Risk of Human Infections With Highly Pathogenic H5N2 and Low Pathogenic H7N1 Avian Influenza Strains During Outbreaks in Ostriches in South Africa

J Infect Dis. 2017 Sep 15;216(suppl_4):S512-S519. doi: 10.1093/infdis/jix018.

Abstract

Background: Risk factors for human infection with highly pathogenic (HP) and low-pathogenic (LP) avian influenza (AI) H5N2 and H7N1 were investigated during outbreaks in ostriches in the Western Cape province, South Africa.

Methods: Serum surveys were conducted for veterinarians, farmworkers, and laboratory and abattoir workers involved in 2 AI outbreaks in the Western Cape province: (1) controlling and culling of 42000 ostriches during (HPAI)H5N2 outbreaks in ostriches (2011) (n = 207); (2) movement control during (LPAI)H7N1 outbreaks in 2012 (n = 66). A third serosurvey was conducted on state veterinarians from across the country in 2012 tasked with disease control in general (n = 37). Antibodies to H5 and H7 were measured by means of hemagglutination inhibition and microneutralization assays, with microneutralization assay titers >40 considered positive.

Results: Two of 207 (1%) participants were seropositive for H5 and 4 of 207 (2%) for H7 in 2011, compared with 1 of 66 (1.5%) and 8 of 66 (13%) in 2012. Although individuals in all professions tested seropositive, abattoir workers (10 of 97; 10.3%) were significantly more at risk of influenza A(H7N1) infection (P = .001) than those in other professions (2 of 171;1.2%). Among state veterinarians, 4 of 37(11%) were seropositive for H7 and 1 of 37 (2.7%) for H5. Investigations of (LP)H7N1-associated fatalities in wild birds and quarantined exotic birds in Gauteng, AI outbreaks in poultry in KwaZulu-Natal, and ostriches in Western Cape province provide possible exposure events.

Conclusion: (LPAI)H7N1 strains pose a greater infection-risk than (HPAI)H5N2 strains to persons involved in control of outbreaks in infected birds, with ostrich abattoir workers at highest risk.

Keywords: Africa; Avian Influenza; H5N2; Highly pathogenic; Low Pathogenic H7N1; humans; ostriches.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Animals, Wild
  • Antibodies, Viral / blood
  • Antigens, Viral / blood
  • Disease Outbreaks*
  • Female
  • Hemagglutination Inhibition Tests
  • Humans
  • Influenza A Virus, H5N2 Subtype / isolation & purification*
  • Influenza A Virus, H7N1 Subtype / isolation & purification*
  • Influenza in Birds / epidemiology*
  • Influenza in Birds / transmission
  • Influenza, Human / epidemiology*
  • Male
  • Middle Aged
  • Risk Factors
  • Seroepidemiologic Studies
  • South Africa / epidemiology
  • Specimen Handling
  • Struthioniformes / virology*
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Antibodies, Viral
  • Antigens, Viral