High probability of avian influenza virus (H7N7) transmission from poultry to humans active in disease control on infected farms

An epizootic of avian influenza (H7N7) caused a large number of human infections in The Netherlands in 2003. We used data from this epizootic to estimate infection probabilities for persons involved in disease control on infected farms. Analyses were based on databases containing information on the infected farms, person-visits to these farms, and exposure variables (number of birds present, housing type, poultry type, depopulation method, period during epizootic). Case definition was based on self-reported conjunctivitis and positive response to hemagglutination inhibition assay. A high infection probability was associated with clinical inspection of poultry in the area surrounding infected flocks (7.6%; 95% confidence interval [CI], 1.4%–18.9%) and active culling during depopulation (6.2%; 95% CI, 3.7%–9.6%). Low probabilities were estimated for management of biosecurity (0.0%; 95% CI, 0.0%–1.0%) and cleaning assistance during depopulation (0.0%; 95% CI, 0.0%–9.2%). No significant association was observed between the probability of infection and the exposure variables.