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This cross\u2010sectional study was conducted to evaluate evidence for transmission of influenza A virus between pigs and swine workers. Between February and October 2018, samples from swine workers and pigs were collected from three farms in KwaZulu\u2010Natal Province, South Africa. Workers nasal washes and serum samples, and swine oral secretion samples (rope sampling method) were studied for evidence of swine influenza A virus infection using molecular and serological methods. Among 84 human nasal washes and 51 swine oral secretion specimens, 44 (52.4%) and 6 (11.8%) had molecular evidence of influenza A virus. Microneutralization assays with enrolled workers\u2019 sera against swine H1N1 and H3N2 viruses revealed a high prevalence of elevated antibodies. Multivariate risk factor analysis showed that male workers from the age\u2010group quartile 23\u201332 years, who self\u2010reported a recent history of exposure to someone with influenza disease and seldom use of personal protective equipment were at highest risk of molecular detection of influenza A virus. These pilot study data suggest that influenza A viruses are likely highly prevalent in South African swine farms. South Africa would benefit from periodic surveillance for novel influenza viruses in swine farms as well as education and seasonal influenza vaccine programmes for swine workers.<\/jats:p>","DOI":"10.1111\/tbed.14255","type":"journal-article","created":{"date-parts":[[2021,7,30]],"date-time":"2021-07-30T03:53:53Z","timestamp":1627617233000},"page":"2373-2383","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Influenza A viruses are likely highly prevalent in South African swine farms"],"prefix":"10.1155","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1056-4761","authenticated-orcid":false,"given":"Mohamed E.","family":"El Zowalaty","sequence":"first","affiliation":[{"name":"Zoonosis Science Center Department of Medical Biochemistry and Microbiology Uppsala University  Uppsala Sweden"},{"name":"Duke One Health Duke University School of Medicine Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anfal","family":"Abdelgadir","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"},{"name":"Duke Global Health Institute Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura K.","family":"Borkenhagen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"},{"name":"Duke Global Health Institute Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariette F.","family":"Ducatez","sequence":"additional","affiliation":[{"name":"IHAP UMR1225 INRAe ENVT Universit\u00e9 de Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily S.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"},{"name":"Duke Global Health Institute Duke University  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory C.","family":"Gray","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"},{"name":"Duke Global Health Institute Duke University  Durham North Carolina USA"},{"name":"Global Health Research Center Duke\u2010Kunshan University  Kunshan China"},{"name":"Emerging Infectious Diseases Program Duke\u2010NUS Medical School  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2013.16.102.1450"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/emph\/eoy013"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40794-021-00133-7"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz865"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511586576"},{"key":"e_1_2_11_7_1","unstructured":"Easterday B. 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