sarak, Farmgate, Dhaka, Bangladesh.,Master of Science in Veterinary Science (International), Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Holy Akwar
- Emergency Centre for Transboundary Animal Diseases (ECTAD) of Food and Agriculture Organization of United Nations (FAO-UN), Dhaka, Bangladesh
| | - Md Mehedi Hossain
- Department of Livestock Services, Krishi Khamar Sarak, Farmgate, Dhaka, Bangladesh
| | - Md Abu Sufian
- Department of Livestock Services, Krishi Khamar Sarak, Farmgate, Dhaka, Bangladesh
| | - Md Zakiul Hasan
- Emergency Centre for Transboundary Animal Diseases (ECTAD) of Food and Agriculture Organization of United Nations (FAO-UN), Dhaka, Bangladesh
| | - Shovon Chakma
- Emergency Centre for Transboundary Animal Diseases (ECTAD) of Food and Agriculture Organization of United Nations (FAO-UN), Dhaka, Bangladesh
| | - Tongkorn Meeyam
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand.,Faculty of Veterinary Medicine, Veterinary Public Health Centre for Asia Pacific (VPHCAP), Chiang Mai University, Chiang Mai, Thailand
| | - Warangkhana Chaisowwong
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand.,Faculty of Veterinary Medicine, Veterinary Public Health Centre for Asia Pacific (VPHCAP), Chiang Mai University, Chiang Mai, Thailand
| | - Veerasak Punyapornwithaya
- Faculty of Veterinary Medicine, Veterinary Public Health Centre for Asia Pacific (VPHCAP), Chiang Mai University, Chiang Mai, Thailand
| | - Nitish C Debnath
- Emergency Centre for Transboundary Animal Diseases (ECTAD) of Food and Agriculture Organization of United Nations (FAO-UN), Dhaka, Bangladesh
| | - Eric Brum
- Emergency Centre for Transboundary Animal Diseases (ECTAD) of Food and Agriculture Organization of United Nations (FAO-UN), Dhaka, Bangladesh
| | - Duangporn Pichpol
- Department of Veterinary Biosciences and Veterinary Public Health, Faculty of Veterinary Medicine, Chiang Mai University, Chiang Mai, Thailand.,Faculty of Veterinary Medicine, Veterinary Public Health Centre for Asia Pacific (VPHCAP), Chiang Mai University, Chiang Mai, Thailand
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15
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Muzyka D, Rula O, Tkachenko S, Muzyka N, Köthe S, Pishchanskyi O, Stegniy B, Pantin-Jackwood M, Beer M. Highly Pathogenic and Low Pathogenic Avian Influenza H5 Subtype Viruses in Wild Birds in Ukraine. Avian Dis 2020; 63:235-245. [PMID: 31713401 DOI: 10.1637/11880-042718.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 12/09/2018] [Indexed: 11/05/2022]
Abstract
There have been three waves of highly pathogenic avian influenza (HPAI) outbreaks in commercial, backyard poultry, and wild birds in Ukraine. The first (2005-2006) and second (2008) waves were caused by H5N1 HPAI virus, with 45 outbreaks among commercial poultry (chickens) and backyard fowl (chickens, ducks, and geese) in four regions of Ukraine (AR Crimea, Kherson, Odesa, and Sumy Oblast). H5N1 HPAI viruses were isolated from dead wild birds: cormorants (Phalacrocorax carbo) and great crested grebes (Podiceps cristatus) in 2006 and 2008. The third HPAI wave consisted of nine outbreaks of H5N8 HPAI in wild and domestic birds, beginning in November 2016 in the central and south regions (Kherson, Odesa, Chernivtsi, Ternopil, and Mykolaiv Oblast). H5N8 HPAI virus was detected in dead mute swans (Cygnus olor), peacocks (Pavo cristatus) (in zoo), ruddy shelducks (Tadorna ferruginea), white-fronted geese (Anser albifrons), and from environmental samples in 2016 and 2017. Wide wild bird surveillance for avian influenza (AI) virus was conducted from 2006 to 2016 in Ukraine regions suspected of being intercontinental (north-south and east-west) flyways. A total of 21 511 samples were collected from 105 species of wild birds representing 27 families and 11 orders. Ninety-five avian influenza (AI) viruses were isolated (including one H5N2 LPAI virus in 2010) from wild birds with a total of 26 antigenic hemagglutinin (HA) and neuraminidase (NA) combinations. Fifteen of 16 known avian HA subtypes were isolated. Two H5N8 HPAI viruses (2016-2017) and two H5N2 LPAI viruses (2016) were isolated from wild birds and environmental samples (fresh bird feces) during surveillance before the outbreak in poultry in 2016-2017. The Ukrainian H5N1, H5N8 HPAI, and H5N2 LPAI viruses belong to different H5 phylogenetic groups. Our results demonstrate the great diversity of AI viruses in wild birds in Ukraine, as well as the importance of this region for studying the ecology of avian influenza.
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Affiliation(s)
- Denys Muzyka
- National Scientific Center "Institute of Experimental and Clinical Veterinary Medicine", Kharkiv, 61023, Ukraine,
| | - Oleksandr Rula
- National Scientific Center "Institute of Experimental and Clinical Veterinary Medicine", Kharkiv, 61023, Ukraine
| | - Semen Tkachenko
- National Scientific Center "Institute of Experimental and Clinical Veterinary Medicine", Kharkiv, 61023, Ukraine
| | - Nataliia Muzyka
- State Poultry Research Station, v. Birky, Kharkiv Region, 63422, Ukraine
| | - Susanne Köthe
- Friedrich-Loeffler-Institut, 17493 Greifswald-Insel Riems, Germany
| | - Oleksandr Pishchanskyi
- National Scientific Center "Institute of Experimental and Clinical Veterinary Medicine", Kharkiv, 61023, Ukraine
| | - Borys Stegniy
- National Scientific Center "Institute of Experimental and Clinical Veterinary Medicine", Kharkiv, 61023, Ukraine
| | - Mary Pantin-Jackwood
- Exotic and Emerging Avian Viral Diseases Unit, Southeast Poultry Research Laboratory, U.S. National Poultry Research Center, Agricultural Research Service, U.S. Department of Agriculture, Athens, GA 30677
| | - Martin Beer
- Friedrich-Loeffler-Institut, 17493 Greifswald-Insel Riems, Germany
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16
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Sultan HA, Arafa AE, Talaat S, Gaballa AA, Kilany WH, Elfeil WK, Shehata AA, Amarin N. Efficacy of Clade 2.3.2 H5-Recombinant Baculovirus Vaccine in Protecting Muscovy and Pekin Ducks from Clade 2.3.4.4 H5N8 Highly Pathogenic Avian Influenza Infection. Avian Dis 2020; 63:219-229. [PMID: 31713400 DOI: 10.1637/0005-2086-63.1.219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 01/03/2019] [Indexed: 11/05/2022]
Abstract
In late 2016, a highly pathogenic avian influenza (HPAI) virus subtype H5N8 clade 2.3.4.4 was reported in Egypt in migratory birds; subsequently, the virus spread to backyard and commercial poultry in several Egyptian governorates, causing severe economic losses to the poultry industry. Here, a recombinant subunit commercial H5 vaccine prepared from the clade 2.3.2 H5 segment on baculovirus was evaluated in Pekin ducks (Anasplatyrhynchos domesticus) and Muscovy ducks (Cairina moschata) in Biosafety Level 3 isolators by using two vaccination regimes: either a single dose on day 10 and a challenge on day 31 or a double dose on days 10 and 28 and a challenge on day 49. The protection parameters were evaluated after experimental infection with the Egyptian HPAI H5N8 isolate clade 2.3.4.4b (A/common-coot/Egypt/CA285/2016) based on mortality rate, clinical signs, gross lesions, seroconversion, virus shedding, and histopathologic changes. In the single-dose vaccination regime, the mortality rate in Muscovy and Pekin ducks was 10% and 0% vs. 40% and 0% in nonvaccinated challenged ducks, respectively. In the double-dose vaccination regime, the mortality rates in Muscovy and Pekin ducks were 0% and 0% vs. 60% and 40% in nonvaccinated challenged ducks, respectively. Muscovy ducks developed more severe clinical signs and gross lesions than Pekin ducks. In addition, tracheal viral shedding in challenged Muscovy ducks, in the single-dose vaccination regime, was 50%, 22%, and 0% at 3, 5, and 7 days postchallenge (DPC), respectively, and was 0% in all Pekin ducks vs. 100% in all challenged nonvaccinated Muscovy and Pekin ducks at 3, 5, and 7 DPC. The viral shedding in challenged Muscovy and Pekin ducks, in the double-dose vaccination regime, was 0% at 3, 5, and 7 DPC vs. 100% in nonvaccinated challenged Muscovy and Pekin ducks, respectively. The results of this study indicate that the H5 baculovirus-based vaccine can be used in ducks with better vaccination regime based on double-dose vaccination at 10 and 28 days of age. In addition, they highlight the need to evaluate the efficacy of currently used commercial vaccines against challenge with the newly emerged HPAI H5N8 clade 2.3.4.4 in the field in Egypt to ensure proper control strategy in ducks.
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Affiliation(s)
- Hesham A Sultan
- Department of Bird and Rabbit Medicine, Faculty of Veterinary Medicine, University of Sadat City, Menoufiya, Egypt, 32958.,Corresponding author. E-mail:
| | - Abd-Elsatar Arafa
- Reference Laboratory for Veterinary Quality Control on Poultry Production, Animal Health Research Institute, P.O. Box 264-Dokki, Giza, Egypt, 12618
| | - Shaimaa Talaat
- Department of Bird and Rabbit Medicine, Faculty of Veterinary Medicine, University of Sadat City, Menoufiya, Egypt, 32958
| | - Alaa A Gaballa
- Department of Bird and Rabbit Medicine, Faculty of Veterinary Medicine, University of Sadat City, Menoufiya, Egypt, 32958
| | - Walid H Kilany
- Reference Laboratory for Veterinary Quality Control on Poultry Production, Animal Health Research Institute, P.O. Box 264-Dokki, Giza, Egypt, 12618
| | - Wael K Elfeil
- Department of Avian and Rabbit Medicine, Faculty of Veterinary Medicine, University of Suez Canal, Ismailia, Egypt, 41522
| | - Awad A Shehata
- Department of Bird and Rabbit Medicine, Faculty of Veterinary Medicine, University of Sadat City, Menoufiya, Egypt, 32958
| | - N Amarin
- Boehringer Ingelheim, Middle East and North Africa, Dubai, United Arab Emirates
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17
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Jaber SI, Thwiny HT. Serological survey for avian influenza virus infection of backyard poultry and poultry workers in Baghdad and Basrah provinces, Iraq. BULGARIAN JOURNAL OF VETERINARY MEDICINE 2020. [DOI: 10.15547/bjvm.2211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study was to determine the prevalence of avian influenza virus (AIV) subtype H5N1 among backyard birds and poultry workers. The study included backyard birds (chickens and ducks) in rural areas of Baghdad and Basrah provinces, Iraq. Rural areas were divided into wet land and dry land. Total egg samples were 368, divided into 184 eggs (92 chicken eggs and 92 duck eggs) from each province. The total number of human sera was 180 (45 poultry worker and 45 non-poultry worker samples from each province). Competitive ELISA tests were used for detection of specific antibodies against influenza A virus and influenza subtype H5N1 in all samples. Seroprevalence against AIV type A in chickens was 62.5% (115/184) while ducks showed seroprevalence of 40.8% (75/184). The seropositivity among the backyard birds in wet land rural areas was higher than that in dry land rural areas. The samples positive for subtype H5N1 in chickens were 15.7% (18/115) while in ducks: 12% (9/75) with highest seropositivity among chickens in wet land rural areas (18.8%; 12/64). The seropositivity of avian influenza H5N1 was 6% (4/67) among AIV-positive poultry workers and 2.9% (1/34) among non-poultry workers.
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18
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Detecting influenza and emerging avian influenza virus by influenza and pneumonia surveillance systems in a large city in China, 2005 to 2016. BMC Infect Dis 2019; 19:825. [PMID: 31533638 PMCID: PMC6751661 DOI: 10.1186/s12879-019-4405-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/25/2019] [Indexed: 11/25/2022] Open
Abstract
Background Detecting avian influenza virus has become an important public health strategy for controlling the emerging infectious disease. Methods The HIS (hospital information system) modified influenza surveillance system (ISS) and a newly built pneumonia surveillance system (PSS) were used to monitor the influenza viruses in Changsha City, China. The ISS was used to monitor outpatients in two sentinel hospitals and to detect mild influenza and avian influenza cases, and PSS was used to monitor inpatients in 49 hospitals and to detect severe and death influenza cases. Results From 2005 to 2016, there were 3,551,917 outpatients monitored by the ISS system, among whom 126,076 were influenza-like illness (ILI) cases, with the ILI proportion (ILI%) of 3.55%. After the HIS was used, the reported incident cases of ILI and ILI% were increased significantly. From March, 2009 to September, 2016, there were 5,491,560 inpatient cases monitored by the PSS system, among which 362,743 were pneumonia cases, with a proportion of 6.61%. Among pneumonia cases, about 10.55% (38,260/362,743) of cases were severe or death cases. The pneumonia incidence increased each year in the city. Among 15 avian influenza cases reported from January, 2005 to September, 2016, there were 26.7% (4/15) mild cases detected by the HIS-modified ISS system, while 60.0% (9/15) were severe or death cases detected by the PSS system. Two H5N1 severe cases were missed by the ISS system in January, 2009 when the PSS system was not available. Conclusions The HIS was able to improve the efficiency of the ISS for monitoring ILI and emerging avian influenza virus. However, the efficiency of the system needs to be verified in a wider area for a longer time span in China.
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19
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20
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The Pattern of Highly Pathogenic Avian Influenza H5N1 Outbreaks in South Asia. Trop Med Infect Dis 2019; 4:tropicalmed4040138. [PMID: 31783701 PMCID: PMC6958390 DOI: 10.3390/tropicalmed4040138] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/11/2019] [Accepted: 11/11/2019] [Indexed: 12/14/2022] Open
Abstract
Highly pathogenic avian influenza (HPAI) H5N1 has caused severe illnesses in poultry and in humans. More than 15,000 outbreaks in domestic birds from 2005 to 2018 and 861 human cases from 2003 to 2019 were reported across the world to OIE (Office International des Epizooties) and WHO (World Health Organization), respectively. We reviewed and summarized the spatial and temporal distribution of HPAI outbreaks in South Asia. During January 2006 to June 2019, a total of 1063 H5N1 outbreaks in birds and 12 human cases for H5N1 infection were reported to OIE and WHO, respectively. H5N1 outbreaks were detected more in the winter season than the summer season (RR 5.11, 95% CI: 4.28-6.1). Commercial poultry were three times more likely to be infected with H5N1 than backyard poultry (RR 3.47, 95% CI: 2.99-4.01). The highest number of H5N1 outbreaks was reported in 2008, and the smallest numbers were reported in 2014 and 2015. Multiple subtypes of avian influenza viruses and multiple clades of H5N1 virus were detected. Early detection and reporting of HPAI viruses are needed to control and eliminate HPAI in South Asia.
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21
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Alam MU, Rahman M, Abdullah-Al-Masud, Islam MA, Asaduzzaman M, Sarker S, Rousham E, Unicomb L. Human exposure to antimicrobial resistance from poultry production: Assessing hygiene and waste-disposal practices in Bangladesh. Int J Hyg Environ Health 2019; 222:1068-1076. [DOI: 10.1016/j.ijheh.2019.07.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 06/25/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
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22
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Numberger D, Dreier C, Vullioud C, Gabriel G, Greenwood AD, Grossart HP. Recovery of influenza A viruses from lake water and sediments by experimental inoculation. PLoS One 2019; 14:e0216880. [PMID: 31091283 PMCID: PMC6519785 DOI: 10.1371/journal.pone.0216880] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/30/2019] [Indexed: 11/19/2022] Open
Abstract
Influenza A viruses (IAV) are zoonotic pathogens relevant to human, domestic animal and wildlife health. Many avian IAVs are transmitted among waterfowl via a faecal-oral-route. Therefore, environmental water where waterfowl congregate may play an important role in the ecology and epidemiology of avian IAV. Water and sediment may sustain and transmit virus among individuals or species. It is unclear at what concentrations waterborne viruses are infectious or remain detectable. To address this, we performed lake water and sediment dilution experiments with varying concentrations or infectious doses of four IAV strains from seal, turkey, duck and gull. To test for infectivity of the IAV strains in a concentration dependent manner, we applied cultivation to specific pathogen free (SPF) embryonated chicken eggs and Madin-Darby Canine Kidney (MDCK) cells. IAV recovery was more effective from embryonated chicken eggs than MDCK cells for freshwater lake dilutions, whereas, MDCK cells were more effective for viral recovery from sediment samples. Low infectious dose (1 PFU/200 μL) was sufficient in most cases to detect and recover IAV from lake water dilutions. Sediment required higher initial infectious doses (≥ 100 PFU/200 μL).
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Affiliation(s)
| | - Carola Dreier
- Heinrich Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Colin Vullioud
- Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany
| | - Gülsah Gabriel
- Heinrich Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
- University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Alex D. Greenwood
- Leibniz Institute for Zoo and Wildlife Research, Berlin, Germany
- Leibniz Institute of Freshwater Ecology and Inland Fisheries, Stechlin, Germany
- * E-mail: (HPG); (ADG)
| | - Hans-Peter Grossart
- University of Potsdam, Institute of Biochemistry and Biology, Potsdam, Germany
- Freie Universität Berlin, Department of Veterinary Medicine, Institute for Virology, Berlin, Germany
- * E-mail: (HPG); (ADG)
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23
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Pramuwidyatama MG, Hogeveen H, Saatkamp HW. A Systematic Evaluation of Measures Against Highly Pathogenic Avian Influenza (HPAI) in Indonesia. Front Vet Sci 2019; 6:33. [PMID: 30834252 PMCID: PMC6387902 DOI: 10.3389/fvets.2019.00033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 01/28/2019] [Indexed: 11/13/2022] Open
Abstract
Over the past years, many different control measures have been implemented to prevent HPAI infection. The national plan with numerous measures lead to problems in terms of prioritization and budget allocation. Our study objectives are to (i) establish an inventory of measures on HPAI control in Indonesia since the first actions were taken in 2004, (ii) evaluate preferences for different HPAI control measures applied in the West Java province at the district level during 2013–2017, and (iii) establish a basis for further qualitative and quantitative research to improve control for an endemic HPAI in Indonesia. This research was carried out according to the following five steps (i) development of an HPAI management framework for an endemic state, (ii) inventorization of measures directed at HPAI and description of the development of HPAI in Indonesia, (iii) development of a questionnaire for the experts involved, (iv) systematic evaluation of preferences for short- and long-term HPAI strategies and measures applied in the West Java Province based on expert opinion, and (v) data analysis. The study systematically evaluated in total 27 measures. The results of this study show that the animal disease management framework is helpful as a systematic structure to distinguish and evaluate strategies and measures. In our framework, we defined the following strategies: prevention, monitoring, control, mitigation, eradication, and human protection. The findings of our research show that the primary aims of the government were to safeguard humans from HPAI transmission by mitigating HPAI disease in livestock. The measures with the highest priority were preventive vaccination of poultry, biosecurity, and stamping-out infected flocks. This showed that the government predominantly chose a vaccination-based HPAI mitigation strategy. However, the chosen strategy has a low implementation feasibility. A collaboration between the responsible stakeholders farmers may increase the feasibility of the chosen strategy in the future. Furthermore, our findings provide a basis for research into the motivation of farmers to implement different measures as well as into the expected impact of different measures to develop an effective and efficient mitigation approach.
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Affiliation(s)
| | - Henk Hogeveen
- Business Economics Group, Wageningen University and Research, Wageningen, Netherlands.,Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Helmut W Saatkamp
- Business Economics Group, Wageningen University and Research, Wageningen, Netherlands
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24
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Kim WH, An JU, Kim J, Moon OK, Bae SH, Bender JB, Cho S. Risk factors associated with highly pathogenic avian influenza subtype H5N8 outbreaks on broiler duck farms in South Korea. Transbound Emerg Dis 2018; 65:1329-1338. [PMID: 29673109 DOI: 10.1111/tbed.12882] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Indexed: 11/29/2022]
Abstract
Highly Pathogenic Avian Influenza (HPAI) subtype H5N8 outbreaks occurred in poultry farms in South Korea in 2014 resulting in significant damage to the poultry industry. Between 2014 and 2016, the pandemic disease caused significant economic loss and social disruption. To evaluate the risk factors for HPAI infection in broiler duck farms, we conducted a retrospective case-control study on broiler duck farms. Forty-three farms with confirmed laboratories on premises were selected as the case group, and 43 HPAI-negative farms were designated as the control group. Control farms were matched based on farm location and were within a 3-km radius from the case premises. Spatial and environmental factors were characterized by site visit and plotted through a geographic information system (GIS). Univariable and multivariable logistic regression models were developed to assess possible risk factors associated with HPAI broiler duck farm infection. Four final variables were identified as risk factors in a final multivariable logistic model: "Farms with ≥7 flocks" (odds ratio [OR] = 6.99, 95% confidence interval [CI] 1.34-37.04), "Farm owner with ≥15 years of raising poultry career" (OR = 7.91, 95% CI 1.69-37.14), "Presence of any poultry farms located within 500 m of the farm" (OR = 6.30, 95% CI 1.08-36.93) and "Not using a faecal removal service" (OR = 27.78, 95% CI 3.89-198.80). This highlights that the HPAI H5N8 outbreaks in South Korea were associated with farm owner education, number of flocks and facilities and farm biosecurity. Awareness of these factors may help to reduce the spread of HPAI H5N8 across broiler duck farms in Korea during epidemics. Greater understanding of the risk factors for H5N8 may improve farm vulnerability to HPAI and other subtypes and help to establish policies to prevent re-occurrence. These findings are relevant to global prevention recommendations and intervention protocols.
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Affiliation(s)
- W-H Kim
- BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - J-U An
- BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - J Kim
- BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul, Korea
| | - O-K Moon
- Animal and Plant Quarantine Agency, Gimcheon, Korea
| | - S H Bae
- Department of Geography Education, Kangwon National University, Chuncheon, Korea
| | - J B Bender
- Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - S Cho
- BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul, Korea
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25
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Ryu S, Lim JS, Cowling BJ, Chun BC. Low risk of avian influenza A (H5N6) transmission to depopulation workers in Korea. Influenza Other Respir Viruses 2018; 12:412-415. [PMID: 29236360 PMCID: PMC5907809 DOI: 10.1111/irv.12530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2017] [Indexed: 11/27/2022] Open
Abstract
An outbreak of highly pathogenic avian influenza A (H5N6) virus occurred between November 20, 2016, and March 1, 2017 in poultry farms, in the Gyeonggi Province, Republic of Korea. To identify the risk of transmission of H5N6 to depopulation workers, active and passive surveillance was conducted. Virological testing of respiratory swabs with real‐time reverse transcription‐polymerase chain reaction was performed for workers who reported respiratory symptoms. Among 4633 depopulation workers, 22 reported respiratory symptoms, but all tested negative for H5N6. Personal protective equipment in addition to antiviral prophylaxis was adequate to limit transmission of H5N6 from poultry to humans.
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Affiliation(s)
- Sukhyun Ryu
- Division of Infectious Disease Control, Gyeonggi Provincial Government, Suwon, Korea.,Department of Epidemiology and Medical Informatics, Graduate School of Public Health, Korea University, Seoul, Korea
| | - Jun-Sik Lim
- Disease Diagnostic Team, Gyeonggi Province Veterinary Service, Suwon, Korea
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Byung Chul Chun
- Department of Epidemiology and Medical Informatics, Graduate School of Public Health, Korea University, Seoul, Korea.,Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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26
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Havers FP, Campbell AP, Uyeki TM, Fry AM. Commentary: A Historical Review of Centers for Disease Control and Prevention Antiviral Treatment and Postexposure Chemoprophylaxis Guidance for Human Infections With Novel Influenza A Viruses Associated With Severe Human Disease. J Infect Dis 2017; 216:S575-S580. [PMID: 28934460 DOI: 10.1093/infdis/jix065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Human infections with novel influenza A viruses are of global public health concern, and antiviral medications have a potentially important role in treatment and prevention of human illness. Initial guidance was developed by the U.S. Centers for Disease Control and Prevention after the emergence of human infections with avian influenza A(H5N1) and has evolved over time, with identification of influenza A(H7N9) virus infections in humans, as well as detection of avian influenza viruses in birds in the United States. This commentary describes the historical context and current guidance for the use of influenza antiviral medications for treatment and post-exposure chemoprophylaxis of human infections with novel influenza A viruses associated with severe human illness, or with the potential to cause severe human disease, and provides the scientific rationale behind current recommendations.
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Affiliation(s)
- Fiona P Havers
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Angela P Campbell
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Timothy M Uyeki
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alicia M Fry
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia
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27
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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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28
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Christian KA, Iuliano AD, Uyeki TM, Mintz ED, Nichol ST, Rollin P, Staples JE, Arthur RR. What We Are Watching-Top Global Infectious Disease Threats, 2013-2016: An Update from CDC's Global Disease Detection Operations Center. Health Secur 2017; 15:453-462. [PMID: 28805465 PMCID: PMC5661857 DOI: 10.1089/hs.2017.0004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 05/10/2017] [Accepted: 05/11/2017] [Indexed: 02/04/2023] Open
Abstract
To better track public health events in areas where the public health system is unable or unwilling to report the event to appropriate public health authorities, agencies can conduct event-based surveillance, which is defined as the organized collection, monitoring, assessment, and interpretation of unstructured information regarding public health events that may represent an acute risk to public health. The US Centers for Disease Control and Prevention's (CDC's) Global Disease Detection Operations Center (GDDOC) was created in 2007 to serve as CDC's platform dedicated to conducting worldwide event-based surveillance, which is now highlighted as part of the "detect" element of the Global Health Security Agenda (GHSA). The GHSA works toward making the world more safe and secure from disease threats through building capacity to better "Prevent, Detect, and Respond" to those threats. The GDDOC monitors approximately 30 to 40 public health events each day. In this article, we describe the top threats to public health monitored during 2012 to 2016: avian influenza, cholera, Ebola virus disease, and the vector-borne diseases yellow fever, chikungunya virus, and Zika virus, with updates to the previously described threats from Middle East respiratory syndrome-coronavirus (MERS-CoV) and poliomyelitis.
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29
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Root ED, Agustian D, Kartasasmita C, Uyeki TM, Simões EAF. Demographic and ecological risk factors for human influenza A virus infections in rural Indonesia. Influenza Other Respir Viruses 2017; 11:425-433. [PMID: 28715152 PMCID: PMC5596523 DOI: 10.1111/irv.12468] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2017] [Indexed: 11/26/2022] Open
Abstract
Background Indonesia has the world's highest reported mortality for human infections with highly pathogenic avian influenza (HPAI) A(H5N1) virus. Indonesia is an agriculturally driven country where human‐animal mixing is common and provides a unique environment for zoonotic influenza A virus transmission. Objectives To identify potential demographic and ecological risk factors for human infection with seasonal influenza A viruses in rural Indonesia, a population‐based study was conducted in Cileunyi and Soreang subdistricts near Bandung in western Java from 2008 to 2011. Methods Passive influenza surveillance with RT‐PCR confirmation of influenza A viral RNA in respiratory specimens was utilized for case ascertainment. A population census and mapping were utilized for population data collection. The presence of influenza A(H3N2) and A(H1N1)pdm09 virus infections in a household was modeled using Generalized Estimating Equations. Results Each additional child aged <5 years in a household increased the odds of H3N2 approximately 5 times (OR=4.59, 95%CI: 3.30‐6.24) and H1N1pdm09 by 3.5 times (OR=3.53, 95%CI: 2.51‐4.96). In addition, the presence of 16‐30 birds in the house was associated with an increased odds of H3N2 (OR=5.08, 95%CI: 2.00‐12.92) and H1N1pdm09 (OR=12.51 95%CI: 6.23‐25.13). Conclusion Our findings suggest an increase in influenza A virus infections in rural Indonesian households with young children and poultry.
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Affiliation(s)
| | - Dwi Agustian
- Faculty of Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Cissy Kartasasmita
- Faculty of Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Eric A F Simões
- University of Colorado School of Medicine, Aurora, CO, USA.,Center for Global Health, Colorado School of Public Health, Aurora, CO, USA
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30
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Fournié G, Høg E, Barnett T, Pfeiffer DU, Mangtani P. A Systematic Review and Meta-Analysis of Practices Exposing Humans to Avian Influenza Viruses, Their Prevalence, and Rationale. Am J Trop Med Hyg 2017; 97:376-388. [PMID: 28749769 PMCID: PMC5544094 DOI: 10.4269/ajtmh.17-0014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Almost all human infections by avian influenza viruses (AIVs) are transmitted from poultry. A systematic review was conducted to identify practices associated with human infections, their prevalence, and rationale. Observational studies were identified through database searches. Meta-analysis produced combined odds ratio estimates. The prevalence of practices and rationales for their adoptions were reported. Of the 48,217 records initially identified, 65 articles were included. Direct and indirect exposures to poultry were associated with infection for all investigated viral subtypes and settings. For the most frequently reported practices, association with infection seemed stronger in markets than households, for sick and dead than healthy poultry, and for H7N9 than H5N1. Practices were often described in general terms and their frequency and intensity of contact were not provided. The prevalence of practices was highly variable across studies, and no studies comprehensively explored reasons behind the adoption of practices. Combining epidemiological and targeted anthropological studies would increase the spectrum and detail of practices that could be investigated and should aim to provide insights into the rationale(s) for their existence. A better understanding of these rationales may help to design more realistic and acceptable preventive public health measures and messages.
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Affiliation(s)
- Guillaume Fournié
- Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, United Kingdom
| | - Erling Høg
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tony Barnett
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dirk U Pfeiffer
- School of Veterinary Medicine, City University of Hong Kong, Kowloon, Hong Kong.,Veterinary Epidemiology, Economics and Public Health Group, Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, United Kingdom
| | - Punam Mangtani
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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31
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Harris KA, Freidl GS, Munoz OS, von Dobschuetz S, De Nardi M, Wieland B, Koopmans MPG, Stärk KDC, van Reeth K, Dauphin G, Meijer A, de Bruin E, Capua I, Hill AA, Kosmider R, Banks J, Stevens K, van der Werf S, Enouf V, van der Meulen K, Brown IH, Alexander DJ, Breed AC. Epidemiological Risk Factors for Animal Influenza A Viruses Overcoming Species Barriers. ECOHEALTH 2017; 14:342-360. [PMID: 28523412 DOI: 10.1007/s10393-017-1244-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 03/30/2017] [Accepted: 04/10/2017] [Indexed: 05/21/2023]
Abstract
Drivers and risk factors for Influenza A virus transmission across species barriers are poorly understood, despite the ever present threat to human and animal health potentially on a pandemic scale. Here we review the published evidence for epidemiological risk factors associated with influenza viruses transmitting between animal species and from animals to humans. A total of 39 papers were found with evidence of epidemiological risk factors for influenza virus transmission from animals to humans; 18 of which had some statistical measure associated with the transmission of a virus. Circumstantial or observational evidence of risk factors for transmission between animal species was found in 21 papers, including proximity to infected animals, ingestion of infected material and potential association with a species known to carry influenza virus. Only three publications were found which presented a statistical measure of an epidemiological risk factor for the transmission of influenza between animal species. This review has identified a significant gap in knowledge regarding epidemiological risk factors for the transmission of influenza viruses between animal species.
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Affiliation(s)
- Kate A Harris
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK
| | - Gudrun S Freidl
- Centre for Infectious Disease Research, Diagnostics and Screening (IDS), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Olga S Munoz
- OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE Collaborating Centre for Diseases at the Human-Animal Interface, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Padua, Italy
- One Health Center of Excellence, Emerging Pathogens Institute and Institute of Food and Agricultural Sciences-Department of Animal Sciences, University of Florida, 32611, Gainesville, FL, USA
| | - Sophie von Dobschuetz
- Royal Veterinary College (RVC), London, UK
- Food and Agricultural Organization of the United Nations (FAO), Rome, Italy
| | - Marco De Nardi
- OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE Collaborating Centre for Diseases at the Human-Animal Interface, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Padua, Italy
- SAFOSO AG, Liebefeld, Switzerland
| | - Barbara Wieland
- International Livestock Research Institute ILRI, Box 5689, Addis Ababa, Ethiopia
| | - Marion P G Koopmans
- Centre for Infectious Disease Research, Diagnostics and Screening (IDS), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Viroscience, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Kristien van Reeth
- Laboratory of Virology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Gwen Dauphin
- Food and Agricultural Organization of the United Nations (FAO), Rome, Italy
| | - Adam Meijer
- Centre for Infectious Disease Research, Diagnostics and Screening (IDS), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Erwin de Bruin
- Centre for Infectious Disease Research, Diagnostics and Screening (IDS), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Ilaria Capua
- OIE/FAO and National Reference Laboratory for Newcastle Disease and Avian Influenza, OIE Collaborating Centre for Diseases at the Human-Animal Interface, Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, 35020, Legnaro, Padua, Italy
- One Health Center of Excellence, Emerging Pathogens Institute and Institute of Food and Agricultural Sciences-Department of Animal Sciences, University of Florida, 32611, Gainesville, FL, USA
| | - Andy A Hill
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK
- Royal Veterinary College (RVC), London, UK
- BAE Systems, Farnborough, UK
| | - Rowena Kosmider
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK
| | - Jill Banks
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK
| | | | | | | | - Karen van der Meulen
- Laboratory of Virology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Ian H Brown
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK
| | - Dennis J Alexander
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK
| | - Andrew C Breed
- Animal and Plant Health Agency-Weybridge (APHA), Woodham Lane, New Haw, Addlestone, Surrey, KT15 3NB, UK.
- Epidemiology and One Health Section, Department of Water Resources, Canberra, Australia.
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32
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Nguyen HKL, Nguyen SV, Nguyen AP, Hoang PMV, Le TT, Nguyen TC, Hoang HT, Vuong CD, Tran LTT, Le MQ. Surveillance of Severe Acute Respiratory Infection (SARI) for Hospitalized Patients in Northern Vietnam, 2011-2014. Jpn J Infect Dis 2017; 70:522-527. [PMID: 28367882 DOI: 10.7883/yoken.jjid.2016.463] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Severe acute respiratory infections (SARI) are leading causes of hospitalization, morbidity, and mortality in children worldwide. The aim of this study was to identify viral pathogens responsible for SARI in northern Vietnam in the period from 2011 to 2014. Throat swabs and tracheal aspirates were collected from SARI patients according to WHO guidelines. The presence of 13 different viral pathogens (influenza A[H1N1]pdm09; A/H3N2; A/H5; A/H7 and B; para influenza 1,2,3; RSV; HMPV; adeno; severe acute respiratory syndrome-CoV and rhino) was tested by conventional/real-time reverse transcription-polymerase chain reaction. During the study period, 975 samples were collected and tested. More than 30% (32.1%, 313 samples) of the samples showed evidence of infection with influenza viruses, including A/H3N2 (48 samples), A (H1N1) pdm09 (221 samples), influenza B (42 samples), and co-infection of A (H1N1) pdm09 or A/H3N2 and influenza B (2 samples). Other respiratory pathogens were detected in 101 samples, including rhinovirus (73 samples), adenovirus (10 samples), hMPV (9 samples), parainfluenza 3 (5 samples), parainfluenza 2 (3 samples), and RSV (1 sample). Influenza A/H5, A/H7, or SARS-CoV were not detected. Respiratory viral infection, particularly infection of influenza and rhinoviruses, were associated with high rates of SARI hospitalization, and future studies correlating the clinical aspects are needed to design interventions, including targeted vaccination.
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Affiliation(s)
| | - Son Vu Nguyen
- Virology Department, National Institute of Hygiene and Epidemiology
| | | | | | - Thanh Thi Le
- Virology Department, National Institute of Hygiene and Epidemiology
| | - Thach Co Nguyen
- Virology Department, National Institute of Hygiene and Epidemiology
| | - Huong Thu Hoang
- Virology Department, National Institute of Hygiene and Epidemiology
| | - Cuong Duc Vuong
- Virology Department, National Institute of Hygiene and Epidemiology
| | | | - Mai Quynh Le
- Virology Department, National Institute of Hygiene and Epidemiology
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33
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Wonderlich ER, Swan ZD, Bissel SJ, Hartman AL, Carney JP, O'Malley KJ, Obadan AO, Santos J, Walker R, Sturgeon TJ, Frye LJ, Maiello P, Scanga CA, Bowling JD, Bouwer AL, Duangkhae PA, Wiley CA, Flynn JL, Wang J, Cole KS, Perez DR, Reed DS, Barratt-Boyes SM. Widespread Virus Replication in Alveoli Drives Acute Respiratory Distress Syndrome in Aerosolized H5N1 Influenza Infection of Macaques. THE JOURNAL OF IMMUNOLOGY 2017; 198:1616-1626. [PMID: 28062701 DOI: 10.4049/jimmunol.1601770] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 12/09/2016] [Indexed: 01/01/2023]
Abstract
Human infections with highly pathogenic avian influenza A (H5N1) virus are frequently fatal but the mechanisms of disease remain ill-defined. H5N1 infection is associated with intense production of proinflammatory cytokines, but whether this cytokine storm is the main cause of fatality or is a consequence of extensive virus replication that itself drives disease remains controversial. Conventional intratracheal inoculation of a liquid suspension of H5N1 influenza virus in nonhuman primates likely results in efficient clearance of virus within the upper respiratory tract and rarely produces severe disease. We reasoned that small particle aerosols of virus would penetrate the lower respiratory tract and blanket alveoli where target cells reside. We show that inhalation of aerosolized H5N1 influenza virus in cynomolgus macaques results in fulminant pneumonia that rapidly progresses to acute respiratory distress syndrome with a fatal outcome reminiscent of human disease. Molecular imaging revealed intense lung inflammation coincident with massive increases in proinflammatory proteins and IFN-α in distal airways. Aerosolized H5N1 exposure decimated alveolar macrophages, which were widely infected and caused marked influx of interstitial macrophages and neutrophils. Extensive infection of alveolar epithelial cells caused apoptosis and leakage of albumin into airways, reflecting loss of epithelial barrier function. These data establish inhalation of aerosolized virus as a critical source of exposure for fatal human infection and reveal that direct viral effects in alveoli mediate H5N1 disease. This new nonhuman primate model will advance vaccine and therapeutic approaches to prevent and treat human disease caused by highly pathogenic avian influenza viruses.
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Affiliation(s)
- Elizabeth R Wonderlich
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261.,Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261
| | - Zachary D Swan
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261.,Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261
| | - Stephanie J Bissel
- Division of Neuropathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
| | - Amy L Hartman
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261.,Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261
| | - Jonathan P Carney
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Katherine J O'Malley
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261.,Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
| | - Adebimpe O Obadan
- Department of Population Health, University of Georgia, Athens, GA 30602
| | - Jefferson Santos
- Department of Population Health, University of Georgia, Athens, GA 30602
| | - Reagan Walker
- Division of Laboratory Animal Resources, University of Pittsburgh, Pittsburgh, PA 15260
| | - Timothy J Sturgeon
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261
| | - Lonnie J Frye
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219; and
| | - Pauline Maiello
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219; and
| | - Charles A Scanga
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219; and
| | - Jennifer D Bowling
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261.,Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261
| | - Anthea L Bouwer
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261.,Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261
| | - Parichat A Duangkhae
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261.,Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261
| | - Clayton A Wiley
- Division of Neuropathology, Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
| | - JoAnne L Flynn
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15219; and
| | - Jieru Wang
- Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Kelly S Cole
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261.,Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
| | - Daniel R Perez
- Department of Population Health, University of Georgia, Athens, GA 30602
| | - Douglas S Reed
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261.,Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
| | - Simon M Barratt-Boyes
- Center for Vaccine Research, University of Pittsburgh, Pittsburgh, PA 15261; .,Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15261.,Department of Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
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34
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Ly S, Vong S, Cavailler P, Mumford E, Mey C, Rith S, Van Kerkhove MD, Sorn S, Sok T, Tarantola A, Buchy P. Environmental contamination and risk factors for transmission of highly pathogenic avian influenza A(H5N1) to humans, Cambodia, 2006-2010. BMC Infect Dis 2016; 16:631. [PMID: 27809855 PMCID: PMC5095992 DOI: 10.1186/s12879-016-1950-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 10/21/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Highly pathogenic avian influenza A (H5N1) virus has been of public health concern since 2003. Probable risk factors for A(H5N1) transmission to human have been demonstrated in several studies or epidemiological reports. However, transmission patterns may differ according to demographic characteristics of the population and local practices. This article aggregates these data from three studies with data collected in the previous surveys in 2006 and 2007 to further examine the risks factors associated with presence of anti-A(H5) antibodies among villagers residing within outbreak areas. METHODS We aggregated 5-year data (2006-2010) from serology survey and matched case-control studies in Cambodia to further examine the risks factors associated with A(H5N1) infection among villagers in the outbreak areas. RESULTS Serotesting among villagers detected 35 (1.5 % [0-2.6]) positive cases suggesting recent exposure to A(H5N1) virus. Practices associated with A(H5N1) infection among all ages were: having poultry cage or nesting area under or adjacent to the house (OR: 6.7 [1.6-28.3]; p = 0.010) and transporting poultry to market (OR: 17.6 [1.6-193.7]; p = 0.019). Practices found as risk factors for the infection among age under 20 years were swimming/bathing in ponds also accessed by domestic poultry (OR: 4.6 [1.1-19.1]; p = 0.038). Association with consuming wild birds reached borderline significance (p = 0.066). CONCLUSION Our results suggest that swimming/bathing in contaminated pond water and close contact with poultry may present a risk of A(H5N1) transmission to human.
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Affiliation(s)
- Sowath Ly
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Sirenda Vong
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Philippe Cavailler
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia
- Agence de Médecine Préventive, Ferney-Voltaire, France
| | | | - Channa Mey
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | - Sareth Rith
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia
| | | | - San Sorn
- National Veterinary Research Institute, Ministry of Agriculture Forestry and Fisheries, Phnom Penh, Cambodia
| | - Touch Sok
- Communicable Disease Control Department, Ministry of Health, Phnom Penh, Cambodia
| | | | - Philippe Buchy
- Institut Pasteur in Cambodia, Phnom Penh, Cambodia
- GSK Vaccines R&D, 150 Beach Road, 189720 Singapore, Singapore
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35
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Differences in the Epidemiology of Childhood Infections with Avian Influenza A H7N9 and H5N1 Viruses. PLoS One 2016; 11:e0161925. [PMID: 27695069 PMCID: PMC5047462 DOI: 10.1371/journal.pone.0161925] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 08/15/2016] [Indexed: 11/19/2022] Open
Abstract
The difference between childhood infections with avian influenza viruses A(H5N1) and A(H7N9) remains an unresolved but critically important question. We compared the epidemiological characteristics of 244 H5N1 and 41 H7N9 childhood cases (<15 years old), as well as the childhood cluster cases of the two viruses. Our findings revealed a higher proportion of H5N1 than H7N9 childhood infections (31.1% vs. 6.4%, p = 0.000). However, the two groups did not differ significantly in age (median age: 5.0 vs. 5.5 y, p = 0.0651). The proportion of clustered cases was significantly greater among children infected with H5N1 than among children infected with H7N9 [46.7% (71/152) vs. 23.6% (13/55), p = 0.005], and most of the childhood cases were identified as secondary cases [46.4% (45/97) vs. 33.3% (10/30), p = 0.000]. Mild status accounted for 79.49% and 22.66%, severe status for 17.95% and 2.34%, and fatal cases for 2.56% and 75.00% of the H7N9 and H5N1 childhood infection cases (all p<0.05), respectively. The fatality rates for the total, index and secondary childhood cluster cases were 52.86% (37/70), 88.5% (23/26) and 33.33% (15/45), respectively, in the H5N1 group, whereas no fatal H7N9 childhood cluster cases were identified. In conclusion, lower severity and greater transmission were found in the H7N9 childhood cases than in the H5N1 childhood cases.
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BETHMONT A, BUI CM, GARDNER L, SARKAR S, CHUGHTAI AA, MACINTYRE CR. Quantified degree of poultry exposure differs for human cases of avian influenza H5N1 and H7N9. Epidemiol Infect 2016; 144:2633-40. [PMID: 27267621 PMCID: PMC9150466 DOI: 10.1017/s0950268816001035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 04/01/2016] [Accepted: 04/29/2016] [Indexed: 11/06/2022] Open
Abstract
Preliminary evidence suggests that direct poultry contact may play a lesser role in transmission of avian influenza A(H7N9) than A(H5N1) to humans. To better understand differences in risk factors, we quantified the degree of poultry contact reported by H5N1 and H7N9 World Health Organization-confirmed cases. We used publicly available data to classify cases by their degree of poultry contact, including direct and indirect. To account for potential data limitations, we used two methods: (1) case population method in which all cases were classified using a range of sources; and (2) case subset method in which only cases with detailed contact information from published research literature were classified. In the case population, detailed exposure information was unavailable for a large proportion of cases (H5N1, 54%; H7N9, 86%). In the case subset, direct contact proportions were higher in H5N1 cases (70·3%) than H7N9 cases (40·0%) (χ 2 = 18·5, P < 0·001), and indirect contact proportions were higher in H7N9 cases (44·6%) than H5N1 cases (19·4%) (χ 2 = 15·5, P < 0·001). Together with emerging evidence, our descriptive analysis suggests direct poultry contact is a clearer risk factor for H5N1 than for H7N9, and that other risk factors should also be considered for H7N9.
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Affiliation(s)
- A. BETHMONT
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - C. M. BUI
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - L. GARDNER
- School of Civil and Environmental Engineering, University of New South Wales, Sydney, NSW, Australia
| | - S. SARKAR
- Section of Integrative Biology, University of Texas, Austin, TX, USA
| | - A. A. CHUGHTAI
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - C. R. MACINTYRE
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
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Rimi NA, Sultana R, Ishtiak-Ahmed K, Rahman MZ, Hasin M, Islam MS, Azziz-Baumgartner E, Nahar N, Gurley ES, Luby SP. Understanding the failure of a behavior change intervention to reduce risk behaviors for avian influenza transmission among backyard poultry raisers in rural Bangladesh: a focused ethnography. BMC Public Health 2016; 16:858. [PMID: 27552983 PMCID: PMC4995615 DOI: 10.1186/s12889-016-3543-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 08/18/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The spread of the highly pathogenic avian influenza (HPAI) H5N1 virus among poultry and humans has raised global concerns and has motivated government and public health organizations to initiate interventions to prevent the transmission of HPAI. In Bangladesh, H5N1 became endemic in poultry and seven human H5N1 cases have been reported since 2007, including one fatality. This study piloted messages to increase awareness about avian influenza and its prevention in two rural communities, and explored change in villagers' awareness and behaviors attributable to the intervention. METHODS During 2009-10, a research team implemented the study in two rural villages in two districts of Bangladesh. The team used a focused ethnographic approach for data collection, including informal interviews and observations to provide detailed contextual information about community response to a newly emerging disease. They collected pre-intervention qualitative data for one month. Then another team disseminated preventive messages focused on safe slaughtering methods, through courtyard meetings and affixed posters in every household. After dissemination, the research team collected post-intervention data for one month. RESULTS More villagers reported hearing about 'bird flu' after the intervention compared to before the intervention. After the intervention, villagers commonly recalled changes in the color of combs and shanks of poultry as signs of avian influenza, and perceived zoonotic transmission of avian influenza through direct contact and through inhalation. Consequently the villagers valued covering the nose and mouth while handling sick and dead poultry as a preventive measure. Nevertheless, the team did not observe noticeable change in villagers' behavior after the intervention. Villagers reported not following the recommended behaviors because of the perceived absence of avian influenza in their flocks, low risk of avian influenza, cost, inconvenience, personal discomfort, fear of being rebuked or ridiculed, and doubt about the necessity of the intervention. CONCLUSIONS The villagers' awareness about avian influenza improved after the intervention, however, the intervention did not result in any measurable improvement in preventive behaviors. Low cost approaches that promote financial benefits and minimize personal discomfort should be developed and piloted.
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Affiliation(s)
- Nadia Ali Rimi
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Rebeca Sultana
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Kazi Ishtiak-Ahmed
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Md Zahidur Rahman
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Marufa Hasin
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - M. Saiful Islam
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Eduardo Azziz-Baumgartner
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
- Centers for Disease Control and Prevention (CDC), Atlanta, GA USA
| | - Nazmun Nahar
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Emily S. Gurley
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Stephen P. Luby
- Program for Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, 68, Shaheed Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
- Centers for Disease Control and Prevention (CDC), Atlanta, GA USA
- Stanford University, Stanford, CA USA
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Shanta IS, Hasnat MA, Zeidner N, Gurley ES, Azziz-Baumgartner E, Sharker MAY, Hossain K, Khan SU, Haider N, Bhuyan AA, Hossain MA, Luby SP. Raising Backyard Poultry in Rural Bangladesh: Financial and Nutritional Benefits, but Persistent Risky Practices. Transbound Emerg Dis 2016; 64:1454-1464. [PMID: 27311406 DOI: 10.1111/tbed.12536] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Indexed: 11/27/2022]
Abstract
Poultry is commonly raised by households in rural Bangladesh. In 2007, the Government of Bangladesh began a mass media campaign to disseminate 10 recommended precautions to prevent transmission of H5N1 from poultry to humans. This longitudinal study explored the contribution of backyard poultry on household economy and nutrition and compared poultry-raising practices to government recommendations. From 2009 to 2012, we enrolled a nationally representative sample of 2489 primary backyard poultry raisers from 115 rural villages selected by probability proportional to population size. Researchers interviewed the raisers to collect data on poultry-raising practices. They followed the raisers for 2-12 months to collect data on household income and nutrition from poultry. Income from backyard poultry flocks accounted for 2.8% of monthly household income. Return on annual investment (ROI) per flock was 480%. Yearly, median family consumption of eggs was one-fifth of the total produced eggs and three poultry from their own flock. Respondents' reported practices conflicted with government recommendations. Sixty per cent of raisers had never heard of avian influenza or 'bird flu'. Among the respondents, 85% handled sick poultry or poultry that died due to illness, and 49% slaughtered or defeathered sick poultry. In 37% of households, children touched poultry. Fifty-eight per cent never washed their hands with soap after handling poultry, while <1% covered their nose and mouth with a cloth when handling poultry. Only 3% reported poultry illness and deaths to local authorities. These reported practices did not improve during the study period. Raising backyard poultry in rural Bangladesh provides important income and nutrition with an excellent ROI. Government recommendations to reduce the risk of avian influenza transmission did not impact the behaviour of poultry producers. Further research should prioritize developing interventions that simultaneously reduce the risk of avian influenza transmission and increase productivity of backyard poultry.
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Affiliation(s)
| | | | | | | | - E Azziz-Baumgartner
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M A Y Sharker
- icddr,b, Dhaka, Bangladesh.,College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | | | - S U Khan
- icddr,b, Dhaka, Bangladesh.,College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - N Haider
- icddr,b, Dhaka, Bangladesh.,Section for Epidemiology, DTU vet, Technical University of Denmark, Copenhagen, Denmark
| | - A A Bhuyan
- icddr,b, Dhaka, Bangladesh.,Department of Animal Husbandry and Veterinary Science, University of Rajshahi, Rajshahi, Bangladesh
| | - Md A Hossain
- Department of Livestock Service, Ministry of Fisheries and Livestock, Dhaka, Bangladesh
| | - S P Luby
- icddr,b, Dhaka, Bangladesh.,Division of Infectious Disease and Geographic Medicine, Stanford University, Stanford, CA, USA
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Liu S, Sha J, Yu Z, Hu Y, Chan TC, Wang X, Pan H, Cheng W, Mao S, Zhang RJ, Chen E. Avian influenza virus in pregnancy. Rev Med Virol 2016; 26:268-84. [PMID: 27187752 DOI: 10.1002/rmv.1884] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/19/2016] [Accepted: 03/29/2016] [Indexed: 12/19/2022]
Abstract
The unprecedented epizootic of avian influenza viruses, such as H5N1, H5N6, H7N1 and H10N8, has continued to cause disease in humans in recent years. In 2013, another novel influenza A (H7N9) virus emerged in China, and 30% of those patients died. Pregnant women are particularly susceptible to avian influenza and are more likely to develop severe complications and to die, especially when infection occurs in the middle and late trimesters. Viremia is believed to occur infrequently, and thus vertical transmission induced by avian influenza appears to be rare. However, avian influenza increases the risk of adverse pregnancy outcomes, including spontaneous abortion, preterm birth and fatal distress. This review summarises 39 cases of pregnant women and their fetuses from different countries dating back to 1997, including 11, 15 and 13 infections with H7N9, H5N1 and the 2009 pandemic influenza (H1N1), respectively. We analysed the epidemic features, following the geographical, population and pregnancy trimester distributions; underlying diseases; exposure history; medical timelines; human-to-human transmission; pathogenicity and vertical transmission; antivirus treatments; maternal severity and mortality and pregnancy outcome. The common experiences reported in different countries and areas suggest that early identification and treatment are imperative. In the future, vigilant virologic and epidemiologic surveillance systems should be developed to monitor avian influenza viruses during pregnancy. Furthermore, extensive study on the immune mechanisms should be conducted, as this will guide safe, rational immunomodulatory treatment among this high-risk population. Most importantly, we should develop a universal avian influenza virus vaccine to prevent outbreaks of the different subtypes. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Jianping Sha
- Department of Endocrinology, The 421 Hospital of Chinese People's Liberation Army, Guangzhou, China
| | - Zhao Yu
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Yan Hu
- Department of Endocrinology, The 421 Hospital of Chinese People's Liberation Army, Guangzhou, China
| | - Ta-Chien Chan
- Centre for Geographic Information Science, Research Centre for Humanities and Social Science, Academia Sinica, Taipei, Taiwan
| | - Xiaoxiao Wang
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Hao Pan
- Department of Infectious Diseases, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
| | - Wei Cheng
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - Shenghua Mao
- Department of Infectious Diseases, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
| | - Run Ju Zhang
- Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Enfu Chen
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
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Lai S, Qin Y, Cowling BJ, Ren X, Wardrop NA, Gilbert M, Tsang TK, Wu P, Feng L, Jiang H, Peng Z, Zheng J, Liao Q, Li S, Horby PW, Farrar JJ, Gao GF, Tatem AJ, Yu H. Global epidemiology of avian influenza A H5N1 virus infection in humans, 1997-2015: a systematic review of individual case data. THE LANCET. INFECTIOUS DISEASES 2016; 16:e108-e118. [PMID: 27211899 PMCID: PMC4933299 DOI: 10.1016/s1473-3099(16)00153-5] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 01/30/2016] [Accepted: 03/08/2016] [Indexed: 12/13/2022]
Abstract
Avian influenza viruses A(H5N1) have caused a large number of typically severe human infections since the first human case was reported in 1997. However, there is a lack of comprehensive epidemiological analysis of global human cases of H5N1 from 1997-2015. Moreover, few studies have examined in detail the changing epidemiology of human H5N1 cases in Egypt, especially given the most recent outbreaks since November 2014 which have the highest number of cases ever reported globally over a similar period. Data on individual cases were collated from different sources using a systematic approach to describe the global epidemiology of 907 human H5N1 cases between May 1997 and April 2015. The number of affected countries rose between 2003 and 2008, with expansion from East and Southeast Asia, then to West Asia and Africa. Most cases (67.2%) occurred from December to March, and the overall case fatality risk was 53.5% (483/903) which varied across geographical regions. Although the incidence in Egypt has increased dramatically since November 2014, compared to the cases beforehand there were no significant differences in the fatality risk , history of exposure to poultry, history of human case contact, and time from onset to hospitalization in the recent cases.
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Affiliation(s)
- Shengjie Lai
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China; Department of Geography and Environment, University of Southampton, Southampton, UK; Flowminder Foundation, Stockholm, Sweden
| | - Ying Qin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 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
| | - Xiang Ren
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Nicola A Wardrop
- Department of Geography and Environment, University of Southampton, Southampton, UK
| | - Marius Gilbert
- Biological Control and Spatial Ecology, Université Libre de Bruxelles, Brussels, Belgium; Fonds National de la Recherche Scientifique, Brussels, Belgium
| | - Tim K Tsang
- 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
| | - Peng Wu
- 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
| | - Luzhao Feng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui Jiang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhibin Peng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiandong Zheng
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiaohong Liao
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sa Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peter W Horby
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Singapore Infectious Disease Initiative, Singapore
| | - Jeremy J Farrar
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK; Singapore Infectious Disease Initiative, Singapore; International Severe Acute Respiratory and Emerging Infection Consortium, Centre for Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, UK
| | - George F Gao
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China; Chinese Center for Disease Control and Prevention, Beijing, China
| | - Andrew J Tatem
- Department of Geography and Environment, University of Southampton, Southampton, UK; Flowminder Foundation, Stockholm, Sweden; Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - Hongjie Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China; School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
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Manabe T, Yamaoka K, Tango T, Binh NG, Co DX, Tuan ND, Izumi S, Takasaki J, Chau NQ, Kudo K. Chronological, geographical, and seasonal trends of human cases of avian influenza A (H5N1) in Vietnam, 2003-2014: a spatial analysis. BMC Infect Dis 2016; 16:64. [PMID: 26847341 PMCID: PMC4743110 DOI: 10.1186/s12879-016-1391-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 01/27/2016] [Indexed: 11/10/2022] Open
Abstract
Background Human cases of highly pathogenic avian influenza A (H5N1) virus infection continue to occur in Southeast Asia. The objective of this study was to identify when and where human H5N1 cases have occurred in Vietnam and how the situation has changed from the beginning of the H5N1 outbreaks in 2003 through 2014, to assist with implementing methods of targeted disease management. Methods We assessed the disease clustering and seasonal variation of human H5N1 cases in Vietnam to evaluate the geographical and monthly timing trends. The clustering of H5N1 cases and associated mortality were examined over three time periods: the outbreak period (2003–2005), the post-outbreak (2006–2009), and the recent period (2010–2014) using the flexibly shaped space-time scan statistic. The most likely cases to co-cluster and the elevated risks for incidence and mortality were assessed via calculation of the relative risk (RR). The H5N1 case seasonal variation was analysed as the cyclic trend in incidence data using Roger’s statistical test. Results Between 2003 and 2005, H5N1 cases (RR: 2.15, p = 0.001) and mortality (RR: 2.49, p = 0.021) were significantly clustered in northern Vietnam. After 2010, H5N1 cases tended to occur on the border with Cambodia in the south, while H5N1 mortality clustered significantly in the Mekong delta area (RR: 6.62, p = 0.002). A significant seasonal variation was observed (p < 0.001), with a higher incidence of morbidity in December through April. Conclusions These findings indicate that clinical preparedness for H5N1 in Vietnam needs to be strengthened in southern Vietnam in December–April. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1391-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Toshie Manabe
- Teikyo University, Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. .,Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan. .,Waseda University, 1-21-1 Nishi-Waseda, Shinjuku-ku, Tokyo, Japan. .,University of Tsukuba, Graduate School of Comprehensive Human Sciences, Ibaraki, Japan.
| | - Kazue Yamaoka
- Teikyo University, Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
| | - Toshiro Tango
- Teikyo University, Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. .,Center for Medical Statistics, Tokyo, Japan.
| | - Nguyen Gia Binh
- Bach Mai Hospital, Intensive Care Unit, 78 Giai Phong, Dong Da, Hanoi, Vietnam.
| | - Dao Xuan Co
- Bach Mai Hospital, Intensive Care Unit, 78 Giai Phong, Dong Da, Hanoi, Vietnam.
| | - Nguyen Dang Tuan
- Bach Mai Hospital, Intensive Care Unit, 78 Giai Phong, Dong Da, Hanoi, Vietnam.
| | - Shinyu Izumi
- National Center for Global Health and Medicine, Division of Pulmonary Medicine, Tokyo, Japan.
| | - Jin Takasaki
- National Center for Global Health and Medicine, Division of Pulmonary Medicine, Tokyo, Japan.
| | - Ngo Quy Chau
- Department of Pulmonary Medicine, Bach Mai Hospital, 78 Giai Phong, Dong Da, Hanoi, Vietnam.
| | - Koichiro Kudo
- Waseda University, 1-21-1 Nishi-Waseda, Shinjuku-ku, Tokyo, Japan. .,Koto Hospital, 6-8-5 Ojima, Koto-ku, Tokyo, Japan.
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42
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Kilany WH, Safwat M, Mohammed SM, Salim A, Fasina FO, Fasanmi OG, Shalaby AG, Dauphin G, Hassan MK, Lubroth J, Jobre YM. Protective Efficacy of Recombinant Turkey Herpes Virus (rHVT-H5) and Inactivated H5N1 Vaccines in Commercial Mulard Ducks against the Highly Pathogenic Avian Influenza (HPAI) H5N1 Clade 2.2.1 Virus. PLoS One 2016; 11:e0156747. [PMID: 27304069 PMCID: PMC4909235 DOI: 10.1371/journal.pone.0156747] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 05/18/2016] [Indexed: 02/05/2023] Open
Abstract
In Egypt, ducks kept for commercial purposes constitute the second highest poultry population, at 150 million ducks/year. Hence, ducks play an important role in the introduction and transmission of avian influenza (AI) in the Egyptian poultry population. Attempts to control outbreaks include the use of vaccines, which have varying levels of efficacy and failure. To date, the effects of vaccine efficacy has rarely been determined in ducks. In this study, we evaluated the protective efficacy of a live recombinant vector vaccine based on a turkey Herpes Virus (HVT) expressing the H5 gene from a clade 2.2 H5N1 HPAIV strain (A/Swan/Hungary/499/2006) (rHVT-H5) and a bivalent inactivated H5N1 vaccine prepared from clade 2.2.1 and 2.2.1.1 H5N1 seeds in Mulard ducks. A 0.3ml/dose subcutaneous injection of rHVT-H5 vaccine was administered to one-day-old ducklings (D1) and another 0.5ml/dose subcutaneous injection of the inactivated MEFLUVAC was administered at 7 days (D7). Four separate challenge experiments were conducted at Days 21, 28, 35 and 42, in which all the vaccinated ducks were challenged with 106EID50/duck of H5N1 HPAI virus (A/chicken/Egypt/128s/2012(H5N1) (clade 2.2.1) via intranasal inoculation. Maternal-derived antibody regression and post-vaccination antibody immune responses were monitored weekly. Ducks vaccinated at 21, 28, 35 and 42 days with the rHVT-H5 and MEFLUVAC vaccines were protected against mortality (80%, 80%, 90% and 90%) and (50%, 70%, 80% and 90%) respectively, against challenges with the H5N1 HPAI virus. The amount of viral shedding and shedding rates were lower in the rHVT-H5 vaccine groups than in the MEFLUVAC groups only in the first two challenge experiments. However, the non-vaccinated groups shed significantly more of the virus than the vaccinated groups. Both rHVT-H5 and MEFLUVAC provide early protection, and rHVT-H5 vaccine in particular provides protection against HPAI challenge.
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Affiliation(s)
- Walid H. Kilany
- Reference Laboratory for Veterinary Quality Control on Poultry Production (NLQP), Animal Health Research Institute, P.O. Box, 264, Giza, Egypt
- * E-mail: (WHK); (FOF)
| | - Marwa Safwat
- Reference Laboratory for Veterinary Quality Control on Poultry Production (NLQP), Animal Health Research Institute, P.O. Box, 264, Giza, Egypt
| | - Samy M. Mohammed
- Reference Laboratory for Veterinary Quality Control on Poultry Production (NLQP), Animal Health Research Institute, P.O. Box, 264, Giza, Egypt
- Food and Agriculture Organization of the United Nations (FAO)–Emergency Center of Transboundary Animal Diseases (ECTAD), P.O. Box, 2223, Giza, Egypt
| | - Abdullah Salim
- Reference Laboratory for Veterinary Quality Control on Poultry Production (NLQP), Animal Health Research Institute, P.O. Box, 264, Giza, Egypt
| | - Folorunso Oludayo Fasina
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort, South Africa
- * E-mail: (WHK); (FOF)
| | - Olubunmi G. Fasanmi
- Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, & Department of Animal Health, Federal College of Animal Health and Production Technology, Ibadan, Nigeria
| | - Azhar G. Shalaby
- Reference Laboratory for Veterinary Quality Control on Poultry Production (NLQP), Animal Health Research Institute, P.O. Box, 264, Giza, Egypt
| | - Gwenaelle Dauphin
- Food and Agriculture Organization (FAO) Viale delle Terme di Caracalla, 00153 Rome, Italy
| | - Mohammed K. Hassan
- Reference Laboratory for Veterinary Quality Control on Poultry Production (NLQP), Animal Health Research Institute, P.O. Box, 264, Giza, Egypt
| | - Juan Lubroth
- Food and Agriculture Organization (FAO) Viale delle Terme di Caracalla, 00153 Rome, Italy
| | - Yilma M. Jobre
- Food and Agriculture Organization of the United Nations (FAO)–Emergency Center of Transboundary Animal Diseases (ECTAD), P.O. Box, 2223, Giza, Egypt
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Clements BW, Casani JAP. Emerging and Reemerging Infectious Disease Threats. DISASTERS AND PUBLIC HEALTH 2016. [PMCID: PMC7150317 DOI: 10.1016/b978-0-12-801980-1.00010-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This chapter describes the potential public health impact of emerging and reemerging disease. Factors contributing to the emergence of diseases include increasing international travel and commerce, changes in human demographics and behavior, advances in technology and industry, microbial adaptation and the breakdown of public health systems. Of emerging diseases, 60% are zoonotic, making the human–animal biome interaction critical. Preparedness for an emerging disease relies on strong biosurveillance systems for early detection. Control measures to prevent transmission must be implemented early. These include: rapid epidemiologic surveillance and investigations to characterize the disease; transmission prevention through containment and control measures; development and deployment of medical countermeasures; and emergency public information and warning. Recovery after the outbreak of an emerging disease can result in a “new normal” with persistent endemic infection in the community. Describe why diseases “emerge” or “reemerge.” Discuss the impact of emerging infectious diseases on public health preparedness. List the likely sources of emerging infectious diseases in the future. Describe how international travel and commerce contribute to emerging infectious disease threats. Discuss how microbial adaptation contributes to emerging infectious disease threats. List human demographic factors and behaviors contributing to emerging infectious disease threats. Identify the epidemiological clues indicating a possible emerging disease. Describe various types of surveillance approaches. Discuss the breakdown of public health measures and systems. Recognize the actions needed for responding to an emerging disease.
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Harder TC, Buda S, Hengel H, Beer M, Mettenleiter TC. Poultry food products--a source of avian influenza virus transmission to humans? Clin Microbiol Infect 2015; 22:141-146. [PMID: 26686812 DOI: 10.1016/j.cmi.2015.11.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 11/29/2015] [Accepted: 11/29/2015] [Indexed: 11/19/2022]
Abstract
Global human mobility and intercontinental connectivity, expansion of livestock production and encroachment of wildlife habitats by invasive agricultural land use contribute to shape the complexity of influenza epidemiology. The OneHealth approach integrates these and further elements into considerations to improve disease control and prevention. Food of animal origin for human consumption is another integral aspect; if produced from infected livestock such items may act as vehicles of spread of animal pathogens, and, in case of zoonotic agents, as a potential human health hazard. Notifiable zoonotic avian influenza viruses (AIV) have become entrenched in poultry populations in several Asian and northern African countries since 2003. Highly pathogenic (HP) AIV (e.g. H5N1) cause extensive poultry mortality and severe economic losses. HPAIV and low pathogenic AIV (e.g. H7N9) with zoonotic propensities pose risks for human health. More than 1500 human cases of AIV infection have been reported, mainly from regions with endemically infected poultry. Intense human exposure to AIV-infected poultry, e.g. during rearing, slaughtering or processing of poultry, is a major risk factor for acquiring AIV infection. In contrast, human infections through consumption of AIV-contaminated food have not been substantiated. Heating poultry products according to kitchen standards (core temperatures ≥70°C, ≥10 s) rapidly inactivates AIV infectivity and renders fully cooked products safe. Nevertheless, concerted efforts must ensure that poultry products potentially contaminated with zoonotic AIV do not reach the food chain. Stringent and sustained OneHealth measures are required to better control and eventually eradicate, HPAIV from endemic regions.
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Affiliation(s)
- T C Harder
- The Federal Research Institute for Animal Health, Friedrich-Loeffler-Institut, Greifswald Insel-Riems, Germany.
| | - S Buda
- Robert-Koch-Institut, Berlin, Germany
| | - H Hengel
- Institute of Virology, Department of Medical Microbiology and Hygiene, University Medical Centre, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - M Beer
- The Federal Research Institute for Animal Health, Friedrich-Loeffler-Institut, Greifswald Insel-Riems, Germany
| | - T C Mettenleiter
- The Federal Research Institute for Animal Health, Friedrich-Loeffler-Institut, Greifswald Insel-Riems, Germany
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Predicting Disease Severity and Viral Spread of H5N1 Influenza Virus in Ferrets in the Context of Natural Exposure Routes. J Virol 2015; 90:1888-97. [PMID: 26656692 DOI: 10.1128/jvi.01878-15] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 11/24/2015] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Although avian H5N1 influenza virus has yet to develop the capacity for human-to-human spread, the severity of the rare cases of human infection has warranted intensive follow-up of potentially exposed individuals that may require antiviral prophylaxis. For countries where antiviral drugs are limited, the World Health Organization (WHO) has developed a risk categorization for different levels of exposure to environmental, poultry, or human sources of infection. While these take into account the infection source, they do not account for the likely mode of virus entry that the individual may have experienced from that source and how this could affect the disease outcome. Knowledge of the kinetics and spread of virus after natural routes of exposure may further inform the risk of infection, as well as the likely disease severity. Using the ferret model of H5N1 infection, we compared the commonly used but artificial inoculation method that saturates the total respiratory tract (TRT) with virus to upper respiratory tract (URT) and oral routes of delivery, those likely to be encountered by humans in nature. We show that there was no statistically significant difference in survival rate with the different routes of infection, but the disease characteristics were somewhat different. Following URT infection, viral spread to systemic organs was comparatively delayed and more focal than after TRT infection. By both routes, severe disease was associated with early viremia and central nervous system infection. After oral exposure to the virus, mild infections were common suggesting consumption of virus-contaminated liquids may be associated with seroconversion in the absence of severe disease. IMPORTANCE Risks for human H5N1 infection include direct contact with infected birds and frequenting contaminated environments. We used H5N1 ferret infection models to show that breathing in the virus was more likely to produce clinical infection than swallowing contaminated liquid. We also showed that virus could spread from the respiratory tract to the brain, which was associated with end-stage disease, and very early viremia provided a marker for this. With upper respiratory tract exposure, infection of the brain was common but hard to detect, suggesting that human neurological infections might be typically undetected at autopsy. However, viral spread to systemic sites was slower after exposure to virus by this route than when virus was additionally delivered to the lungs, providing a better therapeutic window. In addition to exposure history, early parameters of infection, such as viremia, could help prioritize antiviral treatments for patients most at risk of succumbing to infection.
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Rabaa MA, Tue NT, Phuc TM, Carrique-Mas J, Saylors K, Cotten M, Bryant JE, Nghia HDT, Cuong NV, Pham HA, Berto A, Phat VV, Dung TTN, Bao LH, Hoa NT, Wertheim H, Nadjm B, Monagin C, van Doorn HR, Rahman M, Tra MPV, Campbell JI, Boni MF, Tam PTT, van der Hoek L, Simmonds P, Rambaut A, Toan TK, Van Vinh Chau N, Hien TT, Wolfe N, Farrar JJ, Thwaites G, Kellam P, Woolhouse MEJ, Baker S. The Vietnam Initiative on Zoonotic Infections (VIZIONS): A Strategic Approach to Studying Emerging Zoonotic Infectious Diseases. ECOHEALTH 2015; 12:726-35. [PMID: 26403795 PMCID: PMC4700077 DOI: 10.1007/s10393-015-1061-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 05/20/2015] [Accepted: 08/24/2015] [Indexed: 06/05/2023]
Abstract
The effect of newly emerging or re-emerging infectious diseases of zoonotic origin in human populations can be potentially catastrophic, and large-scale investigations of such diseases are highly challenging. The monitoring of emergence events is subject to ascertainment bias, whether at the level of species discovery, emerging disease events, or disease outbreaks in human populations. Disease surveillance is generally performed post hoc, driven by a response to recent events and by the availability of detection and identification technologies. Additionally, the inventory of pathogens that exist in mammalian and other reservoirs is incomplete, and identifying those with the potential to cause disease in humans is rarely possible in advance. A major step in understanding the burden and diversity of zoonotic infections, the local behavioral and demographic risks of infection, and the risk of emergence of these pathogens in human populations is to establish surveillance networks in populations that maintain regular contact with diverse animal populations, and to simultaneously characterize pathogen diversity in human and animal populations. Vietnam has been an epicenter of disease emergence over the last decade, and practices at the human/animal interface may facilitate the likelihood of spillover of zoonotic pathogens into humans. To tackle the scientific issues surrounding the origins and emergence of zoonotic infections in Vietnam, we have established The Vietnam Initiative on Zoonotic Infections (VIZIONS). This countrywide project, in which several international institutions collaborate with Vietnamese organizations, is combining clinical data, epidemiology, high-throughput sequencing, and social sciences to address relevant one-health questions. Here, we describe the primary aims of the project, the infrastructure established to address our scientific questions, and the current status of the project. Our principal objective is to develop an integrated approach to the surveillance of pathogens circulating in both human and animal populations and assess how frequently they are exchanged. This infrastructure will facilitate systematic investigations of pathogen ecology and evolution, enhance understanding of viral cross-species transmission events, and identify relevant risk factors and drivers of zoonotic disease emergence.
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Affiliation(s)
- Maia A Rabaa
- Centre for Immunity, Infection & Evolution, The University of Edinburgh, Edinburgh, UK
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Ngo Tri Tue
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Tran My Phuc
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Juan Carrique-Mas
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | | | | | - Juliet E Bryant
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hanoi, Vietnam
| | - Ho Dang Trung Nghia
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- The Hospital for Tropical Diseases, 764 Vo Van Kiet, Quan 5, Ho Chi Minh City, Vietnam
| | - Nguyen Van Cuong
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Hong Anh Pham
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Alessandra Berto
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | - Voong Vinh Phat
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Tran Thi Ngoc Dung
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Long Hoang Bao
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hanoi, Vietnam
| | - Ngo Thi Hoa
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | - Heiman Wertheim
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hanoi, Vietnam
| | - Behzad Nadjm
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Hanoi, Vietnam
| | | | - H Rogier van Doorn
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | - Motiur Rahman
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | | | - James I Campbell
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | - Maciej F Boni
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | - Pham Thi Thanh Tam
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Lia van der Hoek
- Laboratory of Experimental Virology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
| | - Peter Simmonds
- Centre for Immunity, Infection & Evolution, The University of Edinburgh, Edinburgh, UK
| | - Andrew Rambaut
- Centre for Immunity, Infection & Evolution, The University of Edinburgh, Edinburgh, UK
| | | | - Nguyen Van Vinh Chau
- The Hospital for Tropical Diseases, 764 Vo Van Kiet, Quan 5, Ho Chi Minh City, Vietnam
| | - Tran Tinh Hien
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | | | - Jeremy J Farrar
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
| | - Guy Thwaites
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK
| | - Paul Kellam
- The Wellcome Trust Sanger Institute, Cambridge, UK
| | - Mark E J Woolhouse
- Centre for Immunity, Infection & Evolution, The University of Edinburgh, Edinburgh, UK
| | - Stephen Baker
- Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Programme, Ho Chi Minh City, Vietnam.
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, UK.
- The Hospital for Tropical Diseases, 764 Vo Van Kiet, Quan 5, Ho Chi Minh City, Vietnam.
- The London School of Hygiene and Tropical Medicine, London, UK.
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Durand LO, Glew P, Gross D, Kasper M, Trock S, Kim IK, Bresee JS, Donis R, Uyeki TM, Widdowson MA, Azziz-Baumgartner E. Timing of influenza A(H5N1) in poultry and humans and seasonal influenza activity worldwide, 2004-2013. Emerg Infect Dis 2015; 21:202-8. [PMID: 25625302 PMCID: PMC4313643 DOI: 10.3201/eid2102.140877] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Co-circulation of H5N1 in poultry and humans during seasonal influenza epidemic periods signals the need for enhanced surveillance and biosafety measures. Co-circulation of influenza A(H5N1) and seasonal influenza viruses among humans and animals could lead to co-infections, reassortment, and emergence of novel viruses with pandemic potential. We assessed the timing of subtype H5N1 outbreaks among poultry, human H5N1 cases, and human seasonal influenza in 8 countries that reported 97% of all human H5N1 cases and 90% of all poultry H5N1 outbreaks. In these countries, most outbreaks among poultry (7,001/11,331, 62%) and half of human cases (313/625, 50%) occurred during January–March. Human H5N1 cases occurred in 167 (45%) of 372 months during which outbreaks among poultry occurred, compared with 59 (10%) of 574 months that had no outbreaks among poultry. Human H5N1 cases also occurred in 59 (22%) of 267 months during seasonal influenza periods. To reduce risk for co-infection, surveillance and control of H5N1 should be enhanced during January–March, when H5N1 outbreaks typically occur and overlap with seasonal influenza virus circulation.
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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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49
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Barnett T, Fournié G, Gupta S, Seeley J. Some considerations concerning the challenge of incorporating social variables into epidemiological models of infectious disease transmission. Glob Public Health 2015; 10:438-48. [PMID: 25648796 DOI: 10.1080/17441692.2015.1007155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Incorporation of 'social' variables into epidemiological models remains a challenge. Too much detail and models cease to be useful; too little and the very notion of infection - a highly social process in human populations - may be considered with little reference to the social. The French sociologist Émile Durkheim proposed that the scientific study of society required identification and study of 'social currents'. Such 'currents' are what we might today describe as 'emergent properties', specifiable variables appertaining to individuals and groups, which represent the perspectives of social actors as they experience the environment in which they live their lives. Here we review the ways in which one particular emergent property, hope, relevant to a range of epidemiological situations, might be used in epidemiological modelling of infectious diseases in human populations. We also indicate how such an approach might be extended to include a range of other potential emergent properties to represent complex social and economic processes bearing on infectious disease transmission.
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Affiliation(s)
- Tony Barnett
- a Department of Global Health and Development , London School of Hygiene and Tropical Medicine , London , UK
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50
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Durand LO, Glew P, Gross D, Kasper M, Trock S, Kim IK, Bresee JS, Donis R, Uyeki TM, Widdowson MA, Azziz-Baumgartner E. Timing of Influenza A(H5N1) in Poultry and Humans and Seasonal Influenza Activity Worldwide, 2004–2013. Emerg Infect Dis 2015. [DOI: 10.3201/eid2102.140087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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