Effects of closing and reopening live poultry markets on the epidemic of human infection with avian influenza A virus.

Jian Lu,Qigang Dai,Changjun Bao,Qiao Wang,Rui Xia,Fenyang Tang,Yefei Zhu,Wendong Liu

doi:10.7555/jbr.30.20150054

Abstract

Live poultry markets (LPMs) are crucial places for human infection of influenza A (H7N9 virus). In Yangtze River Delta, LPMs were closed after the outbreak of human infection with avian influenza A (H7N9) virus, and then reopened when no case was found. Our purpose was to quantify the effect of LPMs’ operations in this region on the transmission of influenza A (H7N9) virus. We obtained information about dates of symptom onset and locations for all human influenza A (H7N9) cases reported from Shanghai, Jiangsu and Zhejiang provinces by May 31, 2014, and acquired dates of closures and reopening of LPMs from official media. A two-phase Bayesian model was fitted by Markov Chain Monte Carlo methods to process the spatial and temporal influence of human cases. A total of 235 cases of influenza A (H7N9) were confirmed in Shanghai, Jiangsu and Zhejiang by May 31, 2014. Using these data, our analysis showed that, after LPM closures, the influenza A (H7N9) outbreak disappeared within two weeks in Shanghai, one week in Jiangsu, and one week in Zhejiang, respectively. Local authorities reopened LPMs when there was no outbreak of influenza A (H7N9), which did not lead to reemergence of human influenza A (H7N9). LPM closures were effective in controlling the H7N9 outbreak. Reopening of LPM in summer did not increase the risk of human infection with H7N9. Our findings showed that LPMs should be closed immediately in areas where the H7N9 virus is confirmed in LPM. When there is no outbreak of H7N9 virus, LPMs can be reopened to satisfy the Chinese traditional culture of buying live poultry. In the long term, local authorities should take a cautious attitude in permanent LPM closure.

Highlights

In March 2013, cases of human infection with a novel avian influenza A (H7N9) virus emerged in China[1,2,3,4,5,6,7]
Since H7N9 virus was initially detected in the Yangtze River Delta, we aimed to assess the effects of closing and reopening Live poultry markets (LPMs) around this area
Our model systematically evaluated the effects of intervention measures to the LPMs on the epidemic of H7N9 in the study areas

Summary

Introduction

In March 2013, cases of human infection with a novel avian influenza A (H7N9) virus emerged in China[1,2,3,4,5,6,7]. Until May 31, 2014, two waves of human influenza. A (H7N9) epidemic affected China, and caused 399 cases. The confirmed infection cases were concentrated in eastern China, including the Yangtze River Delta region and Beijing. Chinese health authorities reported that H7N9 virus was found in domestic poultries, such as chickens, pigeons, and ducks[11,12]. Since there is no evidence of human-to-human transmission so far[13,14], the main focus of intervention measure is to reduce transmission from poultry to humans[15,16,17]

Objectives

Methods

Results

Conclusion