title: Risk signals of an influenza pandemic caused by highly pathogenic avian influenza subtype H5N1: spatio-temporal perspectives.
abstract: Highly pathogenic avian influenza (HPAI) subtype H5N1 is a trans-boundary animal disease that has crossed the animal-human species barrier and over the past decade has had a considerable impact on the poultry industry, wild bird populations and on human health. Understanding the spatio-temporal patterns of H5N1 outbreaks can provide visual clues to the dynamics of disease spread and of areas at risk, and thus improve the cost-effectiveness of disease control and prevention. This study describes the characteristics and investigates the temporal, spatial and space-time dynamics of H5N1 outbreaks in domestic poultry between December 2003 and December 2009 using a global database. The study found that the start date of the epidemic wave was postponed, the duration of the epidemic was prolonged and its magnitude reduced over time, but the disease transmission cycle was not efficiently interrupted. Two 'hot-spot' regions of H5N1 outbreaks were identified: well-documented locations in East and Southeast Asia, as well as a novel location at the boundaries of Europe and Africa, where enhanced surveillance should be conducted. The risk of a pandemic due to H5N1 remains high.
authors.affiliation: Department of Epidemiology, School of Public Health, Fudan University Key Laboratory of Public Health Safety, Ministry of Education, Shanghai 200032, People's Republic of China. epistat@gmail.com
authors.forename: Zhijie
authors.initials: Z
authors.lastname: Zhang
authors.forename: Dongmei
authors.initials: D
authors.lastname: Chen
authors.forename: Yue
authors.initials: Y
authors.lastname: Chen
authors.forename: Tilman M
authors.initials: TM
authors.lastname: Davies
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Vaillancourt
authors.forename: Wenbao
authors.initials: W
authors.lastname: Liu
mesh_terms: D000818:Animals; D014943:Global Health; D053124:Influenza A Virus, H5N1 Subtype; D005585:Influenza in Birds / Q000453:epidemiology* / Q000821:virology; D058873:Pandemics / Q000662:veterinary*; D011200:Poultry; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors