Pandemic influenza planning: shouldn't swine and poultry workers be included?

Recent research has demonstrated that swine and poultry professionals, especially those who work in large confinement facilities, are at markedly increased risk of zoonotic influenza virus infections. In serving as a bridging population for influenza virus spread between animals and man, these workers may introduce zoonotic influenza virus into their homes and communities as well as expose domestic swine and poultry to human influenza viruses. Prolonged and intense occupational exposures of humans working in swine or poultry confinement buildings could facilitate the generation of novel influenza viruses, as well as accelerate human influenza epidemics. Because of their potential bridging role, we posit that such workers should be recognized as a priority target group for annual influenza vaccines and receive special training to reduce the risk of influenza transmission. They should also be considered for increased surveillance and priority receipt of pandemic vaccines and antivirals.