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

the Combating Swine Influenza (COSI) Consortium; the Flu Watch Group; Fragaszy, Ellen; Ishola, David A.; Brown, Ian H.; Enstone, Joanne; Nguyen-Van-Tam, Jonathan S.; Simons, Robin; Tucker, Alexander W.; Wieland, Barbara; Williamson, Susanna M.; Hayward, Andrew C.; Wood, James L.N.

Authors

the Combating Swine Influenza (COSI) Consortium

the Flu Watch Group

Ellen Fragaszy

David A. Ishola

Ian H. Brown

Joanne Enstone joanne.enstone@nottingham.ac.uk

Robin Simons

Alexander W. Tucker

Barbara Wieland

Susanna M. Williamson

Andrew C. Hayward

James L.N. Wood



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: 42% 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 (CI), Adjusted Odds Ratio after accounting for possible cross reactivity with other swine A(H1) viruses (aOR) 25.30, 95% CI [1.44-536.34], 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 immunization of pig industry workers may reduce transmission and the potential for virus reassortment.

Citation

the Combating Swine Influenza (COSI) Consortium, , the Flu Watch Group, , Fragaszy, E., Ishola, D. A., Brown, I. H., Enstone, J., …Wood, J. L. (2016). Increased risk of A(H1N1)pdm09 influenza infection in UK pig industry workers compared to a general population cohort. Influenza and Other Respiratory Viruses, 10(4), 291-300. https://doi.org/10.1111/irv.12364

Journal Article Type Article
Acceptance Date Nov 9, 2015
Online Publication Date Jan 29, 2016
Publication Date Jan 29, 2016
Deposit Date Jun 29, 2016
Publicly Available Date Jun 29, 2016
Journal Influenza and Other Respiratory Viruses
Print ISSN 1750-2640
Electronic ISSN 1750-2659
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 10
Issue 4
Pages 291-300
DOI https://doi.org/10.1111/irv.12364
Keywords Humans, influenza, occupational exposure, serology, swine
zoonoses
Public URL http://eprints.nottingham.ac.uk/id/eprint/34446
Publisher URL http://onlinelibrary.wiley.com/doi/10.1111/irv.12364/abstract
Related Public URLs http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910179/
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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