Live poultry exposure, Guangzhou, China, 2006

Background: Live poultry in wet markets and backyard husbandry comprise potentially major exposure sources for human cases of H5N1 avian influenza. In China the magnitude of risk from this exposure is unknown. We estimated exposure based on self-reported behavior. Methods: In January-March 2006, 1550 face-to-face interviews derived from stratified cluster and randomized within-household sampling provided data on live poultry exposure in Guangzhou, China based on self-reported buying and touching patterns. Standardized exposures were calculated and after adjustment extrapolated to the urban population. Results: The results, adjusted for gender, showed that 1,248/1,550 (80%, 95% Confidence Limits 78-82%) respondents reported an average of 20.5 live chicken purchases/household annually. Of those buying poultry 33% touched poultry before buying while 20% of households raised live poultry. Total exposures from wet market and backyard husbandry in Guangzhou greatly exceed those of adjacent Hong Kong (15,280,000 e/year vs. 1,110,900 e/year). Backyard exposure frequency likely exceeds that from live poultry retail, but purchases were more prevalent and hence comprise a significant risk source. Conclusion: The Guangzhou population faces risks from the high prevalence of exposures during purchase and poultry rearing. Better management for raising and selling poultry in Guangzhou is needed. (C) 2009 Elsevier B.V. All rights reserved.