Highly Pathogenic Avian Influenza (H5N1): Pathways of Exposure at the Animal‐Human Interface, a Systematic Review
Identifieur interne : 000611 ( Ncbi/Merge ); précédent : 000610; suivant : 000612Highly Pathogenic Avian Influenza (H5N1): Pathways of Exposure at the Animal‐Human Interface, a Systematic Review
Auteurs : Maria D. Van Kerkhove [Royaume-Uni] ; Elizabeth Mumford [Suisse] ; Anthony W. Mounts [Suisse] ; Joseph Bresee [États-Unis] ; Sowath Ly [Cambodge] ; Carolyn B. Bridges [États-Unis] ; Joachim Otte [Italie]Source :
- PLoS ONE [ 1932-6203 ] ; 2011.
Abstract
The threat posed by highly pathogenic avian influenza A H5N1 viruses to humans remains significant, given the continued occurrence of sporadic human cases (499 human cases in 15 countries) with a high case fatality rate (approximately 60%), the endemicity in poultry populations in several countries, and the potential for reassortment with the newly emerging 2009 H1N1 pandemic strain. Therefore, we review risk factors for H5N1 infection in humans.
Several epidemiologic studies have evaluated the risk factors associated with increased risk of H5N1 infection among humans who were exposed to H5N1 viruses. Our review shows that most H5N1 cases are attributed to exposure to sick poultry. Most cases are sporadic, while occasional limited human-to-human transmission occurs. The most commonly identified factors associated with H5N1 virus infection included exposure through contact with infected blood or bodily fluids of infected poultry via food preparation practices; touching and caring for infected poultry; consuming uncooked poultry products; exposure to H5N1 via swimming or bathing in potentially virus laden ponds; and exposure to H5N1 at live bird markets.
Research has demonstrated that despite frequent and widespread contact with poultry, transmission of the H5N1 virus from poultry to humans is rare. Available research has identified several risk factors that may be associated with infection including close direct contact with poultry and transmission via the environment. However, several important data gaps remain that limit our understanding of the epidemiology of H5N1 in humans. Although infection in humans with H5N1 remains rare, human cases continue to be reported and H5N1 is now considered endemic among poultry in parts of Asia and in Egypt, providing opportunities for additional human infections and for the acquisition of virus mutations that may lead to more efficient spread among humans and other mammalian species. Collaboration between human and animal health sectors for surveillance, case investigation, virus sharing, and risk assessment is essential to monitor for potential changes in circulating H5N1 viruses and in the epidemiology of H5N1 in order to provide the best possible chance for effective mitigation of the impact of H5N1 in both poultry and humans.
The opinions expressed in this article are those of the authors and do not necessarily reflect those of the institutions or organizations with which they are affiliated.
Url:
DOI: 10.1371/journal.pone.0014582
PubMed: 21283678
PubMed Central: 3025925
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PMC:3025925Le document en format XML
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>The threat posed by highly pathogenic avian influenza A H5N1 viruses to humans remains significant, given the continued occurrence of sporadic human cases (499 human cases in 15 countries) with a high case fatality rate (approximately 60%), the endemicity in poultry populations in several countries, and the potential for reassortment with the newly emerging 2009 H1N1 pandemic strain. Therefore, we review risk factors for H5N1 infection in humans.</p>
</sec>
<sec><title>Methods and Findings</title>
<p>Several epidemiologic studies have evaluated the risk factors associated with increased risk of H5N1 infection among humans who were exposed to H5N1 viruses. Our review shows that most H5N1 cases are attributed to exposure to sick poultry. Most cases are sporadic, while occasional limited human-to-human transmission occurs. The most commonly identified factors associated with H5N1 virus infection included exposure through contact with infected blood or bodily fluids of infected poultry via food preparation practices; touching and caring for infected poultry; consuming uncooked poultry products; exposure to H5N1 via swimming or bathing in potentially virus laden ponds; and exposure to H5N1 at live bird markets.</p>
</sec>
<sec><title>Conclusions</title>
<p>Research has demonstrated that despite frequent and widespread contact with poultry, transmission of the H5N1 virus from poultry to humans is rare. Available research has identified several risk factors that may be associated with infection including close direct contact with poultry and transmission via the environment. However, several important data gaps remain that limit our understanding of the epidemiology of H5N1 in humans. Although infection in humans with H5N1 remains rare, human cases continue to be reported and H5N1 is now considered endemic among poultry in parts of Asia and in Egypt, providing opportunities for additional human infections and for the acquisition of virus mutations that may lead to more efficient spread among humans and other mammalian species. Collaboration between human and animal health sectors for surveillance, case investigation, virus sharing, and risk assessment is essential to monitor for potential changes in circulating H5N1 viruses and in the epidemiology of H5N1 in order to provide the best possible chance for effective mitigation of the impact of H5N1 in both poultry and humans.</p>
</sec>
<sec><title>Disclaimer</title>
<p>The opinions expressed in this article are those of the authors and do not necessarily reflect those of the institutions or organizations with which they are affiliated.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosone</journal-id>
<journal-title-group><journal-title>PLoS ONE</journal-title>
</journal-title-group>
<issn pub-type="epub">1932-6203</issn>
<publisher><publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">21283678</article-id>
<article-id pub-id-type="pmc">3025925</article-id>
<article-id pub-id-type="publisher-id">10-PONE-RA-21626R1</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0014582</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline"><subject>Public Health and Epidemiology</subject>
<subject>Infectious Diseases/Respiratory Infections</subject>
<subject>Public Health and Epidemiology/Global Health</subject>
<subject>Public Health and Epidemiology/Infectious Diseases</subject>
</subj-group>
</article-categories>
<title-group><article-title>Highly Pathogenic Avian Influenza (H5N1): Pathways of Exposure at the Animal‐Human Interface, a Systematic Review</article-title>
<alt-title alt-title-type="running-head">Human Risk of H5N1</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Van Kerkhove</surname>
<given-names>Maria D.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1"><sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mumford</surname>
<given-names>Elizabeth</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mounts</surname>
<given-names>Anthony W.</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bresee</surname>
<given-names>Joseph</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ly</surname>
<given-names>Sowath</given-names>
</name>
<xref ref-type="aff" rid="aff4"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bridges</surname>
<given-names>Carolyn B.</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Otte</surname>
<given-names>Joachim</given-names>
</name>
<xref ref-type="aff" rid="aff5"><sup>5</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
<addr-line>MRC Centre for Outbreak Analysis and Modelling, Imperial College London, London, United Kingdom</addr-line>
</aff>
<aff id="aff2"><label>2</label>
<addr-line>World Health Organization, Global Influenza Programme, Geneva, Switzerland</addr-line>
</aff>
<aff id="aff3"><label>3</label>
<addr-line>Influenza Division, National Center for Immunization and Respiratory Diseases (NCIRD), Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America</addr-line>
</aff>
<aff id="aff4"><label>4</label>
<addr-line>Institut Pasteur du Cambodge, Phnom Penh, Cambodia</addr-line>
</aff>
<aff id="aff5"><label>5</label>
<addr-line>Animal Production and Health Division, Food and Agriculture Organization of the United Nations, Rome, Italy</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Braga</surname>
<given-names>Erika Martins</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1">Universidade Federal de Minas Gerais, Brazil</aff>
<author-notes><corresp id="cor1">* E-mail: <email>m.vankerkhove@imperial.ac.uk</email>
</corresp>
<fn fn-type="con"><p>Analyzed the data: MDVK. Wrote the paper: MDVK. Conceived the paper: MDVK, JO. Reviewed and edited versions of the manuscript: EM AM JB SL CB JO.</p>
</fn>
</author-notes>
<pub-date pub-type="collection"><year>2011</year>
</pub-date>
<pub-date pub-type="epub"><day>24</day>
<month>1</month>
<year>2011</year>
</pub-date>
<volume>6</volume>
<issue>1</issue>
<elocation-id>e14582</elocation-id>
<history><date date-type="received"><day>26</day>
<month>7</month>
<year>2010</year>
</date>
<date date-type="accepted"><day>21</day>
<month>10</month>
<year>2010</year>
</date>
</history>
<permissions><copyright-statement>This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.</copyright-statement>
<copyright-year>2011</copyright-year>
<license xlink:href="https://creativecommons.org/publicdomain/zero/1.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration, which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.</license-p>
</license>
</permissions>
<abstract><sec><title>Background</title>
<p>The threat posed by highly pathogenic avian influenza A H5N1 viruses to humans remains significant, given the continued occurrence of sporadic human cases (499 human cases in 15 countries) with a high case fatality rate (approximately 60%), the endemicity in poultry populations in several countries, and the potential for reassortment with the newly emerging 2009 H1N1 pandemic strain. Therefore, we review risk factors for H5N1 infection in humans.</p>
</sec>
<sec><title>Methods and Findings</title>
<p>Several epidemiologic studies have evaluated the risk factors associated with increased risk of H5N1 infection among humans who were exposed to H5N1 viruses. Our review shows that most H5N1 cases are attributed to exposure to sick poultry. Most cases are sporadic, while occasional limited human-to-human transmission occurs. The most commonly identified factors associated with H5N1 virus infection included exposure through contact with infected blood or bodily fluids of infected poultry via food preparation practices; touching and caring for infected poultry; consuming uncooked poultry products; exposure to H5N1 via swimming or bathing in potentially virus laden ponds; and exposure to H5N1 at live bird markets.</p>
</sec>
<sec><title>Conclusions</title>
<p>Research has demonstrated that despite frequent and widespread contact with poultry, transmission of the H5N1 virus from poultry to humans is rare. Available research has identified several risk factors that may be associated with infection including close direct contact with poultry and transmission via the environment. However, several important data gaps remain that limit our understanding of the epidemiology of H5N1 in humans. Although infection in humans with H5N1 remains rare, human cases continue to be reported and H5N1 is now considered endemic among poultry in parts of Asia and in Egypt, providing opportunities for additional human infections and for the acquisition of virus mutations that may lead to more efficient spread among humans and other mammalian species. Collaboration between human and animal health sectors for surveillance, case investigation, virus sharing, and risk assessment is essential to monitor for potential changes in circulating H5N1 viruses and in the epidemiology of H5N1 in order to provide the best possible chance for effective mitigation of the impact of H5N1 in both poultry and humans.</p>
</sec>
<sec><title>Disclaimer</title>
<p>The opinions expressed in this article are those of the authors and do not necessarily reflect those of the institutions or organizations with which they are affiliated.</p>
</sec>
</abstract>
<counts><page-count count="8"></page-count>
</counts>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Cambodge</li>
<li>Italie</li>
<li>Royaume-Uni</li>
<li>Suisse</li>
<li>États-Unis</li>
</country>
<region><li>Angleterre</li>
<li>Grand Londres</li>
<li>Géorgie (États-Unis)</li>
<li>Latium</li>
</region>
<settlement><li>Londres</li>
<li>Rome</li>
</settlement>
</list>
<tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Van Kerkhove, Maria D" sort="Van Kerkhove, Maria D" uniqKey="Van Kerkhove M" first="Maria D." last="Van Kerkhove">Maria D. Van Kerkhove</name>
</region>
</country>
<country name="Suisse"><noRegion><name sortKey="Mumford, Elizabeth" sort="Mumford, Elizabeth" uniqKey="Mumford E" first="Elizabeth" last="Mumford">Elizabeth Mumford</name>
</noRegion>
<name sortKey="Mounts, Anthony W" sort="Mounts, Anthony W" uniqKey="Mounts A" first="Anthony W." last="Mounts">Anthony W. Mounts</name>
</country>
<country name="États-Unis"><region name="Géorgie (États-Unis)"><name sortKey="Bresee, Joseph" sort="Bresee, Joseph" uniqKey="Bresee J" first="Joseph" last="Bresee">Joseph Bresee</name>
</region>
<name sortKey="Bridges, Carolyn B" sort="Bridges, Carolyn B" uniqKey="Bridges C" first="Carolyn B." last="Bridges">Carolyn B. Bridges</name>
</country>
<country name="Cambodge"><noRegion><name sortKey="Ly, Sowath" sort="Ly, Sowath" uniqKey="Ly S" first="Sowath" last="Ly">Sowath Ly</name>
</noRegion>
</country>
<country name="Italie"><region name="Latium"><name sortKey="Otte, Joachim" sort="Otte, Joachim" uniqKey="Otte J" first="Joachim" last="Otte">Joachim Otte</name>
</region>
</country>
</tree>
</affiliations>
</record>
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