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Mitigating Zoonotic Disease Transmission Among Youth Participating in Agricultural Exhibitions

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Mitigating Zoonotic Disease Transmission Among Youth Participating in Agricultural Exhibitions Mitigating zoonotic disease transmission among youth participating in agricultural exhibitions DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University By Jacqueline M. Nolting Graduate Program in Agricultural and Extension Education The Ohio State University 2018 Dissertation Committee: Dr. Scott Scheer - Advisor Dr. Armando Hoet Dr. Jeffrey King Dr. M. Susie Whittington Copyrighted by Jacqueline Michele Nolting 2018 Abstract Educating youth regarding the risk of zoonotic disease is an important animal and public health concern as nearly three out five new human illnesses are zoonotic. In addition, disease prevention was determined to be the life skill least represented in 4-H youth development programming, making this an important addition to youth programs. Justification for increased diligence in this area is highlighted by the continual cases of reported zoonotic transmission of influenza A viruses between pigs and people, which has received considerable publicity following the H3N2 variant influenza A virus (H3N2v) outbreaks of 2011-2017. Most cases of H3N2v reported have been in youth swine exhibitors associated with agricultural fairs. Building a repertoire of mitigation strategies based on scientific evidence is a key component to the development of sustainable educational programming because it provides a means by which exhibitors can be a part of the solution. Leading transitions is impossible without evidence to support the proposed behavioral changes; therefore data collected from the studies conducted at The Ohio State University have been used to develop a multi-faceted educational program to educate youth on the risk associated with zoonotic disease. Youth involved in swine exhibition are unaware of the risk posed by influenza A viruses, and other zoonotic diseases, that are transmitted between swine and humans. As a result, management practices to prevent transmission events are not being followed and each year humans become infected with influenza A viruses from exposure to exhibition ii swine. Educating youth about the risks associated and potential mitigation strategies to lessen those risks is being initiated to protect human and animal health. As a result the following research questions were developed. 1) How do youth swine exhibitors‟ knowledge about IAVs change when participating in scenario-based training exercises? 2) What predictor variables determine IAV knowledge through scenario-based training exercises? 3) Has the dissemination of the “Swine Zoonotic Disease Risks and Prevention” chapter of the Swine Resource Handbook been effective? 4) How did the “Becoming a Swientist” Program influence the healthy habits of swine exhibitors? 5) What were the perceptions and behaviors of jackpot swine exhibitors related to IAV? Mixed methods were used to evaluate these questions which resulted in significant gains in knowledge and the adoption of healthy habit behaviors. In addition, perceptions and behaviors of jackpot showmen were observed using a survey to determine the effectiveness of recommendations included in the “Measures to Minimize Influenza Transmission at Swine Exhibitions” document. This study provides evidence that developing and disseminating static recommendations to reduce zoonotic disease transmission is not enough to change human behavior and interactive methods must be deployed to prevent future variant IAV infections associated with swine exhibitions. iii Dedication Dedicated to Eric and Alex; may you always chase your dreams. To leave the world a bit better, whether by a healthy child, a garden path, or a redeemed social condition; to know even one life breathed easier because you lived. This is to have succeeded. – attributed to Ralph Waldo Emerson iv Acknowledgments I express sincere gratitude to Andy Bowman and the entire Animal Influenza Ecology and Epidemiology Research Program team for their tremendous support and effort to initiate these educational programs. I would also like to graciously thank extension educators from the five participating counties for their cooperation and assistance with the organization and execution of training sessions. This work was funded by Council for State and Territorial Epidemiologists under contract number [PREV- 31299] in collaboration with federal funds from the Centers of Excellence for Influenza Research and Surveillance (CEIRS), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, under Contract No. [HHSN272201400006C]. v Vita Education 2008 M.S. The Ohio State University, Major: Veterinary Preventive Medicine 2005 B.S. The Ohio State University, Major: Animal Science Positions and Employment 2014-present Clinical Laboratory Manager, Veterinary Preventive Medicine, The Ohio State University 2012-2015 Adjunct Instructor, Columbus State Community College 2011- 2015 Adjunct Instructor, Central Ohio Technical College 2010-2014 Research Associtate, Veterinary Preventive Medicine, The Ohio State University 2005-2010 Research Assistant, Veterinary Preventive Medicine, The Ohio State University Awards SEEDS: The OARDC Research Enhancement Competitive Grant for Graduate Students. Project entiteled “Prescence of influenza A viruses in poultry and waterfowl at Ohio agricultual fairs. vi Publications 1. Nolting JM, Midla J, Whittington MS, Scheer SD, Bowman AS. Educating youth swine exhibitors on influenza A virus transmission at agricultural fairs. Zoonoses and Public Health. 2017;00:1–5. https://doi.org/10.1111/zph.12422 2. Nolting JM, Fries AC, Gates RJ, Bowman AS, Slemons RD, "Influenza A viruses from over-wintering and spring-migrating waterfowl in the Lake Erie Basin, United States". Avian Diseases. (In Press) 3. Elizabeth Bailey, Li-Ping Long, Nan Zhao, Jeff Hall, John A. Baroch, Jacqueline Nolting, Lucy Senter, Frederick L. Cunningham, G. Todd Pharr, Larry Hanson, Richard Slemons, Thomas J. DeLiberto, and Xiu-Feng Wan, (2017) "Antigenic Characterization of H3 Subtypes of Avian Influenza A Viruses in North America". Avian Diseases. 4. Bowman AS, Nolting JM, Workman JD, Cooper M, Fisher AE, Marsh BM, Forshey T, "The inability to screen exhibition swine for influenza A virus using body temperature.” Zoonoses and Public Health. (In Press) 5. Runstadler,J,A; Happ,G,M; Slemons,R,D; Sheng,Z-M; GUNDLACH,N; Petrula,M; Senne,D; Nolting,J; Evers,D,L; Modrell,A; Huson,H; Hills,S; Rothe,T; Marr,T; Taubenberger,J,K, "Using RRT-PCR analysis and virus isolation to determine the prevalence of avian influenza virus infections in ducks at Minto Flats State Game Refuge, Alaska, during August 2005". (2007) Archives of Virology. Vol. 152, no. 10: 1901-1910. 6. Dugan,Vivien,G; Chen,Rubing; Spiro,David,J; Sengamalay,Naomi; Zaborsky,Jennifer; Ghedin,Elodie; Nolting,Jacqueline; Swayne,David,E; Runstadler,Jonathan,A; Happ,George,M; Senne,Dennis,A; Wang,Ruixue; Slemons,Richard,D; Holmes,Edward,C; Taubenberger,Jeffery,K, "The evolutionary genetics and emergence of avian influenza viruses in wild birds".(2008) PLOS Pathogen. Vol. 4, no. 5: e1000076. 7. Dugan,Vivien,G; Dunham,Eleca,J; Jin,Guozhong; Sheng,Zong-mei; Kaser,Emilee; Nolting,Jacqueline,M; Alexander,H,Lloyd; Slemons,Richard,D; Taubenberger,Jeffery,K, "Phylogenetic analysis of low pathogenicity H5N1 and H7N3 influenza A virus isolates recovered from sentinel, free flying, wild mallards at one study site during 2006". (2011) Virology. Vol. 417, no. 1: 98-105. 8. Bowman,Andrew,S; Sreevatsan,Srinand; Killian,Mary,L; Page,Shannon,L; Nelson,Sarah,W; Nolting,Jacqueline,M; Cardona,Carol; Slemons,Richard,D, "Molecular evidence for interspecies transmission of H3N2pM/H3N2v influenza A vii viruses at an Ohio agricultural fair, July 2012". (2012) Emerging Microbes & Infections. Vol. 1, e33. 9. Bowman,Andrew,S; Nolting,Jacqueline,M; Nelson,Sarah,W; Slemons,Richard,D, "Subclinical influenza virus A infections in pigs exhibited at agricultural fairs, Ohio, USA, 2009-2011." (2012) Emerging infectious diseases. Vol. 18, no. 12: 1945-1950. 10. Nolting,Jacqueline; Fries,Anthony,C; Slemons,Richard,D; Courtney,Chad; Hines,Nichole; Pedersen,Janice, "Recovery of H14 influenza A virus isolates from sea ducks in the Western Hemisphere." (2012) PLoS currents. Vol. 4, RRN1290-?. 11. Bowman,Andrew,S; Nelson,Sarah,W; Edwards,Jody,L; Hofer,Christian,C; Nolting,Jacqueline,M; Davis,Ian,C; Slemons,Richard,D, "Comparative effectiveness of isolation techniques for contemporary Influenza A virus strains circulating in exhibition swine" (2013) Journal of Veterinary Diagnostic Investigation . Vol. 25, no. 1: 82-90. 12. Fries,Anthony,C; Nolting,Jacqueline,M; Danner,Angela; Webster,Robert,G; Bowman,Andrew,S; Krauss,Scott; Slemons,Richard,D, "Evidence for the Circulation and Inter-Hemispheric Movement of the H14 Subtype Influenza A Virus"(2013) PLOS ONE. Vol. 8, no. 3: e59216. 13. Feng,Zhixin; Gomez,Janet; Bowman,Andrew,S; Ye,Jianqiang; Long,Li-Ping; Nelson,Sarah,W; Yang,Jialiang; Martin,Brigitte; Jia,Kun; Nolting,Jacqueline,M; Cunningham,Fred; Cardona,Carol; Zhang,Jianqiang; Yoon,Kyoung-Jin; Slemons,Richard,D; Wan,Xiu-Feng, "Antigenic Characterization of H3N2 Influenza A Viruses from Ohio Agricultural Fairs"(2013) Journal of Virology. Vol. 87, no. 13: 7655-7667. 14. Nolting,Jacqueline,M; Dennis,Patricia; Long,Lindsey; Holtvoigt,Lauren; Brown,Deniele; King,Mary,Jo; Shellbarger,Wynonna; Hanley,Chris; Killian,Mary,Lea; Slemons,Richard,D, "Low Pathogenic Influenza A Virus Activity at
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