Abstract
SummaryInfluenza A viruses circulate in swine and can spread rapidly among swine when housed in close proximity, such as at agricultural fairs. Youth who have close and prolonged contact with influenza-infected swine at agricultural fairs may be at increased risk of acquiring influenza virus infection from swine. Animal and human health officials have issued written measures to minimize influenza transmission at agricultural exhibitions; however, there is little information on the knowledge, attitudes, and practice (KAP) of these measures among animal exhibitors. After an August 2016 outbreak of influenza A(H3N2) variant (“H3N2v”) virus infections (i.e., humans infected with swine influenza viruses) in Michigan, we surveyed households of animal exhibitors at eight fairs (including one with known H3N2v infections) to assess their KAP related to variant virus infections and their support for prevention measures. Among 170 households interviewed, most (90%, 151/167) perceived their risk of acquiring influenza from swine to be low or very low. Animal exhibitor households reported high levels of behaviours that put them at increased risk of variant influenza virus infections, including eating or drinking in swine barns (43%, 66/154) and hugging, kissing or snuggling with swine at agricultural fairs (31%, 48/157). Among several recommendations, including limiting the duration of swine exhibits and restricting eating and drinking in the animal barns, the only recommendation supported by a majority of households was the presence of prominent hand-washing stations with a person to monitor hand-washing behaviour (76%, 129/170). This is a unique study of KAP among animal exhibitors and highlights that animal exhibitor households engage in behaviours that could increase their risk of variant virus infections and have low support for currently recommended measures to minimize infection transmission. Further efforts are needed to understand the lack of support for recommended measures and to encourage healthy behaviours at fairs.
Highlights
Influenza A viruses sporadically circulate in swine (Nelson et al, 2016a) and can spread rapidly among naïve swine populations housed in close proximity, such as at agricultural fairs (Bliss, Nelson, Nolting, & Bowman, 2016; Bowman, Workman, Nolting, Nelson, & Slemons, 2014; Bowman, Sreevatsan et al, 2012; Killian et al, 2013; Nelson et al, 2016b)
This is a unique study of KAP among animal exhibitors and highlights that animal exhibitor households engage in behaviours that could increase their risk of variant virus infections and have low support for currently recommended measures to minimize infection transmission
When a human is infected with an influenza virus that is circulating in the swine population, it is called a variant influenza virus infection and is denoted with the letter “v.” Variant influenza viruses in humans are different from currently circulating human influenza A/H1 and A/ H3 viruses and have the potential to cause a pandemic if the virus is efficiently transmitted from person to person (Centers for Disease Control and Prevention, 2011; Reed et al, 2009)
Summary
Influenza A viruses sporadically circulate in swine (Nelson et al, 2016a) and can spread rapidly among naïve swine populations housed in close proximity, such as at agricultural fairs (Bliss, Nelson, Nolting, & Bowman, 2016; Bowman, Workman, Nolting, Nelson, & Slemons, 2014; Bowman, Sreevatsan et al, 2012; Killian et al, 2013; Nelson et al, 2016b). Agricultural fairs provide an opportunity for bidi-rectional transmission of influenza viruses (Bowman, Sreevatsan et al.,2012) as millions of people are in close proximity to large numbers of swine (Future Farmers of America, 2016; Michigan Association of Fairs and Exhibitions, 2016), often for prolonged periods of time. Since novel influenza viruses, including variant viruses, became nationally notifiable in 2005, over 400 infections with variant influenza have been reported to the Centers for Disease Control and Prevention (CDC) and estimates suggest that thousands more infections may have occurred (Biggerstaff et al, 2013). Over 3.5 million youth engage in youth agricultural projects each year (Future Farmers of America, 2016; National 4-H Council, 2016)
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