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Volume 21, Number 4—April 2015

Highly Pathogenic Avian Influenza A(H5N1) Virus Infection among Workers at Live Bird Markets, Bangladesh, 2009–2010

Sharifa NasreenComments to Author , Salah Uddin Khan, Stephen P. Luby, Emily S. Gurley, Jaynal Abedin, Rashid Uz Zaman, Badrul Munir Sohel, Mustafizur Rahman, Kathy Hancock, Min Z. Levine, Vic Veguilla, David Wang, Crystal Holiday, Eric Gillis, Katharine Sturm-Ramirez, Joseph S. Bresee, Mahmudur Rahman, Timothy M. Uyeki, Jacqueline M. Katz, and Eduardo Azziz-Baumgartner
Author affiliations: icddr,b, Dhaka, Bangladesh (S. Nasreen, S.U. Khan, S.P. Luby, E.S. Gurley, J. Abedin, R.U. Zaman, B.M. Sohel, M. Rahman, K. Sturm-Ramirez, E. Azziz-Baumgartner); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.P. Luby, K. Hancock, M.Z. Levine, V. Veguilla, D. Wang, C. Holiday, E. Gillis, K. Sturm-Ramirez, J.S. Bresee, T.M. Uyeki, J.M. Katz, E. Azziz-Baumgartner); Institute of Epidemiology, Disease Control and Research, Dhaka (M. Rahman)

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Table 2

Characteristics of live bird market workers with evidence of seroconversion against avian influenza A(H5N1) virus, Bangladesh, 2009–2010*

Characteristic PW1 PW2 PW3 PW4 PW5 PW6
Personal characteristic
Age, y 28 20 22 24 38 19
Smoke tobacco + + +
Have chronic medical condition

Exposure to poultry or virus
Handle sick poultry + + + + + +
Perform tasks with sick poultry
Transport poultry + + + + +
Feed poultry + + + +
Clean feeding tray + + +
Clean water container + + + +
Medicate sick poultry +
Separate sick poultry + + + + +
Slaughter poultry + + + +
Defeather poultry + + +
Eviscerate poultry + + +
Stuff poultry into bags + + + +
Clean feces from pen + +
Hand-carry sick poultry or held poultry on lap + + + + + +
Carry baskets containing sick poultry on head
Eat raw/undercooked poultry or eggs


Precautions taken when handling sick poultry
Use personal protective equipment†
Wash hands at the market after working with the poultry + + +
Change clothes upon returning home
Presence of influenza-like illness in past 21 d

Interval, d, between detection of virus–positive surveillance sample and follow-up collection of serum sample from worker
Neutralizing antibody titer, geometric mean‡
Baseline 5 10 5 5 5 5
Follow-up 40 61 49 40 66 67

*PW, poultry worker; +, characteristic present; −, characteristic not present.
†Apron, gloves, dedicated coveralls, cloth mask, and boots.
‡By microneutralization assay, using influenza A/Bangladesh/3233/2011 (H5N1, clade 2.2) virus.

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Page created: March 17, 2015
Page updated: March 17, 2015
Page reviewed: March 17, 2015
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.