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Journal of Infection
Available online 15 March 2014
In Press, Accepted Manuscript ? Note to users
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Identifying areas with a high risk of human infection with the avian influenza a (H7N9) virus in east asia
Trevon Fullera, Corresponding author contact information, E-mail the corresponding author,
Fiona Haversb,
Cuiling Xuc,
Li-Qun Fangd,
Wu-Chun Caod,
Yuelong Shuc,
Marc-Alain Widdowsone,
Thomas B. Smitha, f
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Summary
Objectives
The rapid emergence, spread, and disease severity of avian influenza A(H7N9) in China has prompted concerns about a possible pandemic and regional spread in the coming months. The objective of this study was to predict the risk of future human infections with H7N9 in China and neighboring countries by assessing the association between H7N9 cases at sentinel hospitals and putative agricultural, climatic, and demographic risk factors.
Methods
This cross-sectional study used the locations of H7N9 cases and negative cases from China?s influenza-like illness surveillance network. After identifying H7N9 risk factors with logistic regression, we used Geographic Information Systems (GIS) to construct predictive maps of H7N9 risk across Asia.
Results
Live bird market density was associated with human H7N9 infections reported in China from March-May 2013. Based on these cases, our model accurately predicted the virus? spread into Guangxi autonomous region in February 2014. Outside China, we find there is a high risk that the virus will spread to northern Vietnam, due to the import of poultry from China.
Conclusions
Our risk map can focus efforts to improve surveillance in poultry and humans, which may facilitate early identification and treatment of human cases.
Keywords
chickens;
influenza in birds;
influenza A virus;
H7N9 subtype;
international health problems;
surveillance
Corresponding author contact information
Corresponding author. 619 Charles E. Young Dr. East, Los Angeles, California 90095-1496 USA. Tel.: +011 310-206-6234; fax: +011 310-825-5446.
Copyright ? 2014 Published by Elsevier Ltd.
Available online 15 March 2014
In Press, Accepted Manuscript ? Note to users
Cover image
Identifying areas with a high risk of human infection with the avian influenza a (H7N9) virus in east asia
Trevon Fullera, Corresponding author contact information, E-mail the corresponding author,
Fiona Haversb,
Cuiling Xuc,
Li-Qun Fangd,
Wu-Chun Caod,
Yuelong Shuc,
Marc-Alain Widdowsone,
Thomas B. Smitha, f
Get rights and content
Summary
Objectives
The rapid emergence, spread, and disease severity of avian influenza A(H7N9) in China has prompted concerns about a possible pandemic and regional spread in the coming months. The objective of this study was to predict the risk of future human infections with H7N9 in China and neighboring countries by assessing the association between H7N9 cases at sentinel hospitals and putative agricultural, climatic, and demographic risk factors.
Methods
This cross-sectional study used the locations of H7N9 cases and negative cases from China?s influenza-like illness surveillance network. After identifying H7N9 risk factors with logistic regression, we used Geographic Information Systems (GIS) to construct predictive maps of H7N9 risk across Asia.
Results
Live bird market density was associated with human H7N9 infections reported in China from March-May 2013. Based on these cases, our model accurately predicted the virus? spread into Guangxi autonomous region in February 2014. Outside China, we find there is a high risk that the virus will spread to northern Vietnam, due to the import of poultry from China.
Conclusions
Our risk map can focus efforts to improve surveillance in poultry and humans, which may facilitate early identification and treatment of human cases.
Keywords
chickens;
influenza in birds;
influenza A virus;
H7N9 subtype;
international health problems;
surveillance
Corresponding author contact information
Corresponding author. 619 Charles E. Young Dr. East, Los Angeles, California 90095-1496 USA. Tel.: +011 310-206-6234; fax: +011 310-825-5446.
Copyright ? 2014 Published by Elsevier Ltd.