Role of wild birds in the spread of highly pathogenic avian influenza virus H5N1 and implications for global surveillance.

This paper reviews outbreaks of Asian-lineage highly pathogenic avian influenza virus (HPAIV) H5N1 in wild birds since June 2006, surveillance strategies, and research on virus epidemiology in wild birds to summarize advances in understanding the role of wild birds in the spread of HPAIV H5N1 and the risk that infected wild birds pose for the poultry industry and for public health. Surveillance of apparently healthy wild birds ("active" surveillance) has not provided early warning of likely infection for the poultry industry, whereas searches for and reports of dead birds ("passive" surveillance) have provided evidence of environmental presence of the virus, but not necessarily its source. Most outbreaks in wild birds have occurred during periods when they are experiencing environmental, physiologic, and possibly psychological stress, including adverse winter weather and molt, but not, apparently, long-distance migration. Examination of carcasses of infected birds and experimental challenge with strains of HPAIV H5N1 have provided insight into the course of infection, the extent of virus shedding, and the relative importance of cloacal vs. oropharyngeal excretion. Satellite telemetry of migrating birds is now providing data on the routes taken by individual birds, their speed of migration, and the duration of stopovers. It is still not clear how virus shedding during the apparently clinically silent phase of infection relates to the distance travelled by infected birds. Mounting an immune response and undertaking strenuous exercise associated with long migratory flights may be competitive. This is an area where further research should be directed in order to discover whether wild birds infected with HPAIV H5N1 are able or willing to embark on migration.