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1 January 2006

Volume 42, Number 1
Clinical Infectious Diseases 2006;42:14–20
© 2005 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2006/4201-0003$15.00
DOI: 10.1086/498977
MAJOR ARTICLE

Are Swine Workers in the United States at Increased Risk of Infection with Zoonotic Influenza Virus?

Kendall P. Myers,1,2

Christopher W. Olsen,4

Sharon F. Setterquist,1

Ana W. Capuano,1

Kelley J. Donham,2

Eileen L. Thacker,3

James A. Merchant,2 and

Gregory C. Gray1

1Center for Emerging Infectious Diseases, Department of Epidemiology, University of Iowa College of Public Health, and 2Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, and 3Veterinary Medical Research Institute, Iowa State University, Ames; and 4Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin, Madison

Background.Pandemic influenza strains originate in nonhuman species. Pigs have an important role in interspecies transmission of the virus. We examined multiple swine‐exposed human populations in the nation’s number 1 swine‐producing state for evidence of previous swine influenza virus infection.

Methods.We performed controlled, cross‐sectional seroprevalence studies among 111 farmers, 97 meat processing workers, 65 veterinarians, and 79 control subjects using serum samples collected during the period of 2002–2004. Serum samples were tested using a hemagglutination inhibition assay against the following 6 influenza A virus isolates collected recently from pigs and humans: A/Swine/WI/238/97 (H1N1), A/Swine/WI/R33F/01 (H1N2), A/Swine/Minnesota/593/99 (H3N2), A/New Caledonia/20/99 (H1N1), A/Panama/2007/99 (H3N2), and A/Nanchang/933/95 (H3N2).

Results.Using multivariable proportional odds modeling, all 3 exposed study groups demonstrated markedly elevated titers against the H1N1 and H1N2 swine influenza virus isolates, compared with control subjects. Farmers had the strongest indication of exposure to swine H1N1 virus infection (odds ratio [OR], 35.3; 95% confidence interval [CI], 7.7–161.8), followed by veterinarians (OR, 17.8; 95% CI, 3.8–82.7), and meat processing workers (OR, 6.5; 95% CI, 1.4–29.5). Similarly, farmers had the highest odds for exposure to swine H1N2 virus (OR, 13.8; 95% CI, 5.4–35.4), followed by veterinarians (OR, 9.5; 95% CI, 3.6–24.6) and meat processing workers (OR, 2.7; 95% CI, 1.1–6.7).

Conclusions.Occupational exposure to pigs greatly increases workers’ risk of swine influenza virus infection. Swine workers should be included in pandemic surveillance and in antiviral and immunization strategies.

Received 6 September 2005; accepted 16 October 2005; electronically published 22 November 2005.

Reprints or correspondence: Dr. Gregory C. Gray, Dept. of Epidemiology, College of Public Health, University of Iowa, 200 Hawkins Dr., C21K GH, Iowa City, IA 52242 ().

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