Transmission Of Highly Pathogenic Avian Influenza Research Articles

Descriptive Epidemiology and Phylodynamics of the “First Wave” of an Outbreak of Highly Pathogenic Avian Influenza (H5N1 Clade 2.3.4.4b) in British Columbia and the Yukon, Canada, April to September 2022

Highly pathogenic avian influenza (HPAI) is a viral disease that causes significant rates of morbidity and mortality in domestic poultry and wild birds, with occasional spillover into mammals, including humans. Beginning in November 2021, Canada experienced its longest and largest outbreak of HPAI in history. A portion of this outbreak (H5N1, clade 2.3.4.4b) occurred in western Canada, specifically in British Columbia (B.C.) and the Yukon, between April 12 and September 11, 2022, which was classified as the “first wave” in this region. Wild birds and mammals identified through passive surveillance and suspect domestic poultry flocks were screened for avian influenza virus (AIV), typed H5 by qPCR, and positive cases were whole genome sequenced. Descriptive epidemiological and phylodynamic analyses were performed to: (1) understand the taxonomic and geographic extent of wild species involved; and (2) examine the origins and probable transmission networks of HPAI viruses introduced into B.C./Yukon by comparing local viruses with those circulating elsewhere in North America. This outbreak included 21 species of wild birds, 2 species of wild mammals, 4 commercial, and 12 domestic small flock infected premises. Canada geese (Branta canadensis) and bald eagles (Haliaeetus leucocephalus) were the most common wild species detected. We demonstrate that north-south avian migration via the Pacific Flyway is the probable route of multiple incursions into this region. Phylogenetic analysis of the hemagglutinin (HA) segment revealed that the B.C./Yukon viruses detected formed five distinct genetic clusters which were maintained across the whole genome. Although, the genome segments were predominantly Eurasian in origin, NP and PB2 segments from all samples, as well as NS and PB1 segments from Cluster 3, had North American origins. Overall, we demonstrate the utility of genomic epidemiology to inform HPAI transmission dynamics across Western Canada and discuss potential knowledge gaps that exist in passive surveillance strategies for HPAI.

Association between highly pathogenic avian influenza outbreaks and weather conditions in Japan.

Highly pathogenic avian influenza (HPAI) poses a significant threat to animal and public health, with outbreaks occurring globally. HPAI poses significant challenges due to its high mortality rate and public health concerns, with outbreaks spreading globally since the emergence of the H5N1 virus in 2003. In Japan, HPAI outbreaks have been particularly prevalent during autumn and winter seasons, with the 2022-2023 winter experiencing the most severe outbreak to date. However, limited research has directly examined the association between HPAI outbreaks and weather conditions in Japan. Here we show that specific weather conditions are associated with an increased risk of HPAI outbreaks on poultry farms in Japan. By analyzing databases of HPAI cases and meteorological data from 2020-2023, we found that higher average air temperatures two to three weeks prior, lower average wind speeds four weeks prior, and longer sunlight hours two and four weeks prior to outbreaks were significantly associated with increased risk of HPAI outbreaks in Japan. These results suggest that weather may influence environmental survival and transmission of the virus, as well as patterns of wild bird movement that could seed new outbreaks. These findings enhance our understanding of the factors influencing HPAI transmission dynamics and highlight the importance of integrating weather forecasts into disease surveillance and prevention strategies.

Research Note: Factors influencing highly pathogenic avian influenza preventive behavior among live poultry market vendors

In China, fresh food has always been a top priority and live poultry has been a staple in the diet for thousands of years. As a result, the live poultry market (LPM) remains a popular and important source for purchasing live poultry among the public. However, LPMs also play a crucial role in spreading and retaining highly pathogenic avian influenza (HPAI) due to the high poultry movement and trade volume. Therefore, the preventive behavior of LPM vendors is essential in blocking the transmission of HPAI and reducing occupational exposure. Based on the health belief model, this study utilized structural equation modeling to examine the effect of risk perceptions on preventive behavior among vendors in the live poultry wholesale market (wLPM) and the live poultry retail market (rLPM) in Guangdong Province. The results indicated that perceived severity and perceived benefits positively influenced the wLPM vendors' ability to adopt preventive behavior (i.e., self-efficacy) while perceived barriers negatively affected self-efficacy in both wLPM and rLPM. Moreover, cues to action positively mediated the relationship between perceived severity, perceived benefits, and self-efficacy of wLPM and rLPM vendors. Cues to action also positively mediated the effect of perceived susceptibility among wLPM vendors. To promote preventive behavior among vendors, the market management companies and the government must provide timely and effective HPAI information through various channels and develop differentiated health campaigns according to the market types to raise vendors' awareness about HPAI.

Modeling long-distance airborne transmission of highly pathogenic avian influenza carried by dust particles

Highly pathogenic avian influenza (HPAI) is continuously causing significant economic losses with massive poultry depopulations. Airborne transmission of HPAI was suspected, as initial bird mortalities were reported near air inlets of poultry houses. In addition, infected farms were distant, indicating that the viruses carried by dust particles might help the viruses travel for long distances in the environment. The objective of this study focused on simulating the airborne transmission of HPAI by using computational modeling to assess the risk of airborne and deposited avian influenza (AI) carried by poultry-litter dust particles. The Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) modeling was used in this study. Data from 168 infected cases in the Mid-Western area of U.S. were obtained from the Animal and Plant Health Inspection Service (APHIS) and Watt Poultry. The concentration simulation modeling was performed to estimate the airborne and deposited AI concentration carried by PM2.5 dust particles. Results showed that concentrations of airborne AI, deposited AI, and combined AI transmitted to other farms in a day were lower than the minimal infective dose for poultry. In most of the scenarios, the predicted probability of infection showed that Iowa-infected farms and turkey poultry houses had the highest infection probability. The findings may provide an understanding of the risk of airborne HPAI virus carried by dust particles and suggest the factors that influence long-distance airborne transmission.

Estimation of introduction time window of highly pathogenic avian influenza virus into broiler chicken farms during the 2020 – 2021 winter season outbreak in Japan

When an infectious disease occurs in an area, early detection of infected farms is important to respond quickly and contain the outbreak on a small scale. Estimating the time window for the introduction of the infection is important for its prevention and control. The aim of this study was to estimate the farm-specific time window from the introduction of the highly pathogenic avian influenza (HPAI) virus into poultry farms using field data from the HPAI H5N8 outbreak in the 2020–2021 winter season in Japan. Daily mortality data from 12 broiler chicken farms during the outbreak were used for the analysis. A mathematical model (Susceptible-Exposed-Infectious-Removed, SEIR model) was applied to generate the within-flock transmission of HPAI. The model-predicted mortality was fitted to the observed excess mortality data induced by HPAI to estimate the farm-specific transmission rate and the time of virus introduction. The estimated value of the transmission rate in each farm was 1.449 day−1 in median (min: 0.661 day−1, max: 3.387 day−1). The time window from the introduction of the virus to notification in each farm was estimated at 14.0 days in median (min: 8.6 days, max: 24.1 days) in the deterministic model. In addition, in the stochastic model considering the randomness of transmission in the early phase of the outbreak, the upper value of 95 % credible interval of the time window ranged from 12 to 34 days, with a median of 21 days. The results suggest that although one to three weeks had elapsed on most farms until notification after the virus introduction, the time window could exceed three weeks considering the stochasticity of disease transmission. As for the potential farm characteristics affecting within-flock transmission, the transmission rate was smaller (p-value=0.02) and the estimated time window from introduction to notification was longer (p-value=0.02) when birds were older. This study provides reliable information for setting up a tracing period for a potential source farm and enhancing the efforts for early detection.

Disease surveillance in England and Wales, June 2022.

Disease surveillance in England and Wales, June 2022.

Dynamics of inter-farm transmission of highly pathogenic avian influenza H5N6 integrating vehicle movements and phylogenetic information

Highly pathogenic avian influenza (HPAI) in poultry holdings commonly spreads through animal trade, and poultry production and health-associated vehicle (PPHaV) movement. To effectively control the spread of disease, it is essential that the contact structure via those movements among farms is thoroughly explored. However, few attempts have been made to scrutinize PPHaV movement compared to poultry trade. Therefore, our study aimed to elucidate the role of PPHaV movement on HPAI transmission. We performed network analysis using PPHaV movement data based on a global positioning system, with phylogenetic information of the isolates during the 2016–2017 HPAI H5N6 epidemic in the Republic of Korea. Moreover, the contribution of PPHaV movement to the spread of HPAI was estimated by Bayesian modeling. The network analysis revealed that there was the relationship between phylogenetic clusters and the contact network via PPHaV movement. Furthermore, the similarity of farm poultry species and the shared integrators between inter-linked infected premises (IPs) were associated with ties within the same phylogenetic clusters. Additionally, PPHaV movement among phylogenetically clustered IPs was estimated to contribute to approximately 30% of HPAI H5N6 infections in IPs on average. This study provides insight into how HPAI spread via PPHaV movement and scientific basis for control strategies.

Elucidating the Local Transmission Dynamics of Highly Pathogenic Avian Influenza H5N6 in the Republic of Korea by Integrating Phylogenetic Information.

Highly pathogenic avian influenza (HPAI) virus is one of the most virulent and infectious pathogens of poultry. As a response to HPAI epidemics, veterinary authorities implement preemptive depopulation as a controlling strategy. However, mass culling within a uniform radius of the infection site can result in unnecessary depopulation. Therefore, it is useful to quantify the transmission distance from infected premises (IPs) before determining the optimal area for preemptive depopulation. Accordingly, we analyzed the transmission risk within spatiotemporal clusters of IPs using transmission kernel estimates derived from phylogenetic clustering information on 311 HPAI H5N6 IPs identified during the 2016–2017 epidemic, Republic of Korea. Subsequently, we explored the impact of varying the culling radius on the local transmission of HPAI given the transmission risk estimates. The domestic duck farm density was positively associated with higher transmissibility. Ring culling over a radius of 3 km may be effective for areas with high dense duck holdings, but this approach does not appear to significantly reduce the risk for local transmission in areas with chicken farms. This study provides the first estimation of the local transmission dynamics of HPAI in the Republic of Korea as well as insight into determining an effective ring culling radius.

The Risk of Highly Pathogenic Influenza A Virus Transmission to Turkey Hen Flocks Through Artificial Insemination.

Artificial insemination is a routine practice for turkeys that can introduce pathogens into breeder flocks in a variety of ways. In this manuscript, a risk analysis on the potential transmission of highly pathogenic avian influenza (HPAI) to naïve hens through artificial insemination is presented. A case of HPAI on a stud farm where the potential transmission of the virus to susceptible hens in the 2015 H5N2 HPAI outbreak in Minnesota is described along with documentation of known and potential transmission pathways from the case. The pathways by which artificial insemination might result in the spread of HPAI to susceptible hens were determined by considering which could result in the 1) entry of HPAI virus onto a premises through semen movement; and 2) exposure of susceptible hens to HPAI as a result of this movement. In the reported case, HPAI virus was detected in semen from infected toms, however, transmission of HPAI to naïve hens through semen is unclear since the in utero infectious dose is not known. This means that the early detection of infection might limit but not eliminate the risk of hen exposure. Because of the numerous potential pathways of spread and the close contact with the birds, it is highly likely that if semen from an HPAI-infected tom flock is used, there will be spread of the virus to naïve hens through insemination. If insemination occurs with semen from stud farms in an HPAI control area, receiving hen farms should have restricted movements to prevent outbreak spread in the event that they become infected.

Evaluation of strategies using simulation model to control a potential outbreak of highly pathogenic avian influenza among poultry farms in Central Luzon, Philippines.

The Philippines confirmed its first epidemic of Highly Pathogenic Avian Influenza (HPAI) on August 11, 2017. It ended in November of 2017. Despite the successful management of the epidemic, reemergence is a continuous threat. The aim of this study was to conduct a mathematical model to assess the spatial transmission of HPAI among poultry farms in Central Luzon. Different control strategies and the current government protocol of 1 km radius pre-emptive culling (PEC) from infected farms were evaluated. The alternative strategies include 0.5km PEC, 1.5km PEC, 2 km PEC, 2.5 km PEC, and 3 km PEC, no pre-emptive culling (NPEC). The NPEC scenario was further modeled with a time of government notification set at 24hours, 48 hours, and 72 hours after the detection. Disease spread scenarios under each strategy were generated using an SEIR (susceptible-exposed-infectious-removed) stochastic model. A spatial transmission kernel was calculated and used to represent all potential routes of infection between farms. We assumed that the latent period occurs between 1-2 days, disease detection at 5-7 days post-infection, notification of authorities at 5-7 days post-detection and start of culling at 1-3 days post notification. The epidemic scenarios were compared based on the number of infected farms, the total number of culled farms, and the duration of the epidemic. Our results revealed that the current protocol is the most appropriate option compared with the other alternative interventions considered among farms with reproductive ratio (Ri) > 1. Shortening the culling radius to 0.5 km increased the duration of the epidemic. Further increase in the PEC zone decreased the duration of the epidemic but may not justify the increased number of farms to be culled. Nonetheless, the no-pre-emptive culling (NPEC) strategy can be an effective alternative to the current protocol if farm managers inform the government immediately within 24 hours of observation of the presence of HPAI in their farms. Moreover, if notification is made on days 1-3 after the detection, the scale and length of the outbreak have been significantly reduced. In conclusion, this study provided a comparison of various control measures for confronting the spread of HPAI infection using the simulation model. Policy makers can use this information to enhance the effectiveness of the current control strategy.

Qualitative risk assessment of transmission pathways of highly pathogenic avian influenza (HPAI) virus at live poultry markets in Dhaka city, Bangladesh.

Analysis of environmental samples obtained from the Live Poultry Markets (LPMs) of Dhaka City, Bangladesh, has revealed that the highest degree of prevalence of highly pathogenic avian influenza A (HPAI, H5N1), besides other subtypes of the LPAI virus, poses the plausible risk of transmission of these viruses between human and poultry species. The present study was conducted using the OIE risk analysis framework to assess the risk level of each pathway successively. The estimated risk parameters were integrated towards to obtain the overall risk level for each specific HPAI transmission pathway using the matrix adapted by Cristobel Zepeda accompanying other expert consultations. The relevant data obtained from published and unpublished sources, together with survey data of field observations, were used to formulate and confirm the risk pathways and their associated risks. The results revealed that the risk of the release of the HPAI virus was medium when exposure was high. Additionally, the consequence would be considered very high with a medium degree of uncertainty for all parameters. Ultimately, the overall risk for transmission was estimated as medium with a medium degree of uncertainty. The findings of this study reveal that there is a significant threat that HPAI virus transmission could occur among poultry and humans and effectively sustain within the environment of the LPMs. Our findings are primarily focused on public health considerations, the hygienic slaughter of poultry and the relevant cleaning and sanitation practices conducted in the LPMs to support evidence-based decision-making processes. The findings of the study have the potential to be used to formulate effective risk reduction measures and can be further adapted in low-resource settings without major infrastructural changes required of the LPMs. All of which would reduce the risk of HPAI virus release and further lessen the degree of exposure and transmission in established LPMs.

Meteorological factors affecting the risk of transmission of HPAI in Miyazaki, Japan

Highly pathogenic avian influenza (HPAI) outbreaks engender a severe economic impact on the poultry industry and public health. Migratory waterfowl are considered the natural hosts of HPAI virus, and HPAI...

Risk of poultry compartments for transmission of Highly Pathogenic Avian Influenza.

When outbreaks of Highly Pathogenic Avian Influenza (HPAI) occur in OIE member countries with until then disease-free status, member countries can use ‘compartmentalisation’. A compartment may be defined as a subset of farms under a common management system, complying with certain stringent surveillance, control and biosecurity measures, and based on that may receive a disease-free status. Based on this disease-free status the compartment is exempted from certain transport restrictions coming into force in case of outbreaks occurring in the country. For deciding whether a candidate compartment is granted official compartment status, it is relevant to assess the additional HPAI transmission risks that would arise due to the exemptions granted. These risks consist of both additional local transmission risks as well as the additional risk of a ‘jump’ of HPAI infection from one poultry area, via the compartment, to another area. Here such risk assessment is carried out using a spatial mathematical model for between-farm transmission in the Netherlands, yielding insight in the roles of compartment composition and contact structure and identify relevant evaluation criteria for granting HPAI compartment status. At the core of this model are transmission probabilities associated with indirect between-farm contacts, e.g. through feed delivery, egg collection and professional visitors. These probabilities were estimated from Dutch epidemic outbreak data in earlier work. The additional risk of a jump of HPAI from one area, via the compartment, to another area is calculated relative to the direct jump risk. The results show that additional transmission risks caused by a compartment to other farms are mainly dependent on the distance of densely populated poultry areas (DPPAs) to the nearest compartment farm. Apart from conditions on these distances, we also recommend specific routing requirements for transport and other movements within the compartment.

Spatial transmission of H5N2 highly pathogenic avian influenza between Minnesota poultry premises during the 2015 outbreak

The spatial spread of highly pathogenic avian influenza (HPAI) H5N2 during the 2015 outbreak in the U.S. state of Minnesota was analyzed through the estimation of a spatial transmission kernel, which quantifies the infection hazard an infectious premises poses to an uninfected premises some given distance away. Parameters were estimated using a maximum likelihood method for the entire outbreak as well as for two phases defined by the daily number of newly detected HPAI-positive premises. The results indicate both a strong dependence of the likelihood of transmission on distance and a significant distance-independent component of outbreak spread for the overall outbreak. The results further suggest that HPAI spread differed during the later phase of the outbreak. The estimated spatial transmission kernel was used to compare the Minnesota outbreak with previous HPAI outbreaks in the Netherlands and Italy to contextualize the Minnesota transmission kernel results and make additional inferences about HPAI transmission during the Minnesota outbreak. Lastly, the spatial transmission kernel was used to identify high risk areas for HPAI spread in Minnesota. Risk maps were also used to evaluate the potential impact of an early marketing strategy implemented by poultry producers in a county in Minnesota during the outbreak, with results providing evidence that the strategy was successful in reducing the potential for HPAI spread.

Dynamics of the 2004 avian influenza H5N1 outbreak in Thailand: The role of duck farming, sequential model fitting and control

The Highly Pathogenic Avian Influenza (HPAI) subtype H5N1 virus persists in many countries and has been circulating in poultry, wild birds. In addition, the virus has emerged in other species and frequent zoonotic spillover events indicate that there remains a significant risk to human health. It is crucial to understand the dynamics of the disease in the poultry industry to develop a more comprehensive knowledge of the risks of transmission and to establish a better distribution of resources when implementing control. In this paper, we develop a set of mathematical models that simulate the spread of HPAI H5N1 in the poultry industry in Thailand, utilising data from the 2004 epidemic. The model that incorporates the intensity of duck farming when assessing transmision risk provides the best fit to the spatiotemporal characteristics of the observed outbreak, implying that intensive duck farming drives transmission of HPAI in Thailand. We also extend our models using a sequential model fitting approach to explore the ability of the models to be used in “real time” during novel disease outbreaks. We conclude that, whilst predictions of epidemic size are estimated poorly in the early stages of disease outbreaks, the model can infer the preferred control policy that should be deployed to minimise the impact of the disease.

Serosurveillance of avian influenza A/H5N6 virus infection in poultry farmers, Gyeonggi Province, Republic of Korea, 2016–2017

ObjectivesBetween November 20, 2016 and April 17, 2017, outbreaks of highly pathogenic avian influenza (HPAI) A/H5N6 occurred on poultry farms in Gyeonggi Province in the Republic of Korea. A serosurvey was conducted among poultry farmers to identify the transmission of HPAI A/H5N6 virus to humans. MethodsA descriptive study of 870 poultry farmers in Gyeonggi Province in Korea was conducted during the 2016–2017 outbreaks. Serological testing was performed using a microneutralization (MN) assay for antibodies against influenza A/duck/ES2/Korea/2016 virus, which has antigenic properties similar to those of the HPAI A/H5N6 virus that caused this poultry outbreak. ResultsOverall, 523 exposed poultry farmers were assessed by serological testing. Consequently, all tested negative for HPAI A/H5N6 virus via MN assay. ConclusionsBased on serological assays, no transmission of HPAI A/H5N6 to humans was identified in this study cohort. Additional studies should be conducted to determine the possibility of poultry-to-human transmission of HPAI A/H5N6.

Knowledge and Perceptions of Highly Pathogenic Avian Influenza (HPAI) among Poultry Traders in Live Bird Markets in Bali and Lombok, Indonesia.

Highly Pathogenic Avian Influenza (HPAI) has been prevalent in Indonesia since 2003 causing major losses to poultry production and human deaths. Live bird markets are considered high risk areas due to the density of large numbers of mixed poultry species of unknown disease status. Understanding trader knowledge and perceptions of HPAI and biosecurity is critical to reducing transmission risk and controlling the disease. An interview-administered survey was conducted at 17 live bird markets on the islands of Bali and Lombok in 2008 and 2009. A total of 413 live poultry traders were interviewed. Respondents were mostly male (89%) with a mean age of 45 years (range: 19–81). The main source of AI information was TV (78%), although personal communication was also identified to be an important source, particularly among female traders (60%) and respondents from Bali (43%). More than half (58%) of live poultry traders interviewed knew that infected birds can transmit HPAI viruses but were generally unaware that viruses can be introduced to markets by fomites. Cleaning cages and disposing of sick and dead birds were recognized as the most important steps to prevent the spread of disease by respondents. Two thirds (n = 277) of respondents were unwilling to report sudden or suspicious bird deaths to authorities. Bali vendors perceive biosecurity to be of higher importance than Lombok vendors and are more willing to improve biosecurity within markets than traders in Lombok. Collectors and traders selling large numbers (>214) of poultry, or selling both chickens and ducks, have better knowledge of HPAI transmission and prevention than vendors or traders selling smaller quantities or only one species of poultry. Education was strongly associated with better knowledge but did not influence positive reporting behavior. Our study reveals that most live poultry traders have limited knowledge of HPAI transmission and prevention and are generally reluctant to report bird deaths. Greater efforts are needed to engage local government, market managers and traders in education and awareness programs, regulatory measures and incentive mechanisms. Understanding and evaluating the social responses to such an integrated approach could lead to more effective HPAI prevention and control.

Intercontinental genetic structure and gene flow in Dunlin (Calidris alpina), a potential vector of avian influenza.

Waterfowl (Anseriformes) and shorebirds (Charadriiformes) are the most common wild vectors of influenza A viruses. Due to their migratory behavior, some may transmit disease over long distances. Migratory connectivity studies can link breeding and nonbreeding grounds while illustrating potential interactions among populations that may spread diseases. We investigated Dunlin (Calidris alpina), a shorebird with a subspecies (C. a. arcticola) that migrates from nonbreeding areas endemic to avian influenza in eastern Asia to breeding grounds in northern Alaska. Using microsatellites and mitochondrial DNA, we illustrate genetic structure among six subspecies: C. a. arcticola,C. a. pacifica,C. a. hudsonia,C. a. sakhalina,C. a. kistchinski, and C. a. actites. We demonstrate that mitochondrial DNA can help distinguish C. a. arcticola on the Asian nonbreeding grounds with >70% accuracy depending on their relative abundance, indicating that genetics can help determine whether C. a. arcticola occurs where they may be exposed to highly pathogenic avian influenza (HPAI) during outbreaks. Our data reveal asymmetric intercontinental gene flow, with some C. a. arcticola short-stopping migration to breed with C. a. pacifica in western Alaska. Because C. a. pacifica migrates along the Pacific Coast of North America, interactions between these subspecies and other taxa provide route for transmission of HPAI into other parts of North America.

Implications of within-farm transmission for network dynamics: Consequences for the spread of avian influenza

The importance of considering coupled interactions across multiple population scales has not previously been studied for highly pathogenic avian influenza (HPAI) in the British commercial poultry industry. By simulating the within-flock transmission of HPAI using a deterministic S-E-I-R model, and by incorporating an additional environmental class representing infectious faeces, we tracked the build-up of infectious faeces within a poultry house over time. A measure of the transmission risk (TR) was computed for each farm by linking the amount of infectious faeces present each day of an outbreak with data describing the daily on-farm visit schedules for a major British catching company. Larger flocks tended to have greater levels of these catching-team visits. However, where density-dependent contact was assumed, faster outbreak detection (according to an assumed mortality threshold) led to a decreased opportunity for catching-team visits to coincide with an outbreak. For this reason, maximum TR-levels were found for mid-range flock sizes (~25,000–35,000 birds). When assessing all factors simultaneously using multivariable linear regression on the simulated outputs, those related to the pattern of catching-team visits had the largest effect on TR, with the most important movement-related factor depending on the mode of transmission. Using social network analysis on a further database to inform a measure of between-farm connectivity, we identified a large fraction of farms (28%) that had both a high TR and a high potential impact at the between farm level. Our results have counter-intuitive implications for between-farm spread that could not be predicted based on flock size alone, and together with further knowledge of the relative importance of transmission risk and impact, could have implications for improved targeting of control measures.

Controlling Highly Pathogenic Avian Influenza, Bangladesh

Controlling Highly Pathogenic Avian Influenza, Bangladesh