Prospective Studies of Avian Influenza Transmission in Asia

亚洲禽流感传播的前瞻性研究

• 批准号: 8057458
• 负责人: Gregory Charles Gray
• 金额: $ 7.07万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-15 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8057458
• 关键词: Address; Adult; Animals; Antiviral Agents; Area; Asia; Avian Influenza; Behavioral; Belgium; Birds; Cambodia; Canada; Cessation of life; China; Clinical; Complex; Confidence Intervals; Containment; Contracts; Country; Data; Detection; Development; Disease model; Domestic Animals; Domestic Fowls; Dose; Ducks; Egypt; Enrollment; Epidemiology; Exposure to; Family; Family member; Family suidae; Felis catus; Future; Gastrointestinal Diseases; Gender; Gray unit of radiation dose; Grouping; H7N7; Health Professional; Home visitation; Hong Kong; House Call; Human; Incidence; Indonesia; Industry; Infection; Influenza; Influenza A Virus, H5N1 Subtype; Institute of Medicine (U.S.); International; Intervention; Invaded; Japan; Laboratories; Laboratory Study; Laos; Life; Little' s Disease; London; Maps; Marketing; Measures; Meat; Modeling; Monitor; Netherlands; New York; Odds Ratio; Oseltamivir; Outcome; Participant; Pathogenicity; Persons; Policies; Population; Preparation; Prevalence; Process; Production; Prospective Studies; Province; Public Health; Published Comment; Quarantine; Questionnaires; Reporting; Reproduction; Research; Research Infrastructure; Research Priority; Research Project Grants; Reverse Transcriptase Polymerase Chain Reaction; Risk; Risk Factors; Sampling; Serological; Seroprevalences; Serum; Site; South Korea; Study Subject; Swab; Techniques; Thailand; Tigers; Time; United States; Vaccination; Vaccines; Vietnam; Viral; Virginia; Virus; Work; World Health Organization; age difference; age group; base; biosecurity; cohort; college; design; domestic bird; economic impact; experience; farmer; flu transmission; follow-up; high risk; human disease; influenza epidemic; influenza outbreak; influenzavirus; innovation; man; mathematical model; meetings; mortality; pandemic disease; pandemic influenza; professor; response; success; symposium; transmission process; virus identification

DESCRIPTION (provided by applicant): The H5N1 avian influenza epidemic that has ravaged multiple species in Asia, now threatens the United States. National response plans call for aggressive human case identification, antiviral use, isolation, and possibly quarantine. The mathematical models upon which the pandemic plans rely lack fundamental objective data such as transmission rates and virus infectiousness. As human disease detection in Asia is based upon clinical encounters, little is known regarding subclinical infections or risk factors for H5N1 infection. Our long term goa/in this proposed research is to epidemiologically describe clinical and subclinical H5N1 transmission such that public health officials might design appropriate H5N1 surveillance and control measures. In this effort we will conduct a controlled, three-year, prospective study of H5N1 transmission among 900 adults occupationally exposed to poultry (poultry farmers, poultry industry workers, meat processing workers, open poultry market workers), and 300 age-group and gender matched non-exposed controls living in three H5N1 endemic areas in Asia: Tangerang, Indonesia; Bali, Indonesia; and Kandaal Province, Cambodia. The study will involve aggressive active surveillance for influenza-like illness among study participants (with nasopharyngeal swab and serum sampling), annual serial serological follow-up of participants, and through home visits, similar studies of the family members exposed to study subjects who develops influenza infection. Microneutralization serologic techniques, RT-PCR, and viral culture will be used to determine influenza infection outcomes. Our objectives are to determine the seroprevalence of evidence of previous H5N1 influenza infection, to estimate the annual incidence of H5N1 influenza infection, to estimate secondary H5N1 influenza infection rates, and to determine risk factors for H5N1 influenza infection. Based upon preliminary data, our central hypotheses are that H5N1 influenza infection will be frequent among these workers, that we will be able to estimate the prevalence and incidence of H5N1 infection, and that we will be able to identify persons at highest risk of H5N1 infection. We are particularly well-suited to conduct this work as we have extensive experience conducting both epidemiological and laboratory-based studies of influenza transmission, and we have exceptional cooperation among public health officials nationally and locally at the field sites. This study is innovative in that no such prospective studies of avian influenza infection have been performed among those person's occupationally exposed to poultry in H5N1 endemic sites.

描述(申请人提供)：H5N1禽流感疫情在亚洲肆虐多个物种，现在威胁到美国。国家应对计划要求积极识别人间病例，使用抗病毒药物，进行隔离，并可能进行隔离。大流行计划所依赖的数学模型缺乏传播率和病毒传染性等基本客观数据。由于亚洲的人类疾病检测是基于临床接触，因此对亚临床感染或H5N1感染的风险因素知之甚少。在这项拟议的研究中，我们的长期目标是从流行病学角度描述临床和亚临床H5N1传播，以便公共卫生官员可以设计适当的H5N1监测和控制措施。在这项工作中，我们将对900名职业接触家禽的成年人(家禽养殖户、家禽业工人、肉类加工工人、开放家禽市场工作人员)和300名年龄组和性别匹配的非暴露对照人群进行为期三年的受控前瞻性研究，这些对照人群生活在亚洲三个H5N1流行区：印度尼西亚坦格朗、印度尼西亚巴厘岛和柬埔寨坎大省。这项研究将包括在研究参与者中积极主动地监测流感样疾病(通过鼻咽拭子和血清采样)，对参与者进行年度连续血清学跟踪，并通过家访，对接触到流感感染的研究对象的家庭成员进行类似的研究。微量中和血清学技术、RT-PCR和病毒培养将用于确定流感感染结果。我们的目标是确定以往H5N1流感感染证据的血清阳性率，估计H5N1流感感染的年度发病率，估计二次H5N1流感感染率，并确定H5N1流感感染的危险因素。根据初步数据，我们的中心假设是，这些工人将经常感染H5N1流感，我们将能够估计H5N1感染的流行率和发病率，我们将能够识别H5N1感染风险最高的人。我们特别适合开展这项工作，因为我们在进行流感传播的流行病学和实验室研究方面拥有丰富的经验，而且我们在国家和地方的实地公共卫生官员之间有着特殊的合作。这项研究是创新的，因为没有在H5N1流行地点与家禽有职业接触的人员中进行这样的禽流感感染前瞻性研究。