Abstract
In the re-emergence of Highly Pathogenic Avian Influenza (HPAI), live bird markets have been identified to play a critical role. In this repeated cross-sectional study, we combined surveillance data collected monthly on Jakarta’s live bird markets over a five-year period, with risk factors related to the structure and management of live bird markets, the trading and slaughtering of birds at these markets, and environmental and demographic conditions in the areas where the markets were located. Over the study period 36.7% (95% CI: 35.1, 38.3) of samples (N = 1315) tested HPAI H5 virus positive. Using General Estimation Equation approaches to account for repeated observations over time, we explored the association between HPAI H5 virus prevalence and potential risk factors. Markets where only live birds and carcasses were sold, but no slaughtering was conducted at or at the vicinity of the markets, had a significantly reduced chance of being positive for H5 virus (OR = 0.2, 95% CI 0.1–0.5). Also, markets, that used display tables for poultry carcasses made from wood, had reduced odds of being H5 virus positive (OR = 0.7, 95% CI 0.5–1.0), while having at least one duck sample included in the pool of samples collected at the market increased the chance of being H5 virus positive (OR = 5.7, 95% CI 3.6–9.2). Markets where parent stock was traded, were more at risk of being H5 virus positive compared to markets where broilers were traded. Finally, the human population density in the district, the average distance between markets and origins of poultry sold at markets and the total rainfall per month were all positively associated with higher H5 virus prevalence. In summary, our results highlight that a combination of factors related to trading and marketing processes and environmental pressures need to be considered to reduce H5 virus infection risk for customers at urban live bird markets. In particular, the relocation of slaughter areas to well-managed separate locations should be considered.
Highlights
Since the first wave of highly pathogenic H5N1 (HPAI H5N1) occurred in 2003/04 in South East Asia, the virus has managed to maintain itself in several countries, resulting in an endemic state and regular disease outbreaks
Investigations revealed that most human cases of Highly Pathogenic Avian Influenza (HPAI) H5N1, and of the more recently discovered strains H7N9 and H10N8, have been linked to visits of live bird markets (LBM) [1,2,3,4,5]
Results from initial surveillance activities implemented in Indonesia revealed a much higher prevalence of HPAI H5N1 at these LBM compared to poultry producing areas, indicating that HPAI virus must spread extensively during the trading process
Summary
Since the first wave of highly pathogenic H5N1 (HPAI H5N1) occurred in 2003/04 in South East Asia, the virus has managed to maintain itself in several countries, resulting in an endemic state and regular disease outbreaks. Many human cases were not reported from areas of high poultry density, but rather from urban areas in which hardly any poultry is produced. Investigations revealed that most human cases of HPAI H5N1, and of the more recently discovered strains H7N9 and H10N8, have been linked to visits of live bird markets (LBM) [1,2,3,4,5]. LBMs provide live poultry that is frequently slaughtered at the markets and sold to the public or small restaurants. Results from initial surveillance activities implemented in Indonesia revealed a much higher prevalence of HPAI H5N1 at these LBM compared to poultry producing areas, indicating that HPAI virus must spread extensively during the trading process. There are important differences in the value chain of backyard poultry (e.g. Kampung or indigenous chickens) and commercial poultry (e.g. broilers and layers) sold in urban LBMs in Indonesia (Figs 1 and 2)
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