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Article: COVID-19 Trends and Forecast in the Eastern Mediterranean Region With a Particular Focus on Pakistan.

Dil, Saima / Dil, Nyla / Maken, Zafar H

2020 Volume 12, Issue 6, Page(s) e8582

Abstract: First reported in China, the coronavirus responsible for coronavirus disease 2019 (COVID-19) has spread to 213 countries and territories around the world as of April 26, 2020. This study was designed to explore COVID-19 trends in the Eastern ... ...

Abstract	First reported in China, the coronavirus responsible for coronavirus disease 2019 (COVID-19) has spread to 213 countries and territories around the world as of April 26, 2020. This study was designed to explore COVID-19 trends in the Eastern Mediterranean Region (EMR), with a particular focus on Pakistan. Daily reports and updates from the Ministry of National Health Services Regulations and Coordination COVID-19 Pakistan and the European Centre for Disease Prevention and Control were collected and study-specific data were extracted and analyzed. Our analysis revealed that, as of April 26, 2020, a total of 22 countries and territories in the EMR have reported COVID-19 cases. Iran had the highest number of cases (89,329) followed by Saudi Arabia (16,299), Pakistan (12,723), and the United Arab Emirates (9,813). Egypt (7.1%), Iran (6.3%), and Iraq (4.9%) had high case fatality rates; Lebanon (3.4%) and Pakistan (2.1%) had moderate case fatality rates; Saudi Arabia and the United Arab Emirates had low case fatality rates of 0.8% and 0.7%, respectively. Iran (76.3%) and Iraq (69.4 %) had the highest recovery rate followed by Pakistan (22.5%), the United Arab Emirates (19.2%), and Saudi Arabia (13.6%). If the current trend continues, based on the susceptible, infected, recovered (SIR) epidemiological model, we predict that EMR countries might experience a surge in the number of COVID-19 cases, resulting in as many as 2.12 million cases in Iran, 0.58 million in Saudi Arabia, and 0.51 million in Pakistan by June 20, 2020. Pakistan is the most populated country in the EMR and was the third most-affected country in terms of the number of cases with moderate case fatality and recovery rates. We predict that Pakistan's weak healthcare system would not be able to sustain care if there is an explosive increase in the number of cases due to insufficient and inconsistent disease prevention and control policies. The best strategy for mitigating the COVID-19 pandemic is to strictly follow recommendations based on epidemiological principles.
Keywords	covid19
Language	English
Publishing date	2020-06-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.8582
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Seroprevalence of avian influenza H9 virus in poultry-shop workers and customers in Rawalpindi, Pakistan

Saima Dil / Zafar Hayat Maken / Muhammad Athar Abbas

Journal of Infection and Public Health, Vol 13, Iss 3, Pp 462- (2020)

2020

Keywords	Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2020-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: COVID 19 Pandemic & Pakistan; Limitations and Gaps

Nadia Noreen / Saima Dil / Saeed Ullah Khan Niazi / Irum Naveed / Naveed Ullah Khan / Farida Khudaid Khan / Shehla Tabbasum / Deepak Kumar

Global Biosecurity, Vol 1, Iss

2020 Volume 4

Abstract: Abstract: Background: The 2019 novel coronavirus disease (COVID-19) has spread to more than 213 countries and as of 17th April 2020, 1995,983 confirmed cases and 131,037 deaths have been reported globally. Pakistan being sharing border with China and ... ...

Abstract	Abstract: Background: The 2019 novel coronavirus disease (COVID-19) has spread to more than 213 countries and as of 17th April 2020, 1995,983 confirmed cases and 131,037 deaths have been reported globally. Pakistan being sharing border with China and Iran, having high frequency of travel and trade has been at risk of viral transmission. Methods: We examined current state of COVID-19 epidemic and preparedness in Pakistan using publicly available data and documents on COVID-19 government dashboard. Results: Pakistan reported its first 2 confirmed cases, on 26th February 2020 linked to travel history of Iran. The number of confirmed cases nationwide rose to 7,025 on 17th April 2020 with 135 deaths and 3276 confirmed cases in Punjab,2008 cases in Sindh,993 in Khyber Pathunkhawa,303 in Baluchistan,237 in Gilgit Baltistan,154 in ICT and 46 in Azad Jammu Kashmir. To-date 7000 Pakistani pilgrims have returned from Iran and placed in quarantine in Taftan. Directing of pilgrims back to their cities without testing at the border resulted in introduction of virus in country. Pakistan’s weak healthcare system with 0.6 bed for 1000 people and less than 0.75% of GDP as health spending is doubtful to bear the COVID-19 shock in case of exponential increase in cases. Conclusion: Low literacy rate and general lack of awareness leading to non-seriousness of people towards the adoption of social distancing and hand hygiene. The high population density in major cities of Pakistan can facilitate in the spread of virus. Three-pronged approach of trace, test and treat needs to be aggressively implemented to halt the community transmission leading to exponential increase in cases. Keywords: COVID-19,Preparedness,Three-pronged approach, community transmission.
Keywords	criterial preparedness,explosive corona trajectory ,exponential increase ,social distancing,risk mitigation,,vulnerable health system ; Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270 ; covid19
Subject code	360
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	University of New South Wales
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Seroprevalence and risk factors of avian influenza H9 virus among poultry professionals in Rawalpindi, Pakistan.

Tahir, Muhammad Farooq / Abbas, Muhammad Athar / Ghafoor, Tamkeen / Dil, Saima / Shahid, Muhammad Akbar / Bullo, Mir Muhammad Hassan / Ain, Qurat Ul / Abbas Ranjha, Muazam / Khan, Mumtaz Ali / Naseem, Muhammad Tahir

Journal of infection and public health

2020 Volume 13, Issue 3, Page(s) 414–417

Abstract: Background: Avian influenza H9 is endemic in commercial and backyard poultry in Pakistan and is a serious occupational health hazard to industry workers. This study aimed to determine the seroprevalence of avian influenza H9 infection in people working ... ...

Abstract	Background: Avian influenza H9 is endemic in commercial and backyard poultry in Pakistan and is a serious occupational health hazard to industry workers. This study aimed to determine the seroprevalence of avian influenza H9 infection in people working with poultry in Rawalpindi, Pakistan and assess the measures they took to protect themselves from infection. Methods: A cross-sectional study was conducted from December 2016 to May 2017 of 419 people working with poultry in Rawalpindi Division, including farm workers, vaccinators, field veterinarians, butchers and staff working in diagnostic laboratories. Potential participants were randomly approached and gave written consent to participate. Data were collected using a standardized questionnaire and serum samples were processed to detect H9 antibodies using the haemagglutination inhibition test. Results: Of the 419 participants, 406 (96.9%) were male. The mean age of the participants was 36.4 (SD 10.86) years. A total of 332 participants agreed to a blood test, 167 of whom were positive for A(H9) antibodies, giving an overall seroprevalence of 50.3%. Laboratory staff had the highest seroprevalence (100%) and veterinarians the lowest (38.5%). Vaccinators, butchers and farm workers had a seroprevalence of 83.3%, 52.4% and 45.5% respectively. Personals who used facemasks had significantly lower (P<0.002) seroprevalence (29.6%) than those who never used them (90.6%). Similarly, those who always used gloves and washed their hands with soap had a seroprevalence of 32.8% compared with 89.0% in those who never took these precautions. Of the participants who handled antigens, 92.3% were seropositive. Conclusion: Laboratory staff and vaccinators are exposed to viral cultures and influenza vaccines respectively which may explain their high seroprevalence.
MeSH term(s)	Adult ; Animal Husbandry ; Animals ; Antibodies, Viral/blood ; Cross-Sectional Studies ; Farmers/statistics & numerical data ; Female ; Humans ; Influenza A Virus, H9N2 Subtype/immunology ; Influenza A Virus, H9N2 Subtype/isolation & purification ; Influenza in Birds/epidemiology ; Influenza, Human/epidemiology ; Influenza, Human/prevention & control ; Influenza, Human/transmission ; Male ; Middle Aged ; Occupational Exposure/statistics & numerical data ; Pakistan/epidemiology ; Poultry/virology ; Risk Factors ; Seroepidemiologic Studies ; Surveys and Questionnaires
Chemical Substances	Antibodies, Viral
Language	English
Publishing date	2020-03-03
Publishing country	England
Document type	Journal Article
ISSN	1876-035X
ISSN (online)	1876-035X
DOI	10.1016/j.jiph.2020.02.030
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Implications of VEGF gene sequence variations and its expression in recurrent pregnancy loss.

Amin, Ina / Pandith, Arshad A / Manzoor, Usma / Mir, Syed Hussain / Afroze, Dil / Koul, Aabid Mustafa / Wani, Saima / Ahmad, Aabida / Qasim, Iqbal / Rashid, Masarat / Wani, Umer M / Anwar, Iqra / Aein, Qurat Ul / Mansoor, Sheikh

Reproductive biomedicine online

2021 Volume 43, Issue 6, Page(s) 1035–1044

Abstract: Research question: What is the association between VEGF gene sequence variants and its mRNA expression in recurrent pregnancy loss (RPL)? Vascular endothelial growth factor (VEGF) has a prominent role in pregnancy and affects pregnancy outcome. The ... ...

Abstract	Research question: What is the association between VEGF gene sequence variants and its mRNA expression in recurrent pregnancy loss (RPL)? Vascular endothelial growth factor (VEGF) has a prominent role in pregnancy and affects pregnancy outcome. The association of VEGF gene 1154G>A, 634G>C and 583C>T polymorphic variations with cases of RPL and full-term fertile women as controls was investigated. Design: Two hundred women with RPL and 240 women healthy controls were included. The restriction fragment length polymorphism method was used for genotyping and quantitative real-time polymerase chain reaction was used for analysis of mRNA expression. Results: In VEGF 1154G>A, significant differences were found in homozygous AA genotype between case and control participants. The variant allele A frequency was significantly more abundant in RPL cases (0.41) than controls (0.19) (P < 0.0001). Only RPL cases with the multi-generation family history of miscarriages and those without any history showed significant differences of combined genotype GA+AA (P < 0.0001). In VEGF 634 G>C, CC genotype and allele C showed significantly increased frequency in RPL cases compared with healthy controls (P < 0.0001). The association between VEGF-1154 G>A SNP and VEGF-A mRNA expression levels was significant in RPL cases (P = 0.004). Also in VEGF-583 C>T, CT genotypes were seen significantly associated with cases (P = 0.003). The heterozygous genotype GA was significantly (P = 0.03) associated with upregulation and downregulation of VEGF mRNA, whereas the homozygous variant genotype AA only leads to low expression levels of VEGF mRNA in patients with RPL. Conclusions: All the variants of VEGF play a vital role in an increased susceptibility to RPL. Also, VEGF-1154, AA genotypes are associated with its altered low mRNA expression in women with RPL and seem to affect pregnancy outcome.
MeSH term(s)	Abortion, Habitual/genetics ; Adult ; Alleles ; Case-Control Studies ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Haplotypes ; Humans ; Polymorphism, Single Nucleotide ; Pregnancy ; Pregnancy Outcome ; Vascular Endothelial Growth Factor A/genetics
Chemical Substances	Vascular Endothelial Growth Factor A
Language	English
Publishing date	2021-08-20
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2113823-0
ISSN	1472-6491 ; 1472-6483
ISSN (online)	1472-6491
ISSN	1472-6483
DOI	10.1016/j.rbmo.2021.08.009
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: COVID 19 Pandemic & Pakistan; Limitations and Gaps

Noreen, Nadia / Dil, Saima / Niazi, Saeed Ullah Khan / Naveed, Irum / Khan, Naveed Ullah / Khan, Farida Khudaidad / Tabbasum, Shehla / Kumar, Deepak

Global Biosecurity; Vol 1, No; 2652-0036

2020 Volume 4

Abstract: Abstract:Background:The 2019 novel coronavirus disease (COVID-19) has spread to more than 213 countries and as of 17th April 2020, 1995,983 confirmed cases and 131,037 deaths have been reported globally. Pakistan being sharing border with China and Iran, ...

Abstract	Abstract:Background:The 2019 novel coronavirus disease (COVID-19) has spread to more than 213 countries and as of 17th April 2020, 1995,983 confirmed cases and 131,037 deaths have been reported globally. Pakistan being sharing border with China and Iran, having high frequency of travel and trade has been at risk of viral transmission.Methods:We examined current state of COVID-19 epidemic and preparedness in Pakistan using publicly available data and documents on COVID-19 government dashboard.Results:Pakistan reported its first 2 confirmed cases, on 26th February 2020 linked to travel history of Iran. The number of confirmed cases nationwide rose to 7,025 on 17th April 2020 with 135 deaths and 3276 confirmed cases in Punjab,2008 cases in Sindh,993 in Khyber Pathunkhawa,303 in Baluchistan,237 in Gilgit Baltistan,154 in ICT and 46 in Azad Jammu Kashmir. To-date 7000 Pakistani pilgrims have returned from Iran and placed in quarantine in Taftan. Directing of pilgrims back to their cities without testing at the border resulted in introduction of virus in country. Pakistan’s weak healthcare system with 0.6 bed for 1000 people and less than 0.75% of GDP as health spending is doubtful to bear the COVID-19 shock in case of exponential increase in cases.Conclusion:Low literacy rate and general lack of awareness leading to non-seriousness of people towards the adoption of social distancing and hand hygiene. The high population density in major cities of Pakistan can facilitate in the spread of virus. Three-pronged approach of trace, test and treat needs to be aggressively implemented to halt the community transmission leading to exponential increase in cases. Keywords:COVID-19,Preparedness,Three-pronged approach, community transmission.
Keywords	Infectious Diseases Epidemiology ; Criterial preparedness,explosive corona trajectory ,exponential increase ,Social distancing,risk mitigation,,vulnerable health system ; covid19
Subject code	360
Language	English
Publishing date	2020-05-21
Publisher	University of New South Wales
Publishing country	au
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Trend Analysis of exponential increase of Covid-19 cases in Pakistan

Nadia Noreen / Irum Naveed / Saima Dil / Saeed Ullah Khan Niazi / Shabana Saleem / Nasser Mohiuddin / Naveed Ullah Khan / Beenish Noor / Mumtaz Ali Khan / Farida Khudaid Khan

Global Biosecurity, Vol 1, Iss

An interpretation

2020 Volume 4

Abstract: Background': The 2019 novel coronavirus (SARS-CoV-2) originated in the central Chinese city, Wuhan, at the end of December 2019. Pakistan reported its first 2 confirmed cases on 26February 2020, linked to a travel history of Iran. This study was ... ...

Abstract	'Background': The 2019 novel coronavirus (SARS-CoV-2) originated in the central Chinese city, Wuhan, at the end of December 2019. Pakistan reported its first 2 confirmed cases on 26February 2020, linked to a travel history of Iran. This study was conducted to see the trends of COVID-19 infection growth and doubling time in Pakistan, from an early containment state to a much belated exponential rise pattern. 'Method': This study is based on the analysis of the publicly available data on COVID-19 from the Ministry of National Health Services Regulations and Coordination’s COVID-19 dashboard and the publicly available National command and operation centre daily situation reports from 26February - 27July 2020 to show the trends and patterns of COVID-19 among the Pakistani population. 'Results': A total of 275,225 COVID-19 patients have been reported, with 5,865 deaths, 1,229 critically ill, and 242,436 recovered. Sindh has the highest number of confirmed cases (92,279). The majority of affected patients are male (72%). Local transmission cases stand at 97%. The percentage positivity has now declined to 4.8%, reaching a peak value of 25.7% in May. An average of 6.4 daily tests were conducted for each confirmed case, which makes 0.11 daily tests per thousand people. Daily cases surge had a 5.8% increase per day, with a 5-fold increase in infection until mid-June, which has now decreased to 80%. On 13 June 2020, the highest number of cases were reported (6,825 new highest daily deaths were reported on 19 June 2020). The case doubling time was 3 days initially and now stands at 28 days. The current CFR is 2.1%, with 5,865 deaths. 'Conclusion': The lack of effective quarantine facilities and limited testing capacities at the Taftan border crossing resulted in the importation of the virus in the country. Risk mitigation measures that were implemented, such as lockdown by provinces and the Federal government, were eased in mid-May due to the economic impact but was followed by a spike in cases. The cumulative confirmed ...
Keywords	exponential growth. case doubling rate,covid-19,smart lockdown ; Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	University of New South Wales
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Seroprevalence and risk factors of avian influenza H9 virus among poultry professionals in Rawalpindi, Pakistan

Muhammad Farooq Tahir / Muhammad Athar Abbas / Tamkeen Ghafoor / Saima Dil / Muhammad Akbar Shahid / Mir Muhammad Hassan Bullo / Qurat ul Ain / Muazam Abbas Ranjha / Mumtaz Ali Khan / Muhammad Tahir Naseem

Journal of Infection and Public Health, Vol 13, Iss 3, Pp 414-

2020 Volume 417

Abstract	Background: Avian influenza H9 is endemic in commercial and backyard poultry in Pakistan and is a serious occupational health hazard to industry workers. This study aimed to determine the seroprevalence of avian influenza H9 infection in people working with poultry in Rawalpindi, Pakistan and assess the measures they took to protect themselves from infection. Methods: A cross-sectional study was conducted from December 2016 to May 2017 of 419 people working with poultry in Rawalpindi Division, including farm workers, vaccinators, field veterinarians, butchers and staff working in diagnostic laboratories. Potential participants were randomly approached and gave written consent to participate. Data were collected using a standardized questionnaire and serum samples were processed to detect H9 antibodies using the haemagglutination inhibition test. Results: Of the 419 participants, 406 (96.9%) were male. The mean age of the participants was 36.4 (SD 10.86) years. A total of 332 participants agreed to a blood test, 167 of whom were positive for A(H9) antibodies, giving an overall seroprevalence of 50.3%. Laboratory staff had the highest seroprevalence (100%) and veterinarians the lowest (38.5%). Vaccinators, butchers and farm workers had a seroprevalence of 83.3%, 52.4% and 45.5% respectively. Personals who used facemasks had significantly lower (P < 0.002) seroprevalence (29.6%) than those who never used them (90.6%). Similarly, those who always used gloves and washed their hands with soap had a seroprevalence of 32.8% compared with 89.0% in those who never took these precautions. Of the participants who handled antigens, 92.3% were seropositive. Conclusion: Laboratory staff and vaccinators are exposed to viral cultures and influenza vaccines respectively which may explain their high seroprevalence. Keywords: Avian influenza, Seroprevalence, Poultry, Pakistan
Keywords	Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Subject code	941
Language	English
Publishing date	2020-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: ‘Characterisation of suspected Crimean-Congo Haemorrhagic Fever (CCHF) cases in a public sector hospital Islamabad’

Nadia Noreen / Dil Saima / Naveed Irum / Rana Jawad Asghar / Asad Ullah Faiz / Naseer Mohiuddin / Mumtaz Ali Khan / Naveed Ullah Khan / Farida Khudaidad / Fawad Khalid Khan

Global Security: Health, Science and Policy, Vol 5, Iss 1, Pp 85-

2020 Volume 92

Abstract: Pakistan has been experiencing a continuous rise in the incidence of Crimean Congo Haemorrhagic Fever (CCHF). Sporadic cases of CCHF are reported from rural areas of Punjab, Azad Jammu Kashmir and Khyber Pakhtunkhwa and neighbouring Afghanistan where ... ...

Abstract	Pakistan has been experiencing a continuous rise in the incidence of Crimean Congo Haemorrhagic Fever (CCHF). Sporadic cases of CCHF are reported from rural areas of Punjab, Azad Jammu Kashmir and Khyber Pakhtunkhwa and neighbouring Afghanistan where cattle herding is common. The objective of this paper was to describe the epidemiology of CCHF. A descriptive study was carried out in the CCHF isolation ward in Islamabad in a tertiary care hospital from February to November 2018. Using a standardised case definition, all patients admitted in the isolation ward with clinical evidence of CCHF were included in the study. After taking the informed consent, data were collected on demographic factors, history of animal contact, tick-bite history, co-morbidity, laboratory results and treatment outcome. Data were analysed as per time, place and person. During the study period, 40 suspected CCHF patients were admitted in the isolation ward, 32 (80%) males were affected. Mean age of the cases was 33.5 years (range 13–70 years). Most affected 17 (42.5%) age group was 20–29 years. Animal contact history was found in Thirty-seven (92.5%) of cases and 28 (70%) with tick bites. Most of the cases, 26 (65%), were reported from July to August. Forty patients in this study were tested by Real Time Polymerase Chain Reaction (PCR), 20 (50%) were positive, out of which 6(30%) expired. Majority of the positive patients were animal handlers by occupation (37.5%). Proper personal protective equipment was available. The reference laboratory facility was not available for immediate investigations was sent to National Institute of Health for confirmation. The overall results show the important risk factors for CCHF a history of tick bites, high-risk occupations and having contact with livestock. Public health measures should focus on preventing tick bites, increasing awareness of CCHF signs and symptoms, timely investigation, and treatment to reduce mortality. Our analyses recommend the government to set up isolation units in all major ...
Keywords	azad jammu kashmir ; khyber pakhtunkhwa ; real time polymerase chain reaction(pcr) ; personal protective equipment ; surveillance system ; Public aspects of medicine ; RA1-1270 ; Military Science ; U
Subject code	616
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Seroprevalence and risk factors of avian influenza H9 virus among poultry professionals in Rawalpindi, Pakistan

Muhammad F. Tahir / Muhammad A. Abbas / Tamkeen Ghafoor / Saima Dil / Muhammad A. Shahid / Mir M.H. Bullo / Qurat ul Ain / Muazam A. Ranjha / Mumtaz A. Khan / Muhammad T. Naseem

Journal of Infection and Public Health, Vol 12, Iss 4, Pp 482-

2019 Volume 485

Abstract	Background: Avian influenza H9 is endemic in commercial and backyard poultry in Pakistan and is a serious occupational health hazard to industry workers. This study aimed to determine the seroprevalence of avian influenza H9 infection in people working with poultry in Rawalpindi, Pakistan and assess the measures they took to protect themselves from infection. Methods: A cross-sectional study was conducted from December 2016 to May 2017 of 419 people working with poultry in Rawalpindi Division, including farm workers, vaccinators, field veterinarians, butchers and staff working in diagnostic laboratories. Potential participants were randomly approached and gave written consent to participate. Data were collected using a standardized questionnaire and serum samples were processed to detect H9 antibodies using the haemagglutination inhibition test. Results: Of the 419 participants, 406 (96.9%) were male. The mean age of the participants was 36.4 (SD 10.86) years. A total of 332 participants agreed to a blood test, 167 of whom were positive for A(H9) antibodies, giving an overall seroprevalence of 50.3%. Laboratory staff had the highest seroprevalence (100%) and veterinarians the lowest (38.5%). Vaccinators, butchers and farm workers had a seroprevalence of 83.3%, 52.4% and 45.5% respectively. Personals who used facemasks had significantly lower (P < 0.002) seroprevalence (29.6%) than those who never used them (90.6%). Similarly, those who always used gloves and washed their hands with soap had a seroprevalence of 32.8% compared with 89.0% in those who never took these precautions. Of the participants who handled antigens, 92.3% were seropositive. Conclusion: Laboratory staff and vaccinators are exposed to viral cultures and influenza vaccines respectively which may explain their high seroprevalence. Keywords: Avian influenza, Seroprevalence, Poultry, Pakistan
Keywords	Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Subject code	941
Language	English
Publishing date	2019-07-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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