Sally Furniss
Well-known member
he Lancet 2004; 363:587-593DOI:10.1016/S0140-6736(04)15589-XArticles
Transmission of H7N7 avian influenza A virus to human beings during a large outbreak in commercial poultry farms in the Netherlands
Dr Marion Koopmans DVM
a 
, Berry Wilbrink PhD a, Marina Conyn PhD b, Gerard Natrop MD f, Hans van der Nat a, Harry Vennema PhD a, Adam Meijer PhD a c, Jim van Steenbergen MD e, Ron Fouchier PhD d, Albert Osterhaus DVM d and Arnold Bosman MD b
Summary
BackgroundAn outbreak of highly pathogenic avian influenza A virus subtype H7N7 started at the end of February, 2003, in commercial poultry farms in the Netherlands. Although the risk of transmission of these viruses to humans was initially thought to be low, an outbreak investigation was launched to assess the extent of transmission of influenza A virus subtype H7N7 from chickens to humans.
MethodsAll workers in poultry farms, poultry farmers, and their families were asked to report signs of conjunctivitis or influenza-like illness. People with complaints were tested for influenza virus type A subtype H7 (A/H7) infection and completed a health questionnaire about type of symptoms, duration of illness, and possible exposures to infected poultry.
Findings453 people had health complaints?349 reported conjunctivitis, 90 had influenza-like illness, and 67 had other complaints. We detected A/H7 in conjunctival samples from 78 (26?4%) people with conjunctivitis only, in five (9?4%) with influenza-like illness and conjunctivitis, in two (5?4%) with influenza-like illness only, and in four (6%) who reported other symptoms. Most positive samples had been collected within 5 days of symptom onset. A/H7 infection was confirmed in three contacts (of 83 tested), one of whom developed influenza-like illness. Six people had influenza A/H3N2 infection. After 19 people had been diagnosed with the infection, all workers received mandatory influenza virus vaccination and prophylactic treatment with oseltamivir. More than half (56%) of A/H7 infections reported here arose before the vaccination and treatment programme.
InterpretationWe noted an unexpectedly high number of transmissions of avian influenza A virus subtype H7N7 to people directly involved in handling infected poultry, and we noted evidence for person-to-person transmission. Our data emphasise the importance of adequate surveillance, outbreak preparedness, and pandemic planning.
http://www.thelancet.com/journals/lancet/article/PIIS014067360415589X/abstract
Transmission of H7N7 avian influenza A virus to human beings during a large outbreak in commercial poultry farms in the Netherlands
Dr Marion Koopmans DVM
a , Berry Wilbrink PhD a, Marina Conyn PhD b, Gerard Natrop MD f, Hans van der Nat a, Harry Vennema PhD a, Adam Meijer PhD a c, Jim van Steenbergen MD e, Ron Fouchier PhD d, Albert Osterhaus DVM d and Arnold Bosman MD bSummary
BackgroundAn outbreak of highly pathogenic avian influenza A virus subtype H7N7 started at the end of February, 2003, in commercial poultry farms in the Netherlands. Although the risk of transmission of these viruses to humans was initially thought to be low, an outbreak investigation was launched to assess the extent of transmission of influenza A virus subtype H7N7 from chickens to humans.
MethodsAll workers in poultry farms, poultry farmers, and their families were asked to report signs of conjunctivitis or influenza-like illness. People with complaints were tested for influenza virus type A subtype H7 (A/H7) infection and completed a health questionnaire about type of symptoms, duration of illness, and possible exposures to infected poultry.
Findings453 people had health complaints?349 reported conjunctivitis, 90 had influenza-like illness, and 67 had other complaints. We detected A/H7 in conjunctival samples from 78 (26?4%) people with conjunctivitis only, in five (9?4%) with influenza-like illness and conjunctivitis, in two (5?4%) with influenza-like illness only, and in four (6%) who reported other symptoms. Most positive samples had been collected within 5 days of symptom onset. A/H7 infection was confirmed in three contacts (of 83 tested), one of whom developed influenza-like illness. Six people had influenza A/H3N2 infection. After 19 people had been diagnosed with the infection, all workers received mandatory influenza virus vaccination and prophylactic treatment with oseltamivir. More than half (56%) of A/H7 infections reported here arose before the vaccination and treatment programme.
InterpretationWe noted an unexpectedly high number of transmissions of avian influenza A virus subtype H7N7 to people directly involved in handling infected poultry, and we noted evidence for person-to-person transmission. Our data emphasise the importance of adequate surveillance, outbreak preparedness, and pandemic planning.
http://www.thelancet.com/journals/lancet/article/PIIS014067360415589X/abstract