Extract

To the Editor—From 19 February to 9 May 2013, emerging H7N9 influenza in China has caused 131 cases including 26 deaths, and reignited global concerns regarding pandemic spread of novel influenza viruses [1, 2]. Nearly 60% of H7N9 infected persons have worked with or had contact with poultry [3, 4], demonstrating occupational exposure. However, the relationship between occupation and influenza prevalence is not well understood [5, 6], hampering effective prevention and control [7]. We analyzed the relationship between occupation and prevalence of seasonal and A(H1N1)pdm09 influenza from 2008 to 2012 using data from the China Information System for Disease Control and Prevention.

From 2008 to 2012, 659 067 influenza cases including 494 414 seasonal influenza (SI, consisting of H3 and H1 subtypes) and 164 653 A(H1N1)pdm09 cases were reported in China. Four occupations accounted for 76.8%–86.3% cases of SI (Figure 1A). Students (17.7%–61.0%) or peasants (9.1%–45.5%) were the dominant groups followed by scattered children (7.9%–20.0%, a group of children who are not currently in school or kindergarten, but dwelling in scattered areas) and kindergarten children (5.2%–7.0%). Yearly variations were common; in 2008, students (34.6%) and peasants (32.1%) dominated, while in 2009 students (61.0%) far exceeded the next group (peasants, 9.1%). In 2010, 2011, and 2012, peasants were most affected (29.5%, 45.5%, and 38.1%, respectively) followed by students or scattered children. Occupations of persons infected by A(H1N1)pdm09 influenza presented a different distribution, with students overwhelmingly affected (72.9%; Figure 1B).

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