Occupational Risk from Avian Influenza Viruses at Different Ecological Interfaces Between 1997 and 2019.

Unprotected exposures to infected poultry or wild birds, and/or to the related avian influenza virus (AIV)-contaminated environments, could account for AIV infection in workers. This study was aimed at highlighting the ecological interfaces related to domestic poultry and wild birds posing an occupational risk regarding AIV. A search of all the articles investigating the possible presence of AIV in workers attested through virological and serological techniques and published up to August 2019 was performed on PubMed and Scopus electronic databases. Ninety-four articles consisting of 11 virological, 67 serological, and 16 mixed (both virological and serological) studies were obtained. Both virological and serological evidences of AIV infection were mainly related to H5, H7, and H9 subtypes. In addition, one piece of virological evidence for H10 subtype was reported, whereas seropositivity to all hemagglutinin subtypes from H4 to H11 was detected by serological studies. The number of AIV subtype exposures inferred from serological results showed that workers from large-scale industrial poultry farms and markets were the most represented, whereas workers from small-scale and backyard poultry farms showed seropositivity to a greater number of AIV subtypes. Workers exposed to wild bird habitats tested seropositive to H5, H9, and H11. In the occupational settings, direct contact with infected poultry or wild birds could account for AIV infection in workers. This AIV spillover can result in severe health complications for the workers, also posing a potential pandemic risk to the general population. From a public health perspective, the surveillance and early detection of AIV in workplaces should be a priority faced by a one-health approach.