Priority areas for surveillance and prevention of avian influenza during the water-bird migration season in Pakistan.

Avian influenza viruses may be introduced into domestic poultry through migratory wild birds, particularly from Pakistan, which is situated across the migratory Indus flyway and holds more than 225 wetlands. To answer the question which areas should be given priority in surveillance and prevention with respect to notifiable avian influenza during the migratory season, a subset of Asian waterbird census data was reviewed. The dataset contains 535 local sites and available counts of waterbirds reported from 1987 to 2007. However, as the majority of the sites are not counted regularly gaps in data matrix appeared. The coordinates of 270 known sites completely fitted the administrative boundaries of the country. These coordinates were geo-processed with polygons of water-bodies and a raster map of predicted poultry density. Pixels representing the estimated number of poultry per km2 were found within a 3 to 9 km range of the census sites (or water-bodies) in their proximity. The coordinates were also used to map the maximum reported counts of waterbirds and local clusters of under-sampled sites. A retrospective case-series analysis of previous outbreaks (2006-2008) of influenza A virus, subtype H5N1 was performed, which revealed that 64% of outbreaks, reported to Office International des Epizooties, the World Organization for Animal Health, occurred during the migratory period. This paper highlights the potential use and limitations of the Asian waterbirds census data in the context of avian influenza. The proposed methodology may be used to prioritize districts for surveillance and economize prevention measures provided better data are generated in future.