Giuseppe
Emeritus
[Source: PLoS ONE, full page: (LINK). Abstract, edited.]
Open Access / Peer-Reviewed / Research Article
Distinct Risk Profiles for Human Infections with the Influenza A(H7N9) Virus among Rural and Urban Residents: Zhejiang Province, China, 2013
Fan He, Meng Zhang, Xinyi Wang, Haocheng Wu, Xiaopeng Shang, Fudong Li, Chen Wu, Junfen Lin, Bao-Ping Zhu
Published: May 02, 2014 - DOI: 10.1371/journal.pone.0095015
Abstract
Objective
To identify the risk factors and source of infection leading to human infections with the Influenza A(H7N9) virus in urban and rural areas.
Methods
We conducted a case-control investigation to identify potential exposures and risk factors. Controls were randomly selected from the same community as the cases using random digit dialing. We used exact conditional logistic regression to evaluate the exposures and risk factors, stratified by urban and rural residence.
Results
Buying live or freshly slaughtered poultry from a market was significantly associated with illness onset among both urban [48% of 25 case-patients and 12% of 125 control-persons, adjusted odds ratio (AOR) = 19, 95% CI: 2.3?929] and rural (33% of 18 case-patients and 8.9% of 90 control-persons, AOR = 13, 95% CI:1.5?∞) residents. In rural area, tending to home-raised poultry (56% of 18 case-patients and 10% of 90 control-persons, AOR = 57, 95% CI: 7.5?∞) and existence of a poultry farm in the vicinity of the residence (28% of 18 case-patients and 5.6% of 90 control-persons, AOR = 37, 95% CI: 3.8?∞) were also significantly associated with disease onset. Presence of underlying medical conditions was a significant risk factor for urban residents (76% of 25 case-patients and 13% of 125 control-persons, AOR = 49, 95% CI: 7.1?2132).
Conclusions
Buying live or freshly slaughtered poultry from a market is a risk factor for both urban and rural residents, tending to home-raised poultry and existence of a poultry farm in the vicinity of the residence are risk factors unique for rural residents. The virus might have been in stealth circulation in the poultry population before infecting humans. We recommend strict poultry market management and multisectoral collaboration to identify the extent of poultry infection in China.
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Citation: He F, Zhang M, Wang X, Wu H, Shang X, et al. (2014) Distinct Risk Profiles for Human Infections with the Influenza A(H7N9) Virus among Rural and Urban Residents: Zhejiang Province, China, 2013. PLoS ONE 9(5): e95015. doi:10.1371/journal.pone.0095015
Editor: Hiroshi Nishiura, The University of Tokyo, Japan
Received: November 18, 2013; Accepted: March 21, 2014; Published: May 2, 2014
Copyright: ? 2014 He et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This study was supported by the Program for Zhejiang Leading Team of Science and Technology Innovation (2011R50021). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
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Open Access / Peer-Reviewed / Research Article
Distinct Risk Profiles for Human Infections with the Influenza A(H7N9) Virus among Rural and Urban Residents: Zhejiang Province, China, 2013
Fan He, Meng Zhang, Xinyi Wang, Haocheng Wu, Xiaopeng Shang, Fudong Li, Chen Wu, Junfen Lin, Bao-Ping Zhu
Published: May 02, 2014 - DOI: 10.1371/journal.pone.0095015
Abstract
Objective
To identify the risk factors and source of infection leading to human infections with the Influenza A(H7N9) virus in urban and rural areas.
Methods
We conducted a case-control investigation to identify potential exposures and risk factors. Controls were randomly selected from the same community as the cases using random digit dialing. We used exact conditional logistic regression to evaluate the exposures and risk factors, stratified by urban and rural residence.
Results
Buying live or freshly slaughtered poultry from a market was significantly associated with illness onset among both urban [48% of 25 case-patients and 12% of 125 control-persons, adjusted odds ratio (AOR) = 19, 95% CI: 2.3?929] and rural (33% of 18 case-patients and 8.9% of 90 control-persons, AOR = 13, 95% CI:1.5?∞) residents. In rural area, tending to home-raised poultry (56% of 18 case-patients and 10% of 90 control-persons, AOR = 57, 95% CI: 7.5?∞) and existence of a poultry farm in the vicinity of the residence (28% of 18 case-patients and 5.6% of 90 control-persons, AOR = 37, 95% CI: 3.8?∞) were also significantly associated with disease onset. Presence of underlying medical conditions was a significant risk factor for urban residents (76% of 25 case-patients and 13% of 125 control-persons, AOR = 49, 95% CI: 7.1?2132).
Conclusions
Buying live or freshly slaughtered poultry from a market is a risk factor for both urban and rural residents, tending to home-raised poultry and existence of a poultry farm in the vicinity of the residence are risk factors unique for rural residents. The virus might have been in stealth circulation in the poultry population before infecting humans. We recommend strict poultry market management and multisectoral collaboration to identify the extent of poultry infection in China.
_____
Citation: He F, Zhang M, Wang X, Wu H, Shang X, et al. (2014) Distinct Risk Profiles for Human Infections with the Influenza A(H7N9) Virus among Rural and Urban Residents: Zhejiang Province, China, 2013. PLoS ONE 9(5): e95015. doi:10.1371/journal.pone.0095015
Editor: Hiroshi Nishiura, The University of Tokyo, Japan
Received: November 18, 2013; Accepted: March 21, 2014; Published: May 2, 2014
Copyright: ? 2014 He et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This study was supported by the Program for Zhejiang Leading Team of Science and Technology Innovation (2011R50021). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
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