A Retrospective Cross-Sectional Study (2009-2023): Exploring Influenza A(H1N1)pdm09 Antibody Time Series in Humans...

Swine may act as 'epidemiological bridges' and reservoirs for the emergence of novel zoonotic influenza viruses with pandemic potential. While bidirectional exchange of influenza A viruses at the swine-human interface is well recognised, data on the extent of interspecies transmission are limited.

We analysed the post-seasonal geometric mean titre (GMT) of influenza A(H1N1)pdm09 antibodies in humans and the seasonal prevalence of influenza A(H1N1)pdm09 antibodies in unvaccinated swine from 2009/2010-2022/2023 per county in Norway to search for evidence of interspecies transmission. We explored correlations at the national and individual county level and investigated possible associations by running a negative binomial regression model. Additionally, we distributed an influenza vaccination questionnaire to veterinarians and farmers working with swine to assess vaccination uptake and calculated total response rates per county and overall.

The time series of H1N1pdm09 antibodies from humans and swine show significant positive correlations both across (0.8 Pearson correlation coefficient) and within certain individual counties, with especially high correlations in Innlandet (0.9), Vestland (0.8) and Rogaland (0.7) Counties. Our regression analysis revealed a significant positive association between the annual GMT of H1N1pdm09 antibodies in humans, the annual seroprevalence of H1N1pdm09 antibodies in swine, and the density of swine farms in counties. Vaccination uptake was 39% and 50% in farmers and veterinarians, respectively.

Our findings indicate a temporal relationship between the disease in humans and swine; suggesting spillover, environmental factors facilitating disease spread, and/or indirect relationships driven by unknown factors.

The time series of H1N1pdm09 antibodies in humans and swine shows significant correlations. Regression analysis links GMT of H1N1pdm09 antibodies in humans to seroprevalence of H1N1pdm09 in swine and density of swine farms. This indicates a temporal relationship possibly due to spillover, shared risk factors or indirect relationships driven by unknown factors. The influenza vaccination survey showed a 39% uptake among farmers and 50% among swine veterinarians.