Willingness and influencing factors related to "centralized slaughtering, fresh poultry listing and marketing" strategy among the household chefs in Guangzhou / 中华流行病学杂志

Objective: To study the willingness and influence factors related to "centralized slaughtering, fresh poultry listing and marketing" strategy, among the household chefs, and provide reference for government to adjust and optimize the strategy on avian influenza prevention. Methods: According to the geographical characteristics and regional functions, 6 'monitoring stations' were selected from 12 residential districts of Guangzhou, respectively. Another 21 meat markets which selling live poultry, were selected in each station and 5 household chefs of each market were invited to attend a face to face interview. Basic information, personal cognitive, willingness and influencing factors to the policy were under study. Univariate and multivariate logistic regression methods were used. Results: A total of 664 household chefs underwent the survey and results showed that the rate of support to the "centralized slaughtering, fresh poultry listing and marketing" strategy was 44.6% (296/664). Results from the multi-factor logistic regression showed that those household chefs who were males (OR=1.618, 95% CI: 1.156-2.264, P=0.005), having received higher education (OR=1.814, 95% CI: 1.296-2.539, P=0.001), or believing that the existence of live poultry stalls was related to the transmission of avian influenza (OR=1.918, 95% CI: 1.341-2.743, P<0.001) were factors at higher risk. These household chefs also intended to avoid the use of live poultry stalls (OR=1.666, 95%CI: 1.203-2.309, P=0.002) and accept the "centralized slaughtering, fresh poultry listing and marketing" strategy. Conclusion: Detailed study on this subject and, setting up pilot project in some areas as well as prioritizing the education programs for household chefs seemed helpful to the implementation of the 'freezing-fresh poultry' policy.

A case of human infection with highly pathogenic avian influenza A (H7N9) virus through poultry processing without protection measure / 中华流行病学杂志

Objective: To investigate the infection pattern and etiological characteristics of a case of human infection with highly pathogenic avian influenza A (H7N9) virus and provide evidence for the prevention and control of human infection with highly pathogenic avian influenza virus. Methods: Epidemiological investigation was conducted to explore the case's exposure history, infection route and disease progression. Samples collected from the patient, environments and poultry were tested by using real time reverse transcriptase-polymerase chain reaction (RT-PCR). Virus isolation, genome sequencing and phylogenetic analysis were conducted for positive samples. Results: The case had no live poultry contact history, but had a history of pulled chicken processing without taking protection measure in an unventilated kitchen before the onset. Samples collected from the patient's lower respiratory tract, the remaining frozen chicken meat and the live poultry market were all influenza A (H7N9) virus positive. The isolated viruses from these positive samples were highly homogenous. An insertion which lead to the addition of multiple basic amino acid residues (PEVPKRKRTAR/GL) was found at the HA cleavage site, suggesting that this virus might be highly pathogenic. Conclusions: Live poultry processing without protection measure is an important infection mode of "poultry to human" transmission of avian influenza viruses. Due to the limitation of protection measures in live poultry markets in Guangzhou, it is necessary to promote the standardized large scale poultry farming, the complete restriction of live poultry sales and centralized poultry slaughtering as well as ice fresh sale.

Survey on a norovirus-borne outbreak caused by GⅡ.4 Sydney 2012 variant in a university of Guangzhou, 2017 / 中华流行病学杂志

Objective: To understand the epidemiological and molecular characteristics of a norovirus- borne outbreak caused by GⅡ.4 Sydney 2012 in a university of Guangzhou to provide evidence for the prevention and control strategy on norovirus-caused epidemics. Methods: A self-designed questionnaire was used to collect clinical information from the patients as well as other data related to the epidemic. Pathogen detections were performed through anal swab specimens from the patients, kitchen workers and samples from the environment. Positive samples were further sequenced for phylogenetic analysis. A case-control study was employed to identify the risk factors related to this outbreak. Results: A total of 226 cases of norovirus-borne infection were identified between September 17 and 21, 2017, including 223 students, with an attack rate of 0.73% (223/30 711), and 3 kitchen workers. Students staying in the A dormitory area had the highest attack rate (1.73%, 164/9 459). No clustering was found in different colleges or classes. Results from the case-control study revealed that people who ate at the canteen in A dormitory area during September 18 to 20 was at risk for the onset of illness (OR=10.75, 95%CI: 5.56-20.79). The highest risk was related to the dinner on September 18. Another significant risk factor (OR=3.65, 95%CI: 1.92-6.94) was close personal contact in the same room of the dorm. The 3 norovirus infected kitchen workers were all from the canteen in A dormitory area where the positive rate of norovirus identified in kitchen workers was 26.67% (12/45). Positive samples were sequenced and sub-typed with results showing that the GⅡ.4 Sydney 2012 variant and the nucleotide sequences of cases and kitchen workers were 100% identical. Conclusions: The outbreak was caused by norovirus GⅡ.4 Sydney 2012 variant at campus. Similar outbreaks had been seen since 2013, with the routes of transmission most likely due to food-borne or personal contact.