As at least 50% of the people exposed to infected poultry had H7 antibodies detectable with the modified assay, it was estimated that avian influenza A/H7N7 virus infection occurred in at least 1000, and perhaps as many as 2000 people. The seroprevalence of H7 antibodies in people without contact with infected poultry, but with close household contact to an infected poultry worker, was 59%. This suggests that the population at risk for avian influenza was not limited to those with direct contact to infected poultry, and that person to person transmission may have occurred on a large scale. Final analysis of Dutch avian influenza outbreaks reveals much higher levels of transmission to humans than previously thought.
