Highly pathogenic avian influenza (H5N1) in ducks and in-contact chickens in backyard and smallholder commercial duck farms in Viet Nam.

Scavenging ducks are thought to play an important role in the maintenance and transmission of highly pathogenic avian influenza (HPAI) H5N1 virus among domesticated and wild bird populations in South East Asia, but detailed field epidemiological results describing the infection status of domestic ducks and in-contact chickens have not been published. We conducted a longitudinal study, monitoring ducks and in-contact chickens in 80 flocks in the Mekong Delta of Viet Nam with bi-monthly testing from May 2007 until May 2008. Because H5 vaccination campaigns are conducted at regular intervals in poultry flocks in Viet Nam, both unvaccinated sentinel and H5 vaccinates were monitored. On each farm, a total of 10 birds were selected: 7 ducks (4 unvaccinated and 3 vaccinated) and 3 chickens (2 unvaccinated and 1 vaccinated) that were in close contact with the ducks. Blood samples were tested for H5 antibodies using the hemagglutination inhibition test, with H5 antibody titers ≥2(4) considered to indicate past exposure to H5 field or vaccine virus. Titers of vaccinated birds were analyzed for samples collected more than 3 weeks post-vaccination. Pooled oropharyngeal and cloacal swabs were assessed for H5 viral RNA using real-time PCR. Bird- and flock-level prevalences were estimated accounting for sampling fractions and clustering under the multi-stage sampling design with birds being sampled within flocks within villages in four different provinces. In total, serum and swab samples from 5409 birds-samplings were analyzed. Bird-level seroprevalence was 17.5% (95% CI: 14.1, 20.9) amongst unvaccinated ducks and 10.7% (95% CI: 7.4, 14.4) amongst unvaccinated in-contact chickens. Flock-level seroprevalence (proportion of flock-visits with at least one unvaccinated bird test positive) was 42.6% (95% CI: 38.0, 47.2) for ducks and 19.0% (95% CI: 13.6, 24.4) for chickens. Only 54.3% (95% CI: 39.2, 69.3) of vaccinated ducks and 55.5% (95% CI: 46.8, 64.2) of vaccinated in-contact chickens had H5 antibodies at more than 3 weeks post-vaccination. At about 40% and 48% of flock-visits, less than 50% of sampled vaccinated ducks and chickens, respectively, had positive titers. The flock-level virus prevalence (proportion of flocks with at least one bird positive for H5 virus of the vaccinated and unvaccinated birds tested) was 0.7% (95% CI: 0.0, 2.1). No HPAI outbreaks or mortality suspected to be due to HPAI occurred in study flocks during the observation period. Our results indicate that a substantial proportion of ducks and in-contact chickens were exposed to H5 virus during the study period. In the face of this widespread exposure to H5 virus, and despite only moderate proportions of birds developing positive titers post-vaccination, flocks were not affected by HPAI outbreaks during our study period. The higher bird-level seroprevalence in ducks compared to in-contact chickens may be due to greater durations of antibody persistence in ducks or greater rates of H5 virus exposure. These findings indicate that ducks are potentially an important source of H5 virus for other bird species.