Facing pandemic influenza threats: the importance of including poultry and swine workers in preparedness plans.

Recent research has shown that poultry and swine workers, especially those with intense exposures, are at increased risk of zoonotic influenza virus infections. In multiple studies, US poultry workers and poultry veterinarians have evidence of previous infections with avian influenza virus. Similarly, US swine workers have strong evidence of previous and acute infections with swine influenza viruses. Mathematical modeling has demonstrated that such workers may accelerate the spread of pandemic viruses in their rural communities. Because these workers may contribute to the novel generation of viruses and serve as a bridging population in the cross-species sharing of influenza viruses, it seems prudent to include poultry and swine workers in influenza preparedness programs. Possible preventive and control interventions include special education programs to increase workers' use of personal protective equipment such as gloves, increased surveillance for influenza viruses among workers and their animals, recommendations that workers seek medical attention should they develop influenza-like illness, and workers' priority receipt of annual and pandemic influenza vaccines.