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Population-based Surveillance for Zoonotic Influenza A in Agricultural Workers. Abstract*. Acknowledgements. Conclusion. Results. Materials & Methods. Introduction. Less than 20 enrollees 21 – 35 enrollees 36 or more enrollees.
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in Agricultural Workers
Materials & Methods
Gregory C. Gray, MD, MPH,1 Troy McCarthy,1 Ana W. Capuano, MPS, 1 Charles F. Lynch, MD, PhD,2 Debbie A. Wellman,1 Kelly A. Lesher,1 Sharon F. Setterquist, MT(ASCP),1 Norma J. Miller,1 Patricia A P Gillette,MPH,2 Christopher W. Olsen, DVM, PhD,3 Alexander I. Klimov, PhD,4
Michael C. Alavanja, PhD,5 and Jackie M. Katz, PhD6
Background - Swine may play an important role in cross-species influenza transmission and the genesis of novel influenza strains. We prospectively studied swine workers for serological evidence of zoonotic influenza infection.
Methods - Using data from the Agricultural Health Study (AHS), we identified, screened, and enrolled 803 rural Iowans from 29 counties in a 2-year prospective zoonotic influenza transmission study. Enrollment sera were studied with hemagglutination inhibition assays against two swine and one human influenza viral strains. Demographic and occupational risk factors were studied for associations with antibodies against swine H1N1 and H1N2 viruses using a multivariate proportional odds model at enrollment (AHS and Non-AHS) and follow-up (AHS only).
Results - Among the 803 subjects, 707 worked in swine production (AHS-E), 80 reported no previous swine exposure (AHS-NE) and 15 were excluded because of reported accidental self-injection with swine vaccine. Data and sera from 79 non-AHS control (N-AHS) subjects from a parallel study were used as a reference. (71%) of the 80 AHS-NE live in the same household (mostly wives) of AHS-E. Multivariate models controlled for human influenza viruses, flu shot, age, and/or gender. At enrollment, the AHS-E (>10 or ≤10 years of exposure)and the AHS-NE had markedly elevated adjusted odds of increased antibody titers against swine H1N1 (OR, 95%CI= 55.6, 13.1-236.1;51.3,11.1-236.5; 28.2, 6.1-130.1) and swine H1N2 (OR, 95%CI= 13.5, 6.1-29.8; 13,5.1-33; 6.9, 2.8-17.1) compared to the N-AHS.
Conclusion - These data suggest that swine influenza viral infections are common among swine workers and their non-exposed-to-swine spouses. Agriculture workers should be given special attention in influenza surveillance strategies and in planning for influenza pandemics.
1Center for Emerging Infectious Diseases, Dept. of Epidemiology, University of Iowa College of Public Health, Iowa City, IA; 2Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA; 3Department of Pathobiological Sciences, University of Wisconsin-Madison, Madison, WI; 4Strain Surveillance Section, Influenza Branch, Centers for Disease Control and Prevention, Atlanta, GA; 5National Cancer Institute, Bethesda, MD; 6Immunology and Viral Pathogenesis Section, Centers for Disease Control and Prevention, Atlanta, GA
To validate serological outcomes, culture and molecular studies will be performed on gargle and swab specimens to identify influenza and specific hemagglutinin types.
Coinvestigators - Troy McCarthy, Ana W. Capuano, MPS, Charles F. Lynch, MD, PhD, Debbie A. Wellman, Kelly A. Lesher, Sharon F. Setterquist, MT(ASCP), Norma J. Miller, Patricia A P Gillette, MPH, Christopher W. Olsen, DVM, PhD, Alexander I. Klimov, PhD, Michael C. Alavanja, PhD, and Jackie M. Katz, PhD
Collaborators - Kevin Knudson, PhDCEID Staff - Whitney Baker, Mark Lebeck, Ghazi Kayali
Funding – NIH / NIAID- R21 AI059214-01