Sero-epidemiologic study of influenza A(H7N9) infection among exposed populations, China 2013~2014

Background The first human infections of novel avian influenza A(H7N9) virus were identified in China in March 2013. Sentinel surveillance systems and contact tracing may not identify mild and asymptomatic human infections of influenza A(H7N9) virus.
Objectives We assessed the seroprevalence of antibodies to influenza A(H7N9) virus in three populations during the early stages of the epidemic.
Patients/Methods From March 2013—May 2014, we collected sera from the general population, poultry workers and contacts of confirmed infections in nine Chinese provinces reporting human A(H7N9) infections and, for contacts, second sera 2-3 weeks later. We screened for A(H7N9) antibodies by advanced hemagglutination inhibition (HI) assay and tested sera with HI titers ≥20 by modified microneutralization (MN) assay. MN titers ≥20 or four-fold increases in paired sera were considered seropositive.
Results Among general population sera (n=1480), none were seropositive. Among poultry worker sera (n=1866), 28 had HI titers ≥20; two (0.11%, 95% CI: 0.02%-0.44%) were positive by MN. Among 61 healthcare and 117 non-healthcare contacts’ sera, five had HI titers ≥20, and all were negative by MN. There was no seroconversion among 131 paired sera.