Understanding the associations between on-farm biosecurity practice and equine influenza infection during the 2007 outbreak in Australia

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In a previous premises-level case-control study of the 2007 equine influenza outbreak in Australia, the protective effect of several variables representing on-farm biosecurity practices was identified. However, using logistic regression it was not possible to definitively identify individual effects and associations between each of the personal biosecurity measures implemented by horse premises owners and managers in the face of the outbreak. In this study we apply Bayesian network modelling to identify the complex web of associations between these variables, horse premises infection status and other premises-level covariates.We focussed this analysis primarily on the inter-relationship between the nine variables representing on-farm personal biosecurity measures (of people residing on the premises and those visiting), and all other variables from the final logistic regression model of our previous analysis. Exact structure discovery was used to identify the globally optimal model from across the landscape of all directed acyclic graphs possible for our dataset. Bootstrapping was used to adjust the model for over-fitting.Our final Bayesian graphic network model included 18 variables linked by 23 arcs, each arc analogous to a single multivariable generalised linear model, combined in a probabilistically coherent way. Amongst the personal biosecurity measures, having a footbath in place, certain practices of visitors (hand-washing, changing clothes and shoes) in contact with the horses, and the regularity of horse handling were statistically associated with premises infection status.The results of this in-depth analysis provide new insight into the complex web of direct and indirect associations between risk factors and horse premises infection status during the first 7 weeks of the 2007 equine influenza outbreak in Australia. In future outbreaks, unnecessary contact and handling of horses should be avoided, especially by those coming from off the premises. Prior to any such contact, persons handling horses should use a footbath (if present), change their clothes and shoes, and wash their hands.