An increasing trend of rural infections of human influenza A (H7N9) from 2013 to 2017: A retrospective analysis of patient exposure histories in Zhejiang province, China

Although investigations have shown that closing live poultry markets (LPMs) is highly effective in controlling human influenza A (H7N9) infections, many of the urban LPMs were shut down, but rural LPMs remained open. This study aimed to compare the proportional changes between urban and rural infect...

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Bibliographic Details
Published in:PloS one 2018-02, Vol.13 (2), p.e0193052-e0193052
Main Authors: Chen, Enfu, Wang, Maggie H, He, Fan, Sun, Riyang, Cheng, Wei, Zee, Benny C Y, Lau, Steven Y F, Wang, Xiaoxiao, Chong, Ka Chun
Format: Article
Language:English
Subjects:
Analysis
Biology and Life Sciences
Chickens
Confidence intervals
Demographic aspects
Development and progression
Earth Sciences
Empirical analysis
Epidemics
Exposure
Farms
Fatalities
Health aspects
Infections
Influenza
Influenza A
Medicine and health sciences
Orthomyxoviridae
Pandemics
People and Places
Poultry
Prevalence studies (Epidemiology)
Regression analysis
Risk factors
Rural areas
Shutdowns
Statistical analysis
Statistical tests
Towns
Urban areas
Vaccination
Viruses
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Summary:Although investigations have shown that closing live poultry markets (LPMs) is highly effective in controlling human influenza A (H7N9) infections, many of the urban LPMs were shut down, but rural LPMs remained open. This study aimed to compare the proportional changes between urban and rural infections in the Zhejiang province from 2013 to 2017 by analyzing the exposure histories of human cases. All laboratory-confirmed cases of H7N9 from 2013 (the first wave) to 2017 (the fifth wave) in the Zhejiang province of China were analyzed. Urban and rural infections were defined based on the locations of poultry exposure (direct and indirect) in urban areas (central towns) and rural areas (towns and villages on the outskirts of cities). A Chi-square trend test was used to compare the proportional trend between urban and rural infections over time and logistic regression was used to obtain the odds ratio by years. From 2013 to 2017, a statistically significant trend in rural infections was observed (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0193052