Li Xin-Lou, Liu Kun, Yao Hong-Wu, Sun Ye, Chen Wan-Jun, Sun Ruo-Xi, de Vlas Sake J, Fang Li-Qun, Cao Wu-Chun
State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China.
Department of Public Health, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam 999025, The Netherlands.
Int J Environ Res Public Health. 2015 May 8;12(5):5026-45. doi: 10.3390/ijerph120505026.
Highly pathogenic avian influenza (HPAI) H5N1 has posed a significant threat to both humans and birds, and it has spanned large geographic areas and various ecological systems throughout Asia, Europe and Africa, but especially in mainland China. Great efforts in control and prevention of the disease, including universal vaccination campaigns in poultry and active serological and virological surveillance, have been undertaken in mainland China since the beginning of 2006. In this study, we aim to characterize the spatial and temporal patterns of HPAI H5N1, and identify influencing factors favoring the occurrence of HPAI H5N1 outbreaks in poultry in mainland China. Our study shows that HPAI H5N1 outbreaks took place sporadically after vaccination campaigns in poultry, and mostly occurred in the cold season. The positive tests in routine virological surveillance of HPAI H5N1 virus in chicken, duck, goose as well as environmental samples were mapped to display the potential risk distribution of the virus. Southern China had a higher positive rate than northern China, and positive samples were mostly detected from chickens in the north, while the majority were from duck in the south, and a negative correlation with monthly vaccination rates in domestic poultry was found (R = -0.19, p value = 0.005). Multivariate panel logistic regression identified vaccination rate, interaction between distance to the nearest city and national highway, interaction between distance to the nearest lake and wetland, and density of human population, as well as the autoregressive term in space and time as independent risk factors in the occurrence of HPAI H5N1 outbreaks, based on which a predicted risk map of the disease was derived. Our findings could provide new understanding of the distribution and transmission of HPAI H5N1 in mainland China and could be used to inform targeted surveillance and control efforts in both human and poultry populations to reduce the risk of future infections.
高致病性禽流感（HPAI）H5N1对人类和禽类均构成了重大威胁，它已在亚洲、欧洲和非洲的广大地理区域及各种生态系统中传播，中国大陆地区尤为严重。自2006年初以来，中国大陆地区在疾病防控方面付出了巨大努力，包括在家禽中开展全面疫苗接种运动以及积极进行血清学和病毒学监测。在本研究中，我们旨在描述HPAI H5N1的时空模式，并确定有利于中国大陆地区家禽发生HPAI H5N1疫情的影响因素。我们的研究表明，在家禽接种疫苗后，HPAI H5N1疫情呈零星发生，且大多发生在寒冷季节。将鸡、鸭、鹅以及环境样本中HPAI H5N1病毒常规病毒学监测的阳性检测结果进行绘图，以展示该病毒的潜在风险分布。中国南方的阳性率高于北方，北方的阳性样本大多来自鸡，而南方的大多数阳性样本来自鸭，并且发现与家禽每月疫苗接种率呈负相关（R = -0.19，p值 = 0.005）。多变量面板逻辑回归确定疫苗接种率、到最近城市和国家公路距离的交互作用、到最近湖泊和湿地距离的交互作用、人口密度以及时空自回归项是HPAI H5N1疫情发生的独立风险因素，并据此得出了该疾病的预测风险图。我们的研究结果可为深入了解HPAI H5N1在中国大陆地区的分布和传播提供新认识，并可用于指导针对人类和家禽群体的有针对性监测和防控工作，以降低未来感染风险。
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