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Serological evidence of human infection with avian influenza A(H7N9) virus: a systematic review and meta-analysis

Serological evidence of human infection with avian influenza A(H7N9) virus: a systematic review and meta-analysis
Serological evidence of human infection with avian influenza A(H7N9) virus: a systematic review and meta-analysis

BACKGROUND: The extent of human infections with avian influenza A(H7N9) virus, including mild and asymptomatic infections, is uncertain.

METHODS: We performed a systematic review and meta-analysis of serosurveys for avian influenza A(H7N9) virus infections in humans published during 2013-2020. Three seropositive definitions were assessed to estimate pooled seroprevalence, seroconversion rate and seroincidence by types of exposures. We applied a scoring system to assess the quality of included studies.

RESULTS: Of 31 included studies, pooled seroprevalence of A(H7N9)-virus antibodies from all participants was 0.02%, with poultry workers, close contacts, and general populations having seroprevalence of 0.1%, 0.2% and 0.02% based on the WHO-recommended definition, respectively. Although most infections were asymptomatic, evidence of infection was highest in poultry workers (5% seroconversion, 19.1% seroincidence per 100 person-years). Use of different virus clades did not significantly affect seroprevalence estimates. Most serological studies were of low to moderate quality and did not follow standardized seroepidemiological protocols or WHO-recommended laboratory methods.

CONCLUSIONS: Human infections with avian influenza A(H7N9) virus have been uncommon, especially for general populations. Workers with occupational exposures to poultry and close contacts of A(H7N9) human cases had low risks of infection.

0022-1899
Wang, Wei
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Chen, Xinhua
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Wang, Yan
dcb4d2ad-3e8c-4aaa-b21e-9f67a469ef98
Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Yang, Juan
a7a93a88-e671-435d-8845-9a32087cfe77
Cowling, Benjamin J
0c0bb95a-b3f1-45f7-8c77-abe9bf0ee576
Horby, Peter W
8f921e75-4605-4fb8-bb2c-be66fac6bb96
Uyeki, Timothy M
6333ed07-bca3-404c-bed3-b47a212afc9e
Yu, Hongjie
7921cb68-f4a2-4128-8406-eb0f6872bae7
Wang, Wei
40507c2b-bc53-4988-8b9b-8d60370fd44a
Chen, Xinhua
3eb57fc5-58fc-4585-9f45-6e6344f8d5d1
Wang, Yan
dcb4d2ad-3e8c-4aaa-b21e-9f67a469ef98
Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Yang, Juan
a7a93a88-e671-435d-8845-9a32087cfe77
Cowling, Benjamin J
0c0bb95a-b3f1-45f7-8c77-abe9bf0ee576
Horby, Peter W
8f921e75-4605-4fb8-bb2c-be66fac6bb96
Uyeki, Timothy M
6333ed07-bca3-404c-bed3-b47a212afc9e
Yu, Hongjie
7921cb68-f4a2-4128-8406-eb0f6872bae7

Wang, Wei, Chen, Xinhua, Wang, Yan, Lai, Shengjie, Yang, Juan, Cowling, Benjamin J, Horby, Peter W, Uyeki, Timothy M and Yu, Hongjie (2020) Serological evidence of human infection with avian influenza A(H7N9) virus: a systematic review and meta-analysis. The Journal of Infectious Diseases, [jiaa679]. (doi:10.1093/infdis/jiaa679).

Record type: Article

Abstract

BACKGROUND: The extent of human infections with avian influenza A(H7N9) virus, including mild and asymptomatic infections, is uncertain.

METHODS: We performed a systematic review and meta-analysis of serosurveys for avian influenza A(H7N9) virus infections in humans published during 2013-2020. Three seropositive definitions were assessed to estimate pooled seroprevalence, seroconversion rate and seroincidence by types of exposures. We applied a scoring system to assess the quality of included studies.

RESULTS: Of 31 included studies, pooled seroprevalence of A(H7N9)-virus antibodies from all participants was 0.02%, with poultry workers, close contacts, and general populations having seroprevalence of 0.1%, 0.2% and 0.02% based on the WHO-recommended definition, respectively. Although most infections were asymptomatic, evidence of infection was highest in poultry workers (5% seroconversion, 19.1% seroincidence per 100 person-years). Use of different virus clades did not significantly affect seroprevalence estimates. Most serological studies were of low to moderate quality and did not follow standardized seroepidemiological protocols or WHO-recommended laboratory methods.

CONCLUSIONS: Human infections with avian influenza A(H7N9) virus have been uncommon, especially for general populations. Workers with occupational exposures to poultry and close contacts of A(H7N9) human cases had low risks of infection.

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jiaa679 - Accepted Manuscript
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More information

Submitted date: 5 September 2020
Accepted/In Press date: 15 October 2020
e-pub ahead of print date: 29 October 2020
Additional Information: © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.

Identifiers

Local EPrints ID: 444870
URI: http://eprints.soton.ac.uk/id/eprint/444870
ISSN: 0022-1899
PURE UUID: 4e4d1c61-b138-47ce-9c6d-ff9b41e5cd95
ORCID for Shengjie Lai: ORCID iD orcid.org/0000-0001-9781-8148

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Date deposited: 09 Nov 2020 17:30
Last modified: 12 Nov 2024 03:00

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Contributors

Author: Wei Wang
Author: Xinhua Chen
Author: Yan Wang
Author: Shengjie Lai ORCID iD
Author: Juan Yang
Author: Benjamin J Cowling
Author: Peter W Horby
Author: Timothy M Uyeki
Author: Hongjie Yu

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