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. 2023 Mar;70(2):171-175.
doi: 10.1111/zph.13009. Epub 2022 Nov 21.

Aerosol exposure of live bird market workers to viable influenza A/H5N1 and A/H9N2 viruses, Cambodia

Paul F Horwood  1   2 , Srey Viseth Horm  1 , Sokhoun Yann  1 , Songha Tok  1 , Malen Chan  3 , Annika Suttie  1   4 , Phalla Y  1 , Sareth Rith  1 , Jurre Y Siegers  1 , Sorn San  5 , Holl Davun  5 , Sothyra Tum  5 , Sowath Ly  3 , Arnaud Tarantola  3 , Philippe Dussart  1 , Erik A Karlsson  1
Affiliations

Aerosol exposure of live bird market workers to viable influenza A/H5N1 and A/H9N2 viruses, Cambodia

Paul F Horwood et al. Zoonoses Public Health. 2023 Mar.

Abstract

Live bird markets (LBMs) have been identified as key factors in the spread, persistence and evolution of avian influenza viruses (AIVs). In addition, these settings have been associated with human infections with AIVs of pandemic concern. Exposure to aerosolised AIVs by workers in a Cambodian LBM was assessed using aerosol impact samplers. LBM vendors were asked to wear an air sampler for 30 min per day for 1 week while continuing their usual activities in the LBM during a period of high AIV circulation (February) and a period of low circulation (May). During the period of high circulation, AIV RNA was detected from 100% of the air samplers using molecular methods and viable AIV (A/H5N1 and/or A/H9N2) was isolated from 50% of air samplers following inoculation into embryonated chicken eggs. In contrast, AIV was not detected by molecular methods or successfully isolated during the period of low circulation. This study demonstrates the increased risk of aerosol exposure of LBM workers to AIVs during periods of high circulation and highlights the need for interventions during these high-risk periods. Novel approaches, such as environmental sampling, should be further explored at key high-risk interfaces as a potentially cost-effective alternative for monitoring pandemic threats.

Keywords: A/H5N1; A/H9N2; aerosol; avian; influenza; live bird market.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
A live bird market vendor wearing a personal aerosol impact sampler during the study
FIGURE 2
FIGURE 2
Maximum likelihood phylogeny of the hemagglutinin (HA) and neuraminidase (NA) genes of A/H5N1 viruses detected in air samples in a Cambodian live bird market, 2016. (A) HA and (B) NA of A/H5N1 clade 2.3.2.1c viruses in air and poultry samples. Trees were generated with IQ‐tree using the TVM + V + I + G4 and GTR + F + G4 model, respectively. Phylogenetic support was estimated using 1000 ultrafast bootstrap replicates. Cambodian isolates are shown before 2015 (dark blue), during 2015 (teal) and in 2016 (pink). Air samples from this study are indicated with a pink star. Candidate vaccine viruses are indicated in red. Bootstrap values are indicated next to significant nodes
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