Elsobky Yumna, Eltholth Mahmoud, Abdalla Ehsan, Eissa Nourhan, Hadad Ghada, Nayel Mohamed, Salama Akram, Mousa Walid, Kamal Ahmed, Abu-Seida Ashraf M, Gaidan Osama K, Elkamshishi Mohamed
Department of Animal Hygiene and Zoonosis, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt.
Department of Health Studies, University of London, Egham, UK.
Open Vet J. 2024 Nov;14(11):2911-2923. doi: 10.5455/OVJ.2024.v14.i11.20. Epub 2024 Nov 30.
Highly pathogenic avian influenza (HPAI) (H5N1) has been endemic in Egypt for almost two decades, profoundly impacting both the poultry industry and public health. Egypt stands as a prominent epicenter for HPAI H5N1 outbreaks in Africa, marked by the highest number of positive human cases. Despite continuous governmental efforts, prior research underscored the inadequacy of strategies in controlling the virus spread.
This study identified spatiotemporal patterns and high-risk clusters of HPAI H5N1 outbreaks at the subdistrict level.
This study involved trial tracking of HPAI H5N1 endemicity dynamics, enabling tailored interventions at a regional level based on robust epidemiological investigations to address the persistent challenge of HPAI H5N1 in Egypt. This study illuminated spatiotemporal outbreak dynamics, with specific attention on Menofia governorate.
Despite the region's early poultry impacts, initial outbreaks did not originate from Menofia in studied epidemic waves (EWs). Outbreak risk spatial distribution displayed an escalating pattern at the northern border, followed by risk reduction through the sixth EW. The predominant hot spot region was localized within rural districts, particularly villages, while urbanization coincided with lower outbreak density. Observed smoothed densities revealed epidemic propagation within urban centers, preceding its transition to new areas and establishing direct connections with neighboring cities. Primary cluster prognostication was plausible, occurring in regions previously hosting elevated relative risk clusters during preceding EWs. Identification of enduring pinpoint clusters, persistent for extended durations, indicated close contact dynamics and localized viral circulation within populations.
This study highlights the significance of customized regional interventions based on the rigorous epidemiological framework. This approach is pivotal in the profound comprehension of endemicity dynamics, efficiently limits geographical infection spread, and contains outbreaks within delineated areas.
高致病性禽流感（HPAI）（H5N1）在埃及流行近二十年，对家禽业和公共卫生都产生了深远影响。埃及是非洲HPAI H5N1疫情的一个主要中心，人类确诊病例数量最多。尽管政府不断努力，但先前的研究强调了控制病毒传播策略的不足。
本研究确定了分区层面HPAI H5N1疫情的时空模式和高风险聚集区。
本研究对HPAI H5N1的流行动态进行了追踪试验，以便在强有力的流行病学调查基础上在区域层面进行有针对性的干预，以应对埃及HPAI H5N1的持续挑战。本研究阐明了疫情的时空动态，特别关注米努夫省。
尽管该地区家禽业较早受到影响，但在研究的疫情波中，最初的疫情并非起源于米努夫。疫情风险的空间分布在北部边境呈现上升模式，随后在第六个疫情波中风险降低。主要热点地区集中在农村地区，特别是村庄，而城市化进程伴随着较低的疫情密度。观察到的平滑密度显示，疫情在城市中心传播，然后蔓延到新的地区，并与邻近城市建立直接联系。初步聚类预测是合理的，发生在之前疫情波中相对风险较高的地区。识别出持续时间较长的精确聚类，表明人群中存在密切接触动态和局部病毒传播。
本研究强调了基于严格流行病学框架的定制区域干预措施的重要性。这种方法对于深刻理解流行动态至关重要，能有效限制地理感染传播，并将疫情控制在划定区域内。
