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Volume 21, Number 4—April 2015
Research

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)

Main Article

Table 3

Risks for testing seropositive or seroconverting against avian influenza A(H5N1) virus among live bird market workers, Bangladesh 2009–2010*

Characteristic/behavior
Poultry workers

Regression model
Seronegative, n = 272
Seropositive or seroconverted, n = 18
Simple RR (95% CI)
Multiple RR (95% CI)
p value†
Median age, y (IQR)
27 (23–38)
27 (20–30)

0.9 (0.9–1.0)
0.9 (0.9–1.1)
0.8
Risk behavior
High exposure 4.8 (0.8–28.2) 7.6 (2.8–20.9) <0.001
Feed poultry 196 (72) 17 (94)
Clean feeding tray 156 (57) 15 (83)
Clean water container 155 (57) 16 (89)
Clean feces from poultry pen 125 (46) 14 (78)
Do not wash hands after handling sick poultry 133 (49) 10 (56)
Medium exposure 3.5 (0.8–14.7) 5.1 (1.8–14.1) 0.002
Slaughter poultry 198 (73) 17 (94)
Defeather poultry 142 (52) 15 (83)
Eviscerate poultry 143 (53) 15 (83)
Collect or transport poultry feces 53 (19) 1 (6)
Stuff poultry into bags 113 (42) 14 (78)
Low exposure 1.0 (0.3–3.3)
Smoke 159 (58) 7 (39)
Medicate poultry 15 (6) 2 (11)
Isolate sick poultry 130 (48) 10 (56)
Eat raw/undercooked poultry or eggs
103 (38)
6 (33)




Risk of infection from
Medium-exposure behaviors when frequently performing both medium- and high-exposure behaviors‡ 1.4 (0.3–6.2) 0.6
High-exposure behaviors when frequently performing both high- and medium-exposure behaviors‡ 2.1 (0.4–12.9) 0.4

*Data are no. (%) except as indicated. IQR, interquartile range; RR, risk ratio; –, not applicable.
†Value for multivariate model.
‡The ratio of RR for interaction between medium- and high-exposure behaviors was 0.3 (1.4/5.1 for medium-exposure behaviors and 2.1/7.6 for high-exposure behaviors (95% CI 0.08–0.88; p = 0.031).

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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.
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