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Increased risk of A(H1N1)pdm09 influenza infection in UK pig industry workers compared to a general population cohort.

ABSTRACT: BACKGROUND:Pigs are mixing vessels for influenza viral reassortment, but the extent of influenza transmission between swine and humans is not well understood. OBJECTIVES:To assess whether occupational exposure to pigs is a risk factor for human infection with human and swine-adapted influenza viruses. METHODS:UK pig industry workers were frequency-matched on age, region, sampling month, and gender with a community-based comparison group from the Flu Watch study. HI assays quantified antibodies for swine and human A(H1) and A(H3) influenza viruses (titres ? 40 considered seropositive and indicative of infection). Virus-specific associations between seropositivity and occupational pig exposure were examined using multivariable regression models adjusted for vaccination. Pigs on the same farms were also tested for seropositivity. RESULTS:Forty-two percent of pigs were seropositive to A(H1N1)pdm09. Pig industry workers showed evidence of increased odds of A(H1N1)pdm09 seropositivity compared to the comparison group, albeit with wide confidence intervals (CIs), adjusted odds ratio after accounting for possible cross-reactivity with other swine A(H1) viruses (aOR) 25·3, 95% CI (1·4-536·3), P = 0·028. CONCLUSION:The results indicate that A(H1N1)pdm09 virus was common in UK pigs during the pandemic and subsequent period of human A(H1N1)pdm09 circulation, and occupational exposure to pigs was a risk factor for human infection. Influenza immunisation of pig industry workers may reduce transmission and the potential for virus reassortment.

SUBMITTER: Fragaszy E

PROVIDER: S-EPMC4910179 | biostudies-literature | 2016 Jul

REPOSITORIES: biostudies-literature

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Increased risk of A(H1N1)pdm09 influenza infection in UK pig industry workers compared to a general population cohort.

Fragaszy Ellen E Ishola David A DA Brown Ian H IH Enstone Joanne J Nguyen-Van-Tam Jonathan S JS Simons Robin R Tucker Alexander W AW Wieland Barbara B Williamson Susanna M SM Hayward Andrew C AC Wood James L N JL

Influenza and other respiratory viruses 20160129 4

<h4>Background</h4>Pigs are mixing vessels for influenza viral reassortment, but the extent of influenza transmission between swine and humans is not well understood.<h4>Objectives</h4>To assess whether occupational exposure to pigs is a risk factor for human infection with human and swine-adapted influenza viruses.<h4>Methods</h4>UK pig industry workers were frequency-matched on age, region, sampling month, and gender with a community-based comparison group from the Flu Watch study. HI assays q ...[more]

PMID: 26611769

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Project description:ObjectivesTo review neurological complications after the influenza A (H1N1) pdm09, highlighting the clinical differences between patients with post-vaccine or viral infection.DesignA search on Medline, Ovid, EMBASE, and PubMed databases using the keywords “neurological complications of Influenza AH1N1” or “post-vaccine Influenza AH1N1.”SettingOnly papers written in English, Spanish, German, French, Portuguese, and Italian published from March 2009 to December 2012 were included.SampleWe included 104 articles presenting a total of 1636 patient cases. In addition, two cases of influenza vaccine-related neurological events from our neurological care center, arising during the period of study, were also included.Main outcome measuresDemographic data and clinical diagnosis of neurological complications and outcomes: death, neurological sequelae or recovery after influenza A (H1N1) pdm09 vaccine or infection.ResultsThe retrieved cases were divided into two groups: the postvaccination group, with 287 patients, and the viral infection group, with 1349 patients. Most patients in the first group were adults. The main neurological complications were Guillain-Barre syndrome (GBS) or polyneuropathy (125), and seizures (23). All patients survived. Pediatric patients were predominant in the viral infection group. In this group, 60 patients (4.7%) died and 52 (30.1%) developed permanent sequelae. A wide spectrum of neurological complications was observed.ConclusionsFatal cases and severe, permanent, neurological sequelae were observed in the infection group only. Clinical outcome was more favorable in the post-vaccination group. In this context, the relevance of an accurate neurological evaluation is demonstrated for all suspicious cases, as well as the need of an appropriate long-term clinical and imaging follow-up of infection and post-vaccination events related to influenza A (H1N1) pdm09, to clearly estimate the magnitude of neurological complications leading to permanent disability.

Dataset Information

Increased risk of A(H1N1)pdm09 influenza infection in UK pig industry workers compared to a general population cohort.

Publications

Increased risk of A(H1N1)pdm09 influenza infection in UK pig industry workers compared to a general population cohort.

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