Estimating Risks of Inapparent Avian Exposure for Human Infection: Avian Influenza Virus A (H7N9) in Zhejiang Province, China.
Estimating Risks of Inapparent Avian Exposure for Human Infection: Avian Influenza Virus A (H7N9) in Zhejiang Province, China.
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DOI：
10.1038/srep40016
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发表时间：
2017-01-05
影响因子：
4.6
通讯作者：
Lai PC
中科院分区：
文献类型：
--
作者：
Ge E;Zhang R;Li D;Wei X;Wang X;Lai PC
中国发生散发性甲型H7N9禽流感疑似禽类接触。这种类型的暴露通常不会被注意到，很难建模和测量。感染H7N9禽流感病毒的受感染家禽通常没有症状，这可能会通过不明显的家禽/禽类接触而促进感染，特别是在一个普遍存在后院家禽做法的国家。本研究提出了一种新的方法，将生态学方法和病例对照方法相结合，以量化隐性禽类暴露于人类H7N9感染的风险。在对H7N9病例在社区、社区、区和城市等多个地理尺度上的空间聚集效应进行调整后，发现感染与鸡和鹅的密度显著相关，但与鸭的密度无关。这些暴露风险在地理上各不相同，与河流和湖泊的邻近有关，这些河流和湖泊也是与鸟类有关的环境中不明显暴露的指标。男性、老年人和农民是病毒感染的高危亚群。这些发现使卫生官员能够有针对性地在特定地点开展教育计划和意识培训，以减少隐性暴露的风险。
Inapparent avian exposure was suspected for the sporadic infection of avian influenza A(H7N9) occurring in China. This type of exposure is usually unnoticed and difficult to model and measure. Infected poultry with avian influenza H7N9 virus typically remains asymptomatic, which may facilitate infection through inapparent poultry/bird exposure, especially in a country with widespread practice of backyard poultry. The present study proposed a novel approach that integrated ecological and case-control methods to quantify the risk of inapparent avian exposure on human H7N9 infection. Significant associations of the infection with chicken and goose densities, but not with duck density, were identified after adjusting for spatial clustering effects of the H7N9 cases across multiple geographic scales of neighborhood, community, district and city levels. These exposure risks varied geographically in association with proximity to rivers and lakes that were also proxies for inapparent exposure to avian-related environment. Males, elderly people, and farmers were high-risk subgroups for the virus infection. These findings enable health officials to target educational programs and awareness training in specific locations to reduce the risks of inapparent exposure.
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