Spatial Variation in Risk for Highly Pathogenic Avian Influenza Subtype H5N6 Viral Infections in South Korea: Poultry Population-Based Case-Control Study.

Given the substantial economic damage caused by the continual circulation of highly pathogenic avian influenza (HPAI) outbreaks since 2003, identifying high-risk locations associated with HPAI infections is essential. In this study, using affected and unaffected poultry farms' locations during an HPAI H5N6 epidemic in South Korea, we identified places where clusters of HPAI cases were found. Hotspots were defined as regions having clusters of HPAI cases. With the help of the statistical computer program R, a kernel density estimate and a spatial scan statistic were employed for this purpose. A kernel density estimate and detection of significant clusters through a spatial scan statistic both showed that districts in the Chungcheongbuk-do, Jeollabuk-do, and Jeollanam-do provinces are more vulnerable to HPAI outbreaks. Prior to the migration season, high-risk districts should implement particular biosecurity measures. High biosecurity measures, as well as improving the cleanliness of the poultry environment, would undoubtedly aid in the prevention of HPAIV transmission to poultry farms in these high-risk regions of South Korea.