Coman Alexandru, Maftei Daniel N, Krueger Whitney S, Heil Gary L, Chereches Razvan M, Sirlincan Emanuela, Bria Paul, Dragnea Claudiu, Kasler Iosif, Valentine Marissa A, Gray Gregory C
Center for Health Policy and Public Health, Institute for Social Research, Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania.
College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America.
PLoS One. 2014 May 28;9(5):e98248. doi: 10.1371/journal.pone.0098248. eCollection 2014.
In this prospective study we sought to examine seroepidemiological evidence for acute zoonotic influenza virus infection among Romanian agricultural workers.
Sera were drawn upon enrollment (2009) and again at 12 and 24 months from 312 adult agriculture workers and 51 age-group matched controls. Participants were contacted monthly for 24 months and queried regarding episodes of acute influenza-like illnesses (ILI). Cohort members meeting ILI criteria permitted respiratory swab collections as well as acute and convalescent serum collection. Serologic assays were performed against 9 avian, 3 swine, and 3 human influenza viruses.
During the two-year follow-up, a total of 23 ILI events were reported. Two subjects' specimens were identified as influenza A by rRT-PCR. During the follow-up period, three individuals experienced elevated microneutralization antibody titers ≥1∶80 against three (one each) avian influenza viruses: A/Teal/Hong Kong/w312/97(H6N1), A/Hong Kong/1073/1999(H9N2), or A/Duck/Alberta/60/1976(H12N5). However, none of these participants met the criteria for poultry exposure. A number of subjects demonstrated four-fold increases over time in hemagglutination inhibition (HI) assay titers for at least one of the three swine influenza viruses (SIVs); however, it seems likely that two of these three responses were due to cross-reacting antibody against human influenza. Only elevated antibody titers against A/Swine/Flanders/1/1998(H3N2) lacked evidence for such confounding. In examining risk factors for elevated antibody against this SIV with multiple logistic regression, swine exposure (adjusted OR = 1.8, 95% CI 1.1-2.8) and tobacco use (adjusted OR = 1.8; 95% CI 1.1-2.9) were important predictors.
While Romania has recently experienced multiple incursions of highly pathogenic avian influenza among domestic poultry, this cohort of Romanian agriculture workers had sparse evidence of avian influenza virus infections. In contrast, there was evidence, especially among the swine exposed participants, of infections with human and one swine H3N2 influenza virus.
在这项前瞻性研究中，我们试图调查罗马尼亚农业工人中急性人畜共患流感病毒感染的血清流行病学证据。
采集了312名成年农业工人和51名年龄匹配的对照者在入组时（2009年）以及12个月和24个月时的血清。对参与者进行了为期24个月的每月随访，并询问急性流感样疾病（ILI）发作情况。符合ILI标准的队列成员允许采集呼吸道拭子以及急性期和恢复期血清。针对9种禽流感病毒、3种猪流感病毒和3种人流感病毒进行了血清学检测。
在两年的随访期间，共报告了23起ILI事件。两名受试者的标本经逆转录-聚合酶链反应（rRT-PCR）鉴定为甲型流感。在随访期间，三名个体针对三种（每种一种）禽流感病毒：A/Teal/Hong Kong/w312/97(H6N1)、A/Hong Kong/1073/1999(H9N2)或A/Duck/Alberta/60/1976(H12N5)的微量中和抗体滴度升高至≥1∶80。然而，这些参与者均未符合家禽暴露标准。一些受试者针对三种猪流感病毒（SIV）中至少一种的血凝抑制（HI）试验滴度随时间呈四倍增加；然而，这三种反应中的两种似乎是由于针对人流感的交叉反应抗体所致。只有针对A/Swine/Flanders/1/1998(H3N2)的抗体滴度升高缺乏此类混杂证据。在通过多因素逻辑回归分析针对这种SIV的抗体升高的危险因素时，猪暴露（调整后的比值比[OR] = 1.8，95%可信区间[CI] 1.1 - 2.8）和吸烟（调整后的OR = 1.8；95% CI 1.1 - 2.9）是重要的预测因素。
虽然罗马尼亚最近在家禽中多次发生高致病性禽流感疫情，但这组罗马尼亚农业工人中禽流感病毒感染的证据稀少。相比之下，有证据表明，尤其是在接触猪的参与者中，感染了人流感病毒和一种猪H3N2流感病毒。
