Geostatistical visualisation and spatial statistics for evaluation of the dispersion of epidemic highly pathogenic avian influenza subtype H5N1.

The aim of this study was to evaluate a range of statistical and geostatistical methods for their usefulness in providing insights into how highly pathogenic avian influenza (HPAI) subtype H5N1 might spread through a national population of village poultry. The insights gained allow the generation of disease dispersion hypotheses. The case study data set consisted of 161 outbreaks of HPAI subtype H5N1 in village poultry reported in Romania between October 2005 and June 2006. Reports of village outbreaks (%) occurred in three waves: October-December (14%), February-March (16%), and May-June (68%). Risk mapping - based on variography and kriging - was used to visualize the evolution of the epidemic. Outbreaks first appeared in eastern and southern Romania, particularly within an area that forms part of the Danube River Delta. The largest phase of the epidemic affected villages in all parts of central, southern, and eastern Romania, but outbreaks were clustered in central Romania. Outbreaks spread in an east to west direction. By using geostatistical visualisation and spatial statistics, the evolution of the epidemic could be characterised into two parts: disease introduction, local spread, and sporadic outbreaks, and long-distance disease spread with rapid epidemic propagation. This is consistent with the hypothesis that the environment and landscape (specifically the Danube River Delta) played a critical role in the introduction and initial spread of HPAI subtype H5N1 during the autumn and winter of 2005, and that the movement of poultry might have introduced the infection into central Romania during the spring and summer of 2006. Further research focusing on the spatio-temporal interface between the two parts of the epidemic might reveal how and why it progressed from a confined, local epidemic to a large, national epidemic. Such information would assist efforts to limit the global spread of HPAI subtype H5N1.