Mortality-Based Triggers and Premovement Testing Protocols for Detection of Highly Pathogenic Avian Influenza Virus Infection in Commercial Upland Game Birds.

Outbreaks involving avian influenza viruses are often devastating to the poultry industry economically and otherwise. Disease surveillance is critically important because it facilitates timely detection and generates confidence that infected birds are not moved during business continuity intended to mitigate associated economic losses. The possibility of using an abnormal increase in daily mortality to levels that exceed predetermined thresholds as a trigger to initiate further diagnostic investigations for highly pathogenic avian influenza (HPAI) virus infection in the flock is explored. The range of optimal mortality thresholds varies by bird species, trigger type, and mortality thresholds, and these should be considered when assessing sector-specific triggers. The study uses purposefully collected data and data from the literature to determine optimal mortality triggers for HPAI detection in commercial upland game bird flocks. Three trigger types were assessed for the ability to detect rapidly both HPAI (on the basis of disease-induced and normal mortality data) and false alarm rate (on the basis of normal mortality data); namely, 1) exceeding a set absolute threshold on one day, 2) exceeding a set absolute threshold on two consecutive days, or 3) exceeding a multiple of a seven-day moving average. The likelihood of disease detection using some of these triggers together with premovement real-time reverse transcription PCR (rRT-PCR) testing was examined. Results indicate that the performance of the two consecutive days trigger had the best metrics (i.e., rapid detection with few false alarms) in the trade-off analysis. The collected normal mortality data was zero on 66% of all days recorded, with an overall mean of 0.6 dead birds per day. In the surveillance scenario analyses, combining the default protocol that relied only on active surveillance (i.e., premovement testing of oropharyngeal swab samples from dead birds by rRT-PCR) together with either of the mortality-based triggers improved detection rates on all days postexposure before scheduled movement. For exposures occurring within 8 days of movement, the protocol that combined the default with single-day triggers had slightly more detections than that with two consecutive days triggers. However, all assessed protocol combinations were able to detect all infections that occurred more than 10 days before scheduled movement. These findings can inform risk-based decisions pertaining to continuity of business in the commercial upland game bird industry.