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Evaluation of strategies using simulation model to control a potential outbreak of highly pathogenic avian influenza among poultry farms in Central Luzon, Philippines. PLoS One 2020; 15:e0238815. [PMID: 32913363 PMCID: PMC7482972 DOI: 10.1371/journal.pone.0238815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/23/2020] [Indexed: 12/18/2022] Open
Abstract
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.
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Identification of High-Risk Areas for the Spread of Highly Pathogenic Avian Influenza in Central Luzon, Philippines. Vet Sci 2020; 7:vetsci7030107. [PMID: 32784444 PMCID: PMC7558439 DOI: 10.3390/vetsci7030107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 11/17/2022] Open
Abstract
Highly pathogenic avian influenza virus (HPAIV) is a major problem in the poultry industry. It is highly contagious and is associated with a high mortality rate. The Philippines experienced an outbreak of avian influenza (AI) in 2017. As there is always a risk of re-emergence, efforts to manage disease outbreaks should be optimal. Linked to this is the need for an effective surveillance procedure to capture disease outbreaks at their early stage. Risk-based surveillance is the most effective and economical approach to outbreak management. This study evaluated the potential of commercial poultry farms in Central Luzon to transmit HPAI by calculating their respective reproductive ratios (R0). The reproductive number for each farm is based on the spatial kernel and the infectious period. A risk map has been created based on the calculated R0. There were 882 (76.63%) farms with R0 < 1. Farms with R0 ≥ 1 were all located in Pampanga Province. These farms were concentrated in the towns of San Luis (n = 12) and Candaba (n = 257). This study demonstrates the utility of mapping farm-level R0 estimates for informing HPAI risk management activities.
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Hautefeuille C, Dauphin G, Peyre M. Knowledge and remaining gaps on the role of animal and human movements in the poultry production and trade networks in the global spread of avian influenza viruses - A scoping review. PLoS One 2020; 15:e0230567. [PMID: 32196515 PMCID: PMC7083317 DOI: 10.1371/journal.pone.0230567] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 03/03/2020] [Indexed: 12/28/2022] Open
Abstract
Poultry production has significantly increased worldwide, along with the number of avian influenza (AI) outbreaks and the potential threat for human pandemic emergence. The role of wild bird movements in this global spread has been extensively studied while the role of animal, human and fomite movement within commercial poultry production and trade networks remains poorly understood. The aim of this work is to better understand these roles in relation to the different routes of AI spread. A scoping literature review was conducted according to the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) using a search algorithm combining twelve domains linked to AI spread and animal/human movements within poultry production and trade networks. Only 28 out of 3,978 articles retrieved dealt especially with the role of animal, human and fomite movements in AI spread within the international trade network (4 articles), the national trade network (8 articles) and the production network (16 articles). While the role of animal movements in AI spread within national trade networks has been largely identified, human and fomite movements have been considered more at risk for AI spread within national production networks. However, the role of these movements has never been demonstrated with field data, and production networks have only been partially studied and never at international level. The complexity of poultry production networks and the limited access to production and trade data are important barriers to this knowledge. There is a need to study the role of animal and human movements within poultry production and trade networks in the global spread of AI in partnership with both public and private actors to fill this gap.
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Affiliation(s)
- Claire Hautefeuille
- CIRAD, UMR ASTRE, Montpellier, France
- ASTRE, CIRAD, INRA, University of Montpellier, Montpellier, France
- CEVA Santé Animale, Libourne, France
| | | | - Marisa Peyre
- CIRAD, UMR ASTRE, Montpellier, France
- ASTRE, CIRAD, INRA, University of Montpellier, Montpellier, France
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Scott AB, Toribio JALML, Singh M, Groves P, Barnes B, Glass K, Moloney B, Black A, Hernandez-Jover M. Low- and High-Pathogenic Avian Influenza H5 and H7 Spread Risk Assessment Within and Between Australian Commercial Chicken Farms. Front Vet Sci 2018; 5:63. [PMID: 29686993 PMCID: PMC5900437 DOI: 10.3389/fvets.2018.00063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/14/2018] [Indexed: 11/13/2022] Open
Abstract
This study quantified and compared the probability of avian influenza (AI) spread within and between Australian commercial chicken farms via specified spread pathways using scenario tree mathematical modeling. Input values for the models were sourced from scientific literature, expert opinion, and a farm survey conducted during 2015 and 2016 on Australian commercial chicken farms located in New South Wales (NSW) and Queensland. Outputs from the models indicate that the probability of no establishment of infection in a shed is the most likely end-point after exposure and infection of low-pathogenic avian influenza (LPAI) in one chicken for all farm types (non-free range meat chicken, free range meat chicken, cage layer, barn layer, and free range layer farms). If LPAI infection is established in a shed, LPAI is more likely to spread to other sheds and beyond the index farm due to a relatively low probability of detection and reporting during LPAI infection compared to high-pathogenic avian influenza (HPAI) infection. Among farm types, the median probability for HPAI spread between sheds and between farms is higher for layer farms (0.0019, 0.0016, and 0.0031 for cage, barn, and free range layer, respectively) than meat chicken farms (0.00025 and 0.00043 for barn and free range meat chicken, respectively) due to a higher probability of mutation in layer birds, which relates to their longer production cycle. The pathway of LPAI spread between sheds with the highest average median probability was spread via equipment (0.015; 5-95%, 0.0058-0.036) and for HPAI spread between farms, the pathway with the highest average median probability was spread via egg trays (3.70 × 10-5; 5-95%, 1.47 × 10-6-0.00034). As the spread model did not explicitly consider volume and frequency of the spread pathways, these results provide a comparison of spread probabilities per pathway. These findings highlight the importance of performing biosecurity practices to limit spread of the AI virus. The models can be updated as new information on the mechanisms of the AI virus and on the volume and frequency of movements shed-to-shed and of movements between commercial chicken farms becomes available.
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Affiliation(s)
- Angela Bullanday Scott
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Jenny-Ann L M L Toribio
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Mini Singh
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Peter Groves
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Belinda Barnes
- Quantitative Sciences, Department of Agriculture and Water Resources, Canberra, ACT, Australia
| | - Kathryn Glass
- College of Medicine, Biology and Environment, Australian National University, Canberra, ACT, Australia
| | - Barbara Moloney
- New South Wales Department of Primary Industries, Orange, NSW, Australia
| | - Amanda Black
- New South Wales Department of Primary Industries, Orange, NSW, Australia
| | - Marta Hernandez-Jover
- Graham Centre for Agricultural Innovation, School of Animal and Veterinary Sciences, Charles Sturt University and New South Wales Department of Primary Industries, Wagga Wagga, NSW, Australia.,School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia
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Pepin KM, Spackman E, Brown JD, Pabilonia KL, Garber LP, Weaver JT, Kennedy DA, Patyk KA, Huyvaert KP, Miller RS, Franklin AB, Pedersen K, Bogich TL, Rohani P, Shriner SA, Webb CT, Riley S. Using quantitative disease dynamics as a tool for guiding response to avian influenza in poultry in the United States of America. Prev Vet Med 2013; 113:376-97. [PMID: 24462191 PMCID: PMC3945821 DOI: 10.1016/j.prevetmed.2013.11.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 11/22/2013] [Accepted: 11/24/2013] [Indexed: 02/02/2023]
Abstract
Wild birds are the primary source of genetic diversity for influenza A viruses that eventually emerge in poultry and humans. Much progress has been made in the descriptive ecology of avian influenza viruses (AIVs), but contributions are less evident from quantitative studies (e.g., those including disease dynamic models). Transmission between host species, individuals and flocks has not been measured with sufficient accuracy to allow robust quantitative evaluation of alternate control protocols. We focused on the United States of America (USA) as a case study for determining the state of our quantitative knowledge of potential AIV emergence processes from wild hosts to poultry. We identified priorities for quantitative research that would build on existing tools for responding to AIV in poultry and concluded that the following knowledge gaps can be addressed with current empirical data: (1) quantification of the spatio-temporal relationships between AIV prevalence in wild hosts and poultry populations, (2) understanding how the structure of different poultry sectors impacts within-flock transmission, (3) determining mechanisms and rates of between-farm spread, and (4) validating current policy-decision tools with data. The modeling studies we recommend will improve our mechanistic understanding of potential AIV transmission patterns in USA poultry, leading to improved measures of accuracy and reduced uncertainty when evaluating alternative control strategies.
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Affiliation(s)
- K M Pepin
- Department of Biology, Colorado State University, Fort Collins, CO, USA; Fogarty International Center, National Institute of Health, Bethesda, MD, USA.
| | - E Spackman
- Southeast Poultry Research Laboratory, Agricultural Research Service, United States Department of Agriculture, Athens, GA, USA.
| | - J D Brown
- Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
| | - K L Pabilonia
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
| | - L P Garber
- Centers for Epidemiology and Animal Health, Veterinary Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - J T Weaver
- Centers for Epidemiology and Animal Health, Veterinary Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - D A Kennedy
- Fogarty International Center, National Institute of Health, Bethesda, MD, USA; Center for Infectious Disease Dynamics, Department of Biology, Pennsylvania State University, State College, PA, USA.
| | - K A Patyk
- Centers for Epidemiology and Animal Health, Veterinary Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - K P Huyvaert
- Warner College of Natural Resources, Colorado State University, Fort Collins, CO, USA.
| | - R S Miller
- Centers for Epidemiology and Animal Health, Veterinary Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - A B Franklin
- National Wildlife Research Center, Wildlife Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - K Pedersen
- National Wildlife Research Center, Wildlife Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - T L Bogich
- Fogarty International Center, National Institute of Health, Bethesda, MD, USA; Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.
| | - P Rohani
- Fogarty International Center, National Institute of Health, Bethesda, MD, USA; Department of Ecology and Evolutionary Biology, Center for the Study of Complex Systems, University of Michigan, Ann Arbor, MI, USA.
| | - S A Shriner
- National Wildlife Research Center, Wildlife Services, Animal and Plant Health Inspection Service, United States Department of Agriculture, Fort Collins, CO, USA.
| | - C T Webb
- Department of Biology, Colorado State University, Fort Collins, CO, USA; Fogarty International Center, National Institute of Health, Bethesda, MD, USA.
| | - S Riley
- Fogarty International Center, National Institute of Health, Bethesda, MD, USA; MRC Centre for Outbreak Analysis and Disease Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, Norfolk Place, London, UK.
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Dórea FC, McEwen BJ, McNab WB, Revie CW, Sanchez J. Syndromic surveillance using veterinary laboratory data: data pre-processing and algorithm performance evaluation. J R Soc Interface 2013; 10:20130114. [PMID: 23576782 DOI: 10.1098/rsif.2013.0114] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Diagnostic test orders to an animal laboratory were explored as a data source for monitoring trends in the incidence of clinical syndromes in cattle. Four years of real data and over 200 simulated outbreak signals were used to compare pre-processing methods that could remove temporal effects in the data, as well as temporal aberration detection algorithms that provided high sensitivity and specificity. Weekly differencing demonstrated solid performance in removing day-of-week effects, even in series with low daily counts. For aberration detection, the results indicated that no single algorithm showed performance superior to all others across the range of outbreak scenarios simulated. Exponentially weighted moving average charts and Holt-Winters exponential smoothing demonstrated complementary performance, with the latter offering an automated method to adjust to changes in the time series that will likely occur in the future. Shewhart charts provided lower sensitivity but earlier detection in some scenarios. Cumulative sum charts did not appear to add value to the system; however, the poor performance of this algorithm was attributed to characteristics of the data monitored. These findings indicate that automated monitoring aimed at early detection of temporal aberrations will likely be most effective when a range of algorithms are implemented in parallel.
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Affiliation(s)
- Fernanda C Dórea
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada.
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Nickbakhsh S, Matthews L, Dent JE, Innocent GT, Arnold ME, Reid SWJ, Kao RR. Implications of within-farm transmission for network dynamics: consequences for the spread of avian influenza. Epidemics 2013; 5:67-76. [PMID: 23746799 PMCID: PMC3694308 DOI: 10.1016/j.epidem.2013.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 02/21/2013] [Accepted: 03/04/2013] [Indexed: 11/06/2022] Open
Abstract
Cross-scale dynamics were investigated for avian influenza in British poultry. Transmission risk is dependent on the assumed within-flock transmission mode. Transmission risk may not scale with transmissibility or flock size. Transmission risk corresponds with between-farm impact for 28% of farms. These results have implications for targeted disease control at the farm-level.
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.
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Affiliation(s)
- Sema Nickbakhsh
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Bearsden Road, G61 1QH, Scotland, UK.
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Patyk KA, Helm J, Martin MK, Forde-Folle KN, Olea-Popelka FJ, Hokanson JE, Fingerlin T, Reeves A. An epidemiologic simulation model of the spread and control of highly pathogenic avian influenza (H5N1) among commercial and backyard poultry flocks in South Carolina, United States. Prev Vet Med 2013; 110:510-24. [PMID: 23398856 DOI: 10.1016/j.prevetmed.2013.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 01/10/2013] [Accepted: 01/12/2013] [Indexed: 10/27/2022]
Abstract
Epidemiologic simulation modeling of highly pathogenic avian influenza (HPAI) outbreaks provides a useful conceptual framework with which to estimate the consequences of HPAI outbreaks and to evaluate disease control strategies. The purposes of this study were to establish detailed and informed input parameters for an epidemiologic simulation model of the H5N1 strain of HPAI among commercial and backyard poultry in the state of South Carolina in the United States using a highly realistic representation of this poultry population; to estimate the consequences of an outbreak of HPAI in this population with a model constructed from these parameters; and to briefly evaluate the sensitivity of model outcomes to several parameters. Parameters describing disease state durations; disease transmission via direct contact, indirect contact, and local-area spread; and disease detection, surveillance, and control were established through consultation with subject matter experts, a review of the current literature, and the use of several computational tools. The stochastic model constructed from these parameters produced simulated outbreaks ranging from 2 to 111 days in duration (median 25 days), during which 1 to 514 flocks were infected (median 28 flocks). Model results were particularly sensitive to the rate of indirect contact that occurs among flocks. The baseline model established in this study can be used in the future to evaluate various control strategies, as a tool for emergency preparedness and response planning, and to assess the costs associated with disease control and the economic consequences of a disease outbreak.
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Affiliation(s)
- Kelly A Patyk
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Veterinary Services, Centers for Epidemiology and Animal Health, 2150 Centre Avenue, Building B, Fort Collins, CO 80526, USA.
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Malladi S, Weaver JT, Clouse TL, Bjork KE, Trampel DW. Moving-average trigger for early detection of rapidly increasing mortality in caged table-egg layers. Avian Dis 2012; 55:603-10. [PMID: 22312980 DOI: 10.1637/9636-122910-reg.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Rapidly increasing and unexplained mortality in commercial poultry flocks may signal the presence of a highly transmissible and reportable disease. Activation of an infectious-disease surveillance system occurs when a key production parameter, i.e., mortality, changes. Various triggers have been proposed to alert producers when mortality exceeds normal limits for a given production system to enable early detection of such diseases. In this article we demonstrate that a simple moving-average trigger is useful for detecting any disease syndrome in caged table-egg layer flocks that manifests itself as sudden, rapidly increasing mortality. We superimposed HPAI disease mortality output data derived from a disease transmission model and from a naturally occurring HPAI outbreak onto normal mortality data from 12 healthy commercial egg-layer flocks, and compared the performance of 7-day moving-average triggers to previously proposed triggers. The moving-average trigger is more efficient, resulting in fewer false-positive alerts and an earlier time to disease detection. It can be easily calculated by using a computer spreadsheet providing only 7 days of mortality data and can be practically and inexpensively implemented by large commercial poultry integrators. A moving-average trigger can be an active component of a production-based surveillance system.
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Affiliation(s)
- Sasidhar Malladi
- Center for Animal Health and Food Safety, University of Minnesota, 1354 Eckles Avenue, St. Paul, MN 55108, USA.
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Mathematical Models of Infectious Diseases in Livestock: Concepts and Application to the Spread of Highly Pathogenic Avian Influenza Virus Strain Type H5N1. HEALTH AND ANIMAL AGRICULTURE IN DEVELOPING COUNTRIES 2012. [PMCID: PMC7120485 DOI: 10.1007/978-1-4419-7077-0_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Smith G, Dunipace S. How backyard poultry flocks influence the effort required to curtail avian influenza epidemics in commercial poultry flocks. Epidemics 2011; 3:71-5. [PMID: 21624777 DOI: 10.1016/j.epidem.2011.01.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 01/20/2011] [Accepted: 01/31/2011] [Indexed: 11/17/2022] Open
Abstract
This paper summarizes the evidence that the contribution of backyard poultry flocks to the on-going transmission dynamics of an avian influenza epidemic in commercial flocks is modest at best. Nevertheless, while disease control strategies need not involve the backyard flocks, an analysis of the contribution of each element of the next generation matrix to the basic reproduction number indicates that models which ignores the contribution of backyard flocks in estimating the effort required of strategies focused one host type (e.g. commercial flocks only) necessarily underestimate the level of effort to an extent that may matter to policy makers.
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Affiliation(s)
- G Smith
- School of Veterinary Medicine, University of Pennsylvania, New Bolton Center, Kennett Square, PA 19348, USA.
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