Lessons from Nigeria: the role of roads in the geo-temporal progression of avian influenza (H5N1) virus.

The daily progression of the 2006 (January-June) Nigerian avian influenza (AI H5N1) epidemic was assessed in relation to both spatial variables and the generation interval of the invading virus. Proximity to the highway network appeared to promote epidemic dispersal: from the first AI generation interval onwards > 20% of all cases were located at < 5 km from the nearest major road. Fifty-seven per cent of all cases were located 31 km from three highway intersections. Findings suggest that the spatial features of emerging infections could be key in their control. When the spatial location of a transmission factor is well known, such as that of the highway network, and a substantial percentage of cases (e.g. > 20%) are near that factor, early interventions focusing on transmission factors, such as road blocks that prevent poultry trade, may be more efficacious than interventions applied only to the susceptible population.