Evaluation of interventions and vaccination strategies for low pathogenicity avian influenza: spatial and space-time analyses and quantification of the spread of infection.

In recent years the control of low pathogenicity avian influenza (LPAI) viruses of the H5 and H7 subtypes has increasingly become a concern. We evaluated the measures (stamping out, controlled marketing, emergency and preventive vaccination, farm density reduction and restocking in homogenous areas) implemented to control the LPAI epidemics that occurred in Italy between 2000 and 2005, using a combination of spatial and space-time analyses and estimates of the basic reproduction ratio (R0). Clustering of infected farms decreased over the years, indicating the effectiveness of the control strategies implemented. Controlled marketing [relative risk (RR) 0.46, 95% confidence interval (CI) 0.27-0.80], emergency (RR 0.47, 95% CI 0.39-0.57) and preventive vaccination (RR 0.19, 95% CI 0.09-0.41) were the most effective measures, yet R0<1 was only for preventive vaccination. Our results are useful for identifying the most effective measures for reducing the risk of the spread of LPAI and optimizing the allocation of resources.