title: Seroevidence for a High Prevalence of Subclinical Infection With Avian Influenza A(H5N1) Virus Among Workers in a Live-Poultry Market in Indonesia.
abstract: BACKGROUND
  In Indonesia, highly pathogenic avian influenza A(H5N1) virus has become endemic in poultry and has caused sporadic deadly infections in human. Since 2012, we have conducted fixed-point surveillance of avian influenza viruses at a live-poultry market in East Java, Indonesia. In this study, we examined the seroprevalence of avian influenza A(H5N1) virus infection among market workers.
  
  
  METHODS
  Sera were collected from 101 workers in early 2014 and examined for antibody activity against avian A(H5N1) Eurasian lineage virus by a hemagglutination-inhibition (HI) assay.
  
  
  RESULTS
  By the HI assay, 84% of the sera tested positive for antibody activity against the avian virus. Further analysis revealed that the average HI titer in 2014 was 2.9-fold higher than in 2012 and that seroconversion occurred in 44% of paired sera (11 of 25) between 2012 and 2014. A medical history survey was performed in 2016; responses to questionnaires indicated that none of workers had had severe acute respiratory illness during 2013.
  
  
  CONCLUSIONS
  This study provides evidence of a high prevalence of avian A(H5N1) virus infection in 2013 among workers at a live-poultry market. However, because no instances of hospitalizations were reported, we can conclude the virus did not manifest any clinical symptoms in workers.
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.|Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan.
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.|Department of Pulmonology and Respiratory Medicine.
authors.forename: Laksmi
authors.initials: L
authors.lastname: Wulandari
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.|Department of Clinical Science, Faculty of Veterinary Medicine, Airlangga University, Surabaya, Indonesia.
authors.forename: Emmanuel D
authors.initials: ED
authors.lastname: Poetranto
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.|Department of Pediatrics.
authors.forename: Retno A
authors.initials: RA
authors.lastname: Setyoningrum
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.|Department of Pulmonology and Respiratory Medicine.
authors.forename: Resti
authors.initials: R
authors.lastname: Yudhawati
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.|Department of Pediatrics.
authors.forename: Amelia
authors.initials: A
authors.lastname: Sholikhah
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.
authors.forename: Aldise M
authors.initials: AM
authors.lastname: Nastri
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Poetranto
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.
authors.forename: Adithya Y R
authors.initials: AY
authors.lastname: Candra
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.
authors.forename: Edith F
authors.initials: EF
authors.lastname: Puruhito
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.|Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takahara
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.|Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Yamagishi
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.|Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan.
authors.forename: Masaoki
authors.initials: M
authors.lastname: Yamaoka
authors.affiliation: Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan.
authors.forename: Hak
authors.initials: H
authors.lastname: Hotta
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.|Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Ustumi
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Lusida
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.
authors.lastname: Soetjipto
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.|Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan.
authors.forename: Yohko K
authors.initials: YK
authors.lastname: Shimizu
authors.affiliation: Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease.|Department of Internal Medicine, Faculty of Medicine.
authors.forename: Gatot
authors.initials: G
authors.lastname: Soegiarto
authors.affiliation: Center for Infectious Diseases, Kobe University Graduate School of Medicine, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Mori
mesh_terms: D000822:Animal Husbandry; D000818:Animals; D000914:Antibodies, Viral / Q000097:blood*; D058345:Asymptomatic Infections / Q000453:epidemiology*; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D053124:Influenza A Virus, H5N1 Subtype / Q000276:immunology*; D007251:Influenza, Human / Q000453:epidemiology*; D016273:Occupational Exposure; D011200:Poultry; D016036:Seroepidemiologic Studies
chemical_list: D000914:Antibodies, Viral
keywords: H5N1; HI; avian; hemagglutination inhibition; influenza virus; poultry; seroconversion; seroepidemiology; subclinical infection