An epidemiologic simulation model of the spread and control of highly pathogenic avian influenza (H5N1) among commercial and backyard poultry flocks in South Carolina, United States.

Epidemiologic simulation modeling of highly pathogenic avian influenza (HPAI) outbreaks provides a useful conceptual framework with which to estimate the consequences of HPAI outbreaks and to evaluate disease control strategies. The purposes of this study were to establish detailed and informed input parameters for an epidemiologic simulation model of the H5N1 strain of HPAI among commercial and backyard poultry in the state of South Carolina in the United States using a highly realistic representation of this poultry population; to estimate the consequences of an outbreak of HPAI in this population with a model constructed from these parameters; and to briefly evaluate the sensitivity of model outcomes to several parameters. Parameters describing disease state durations; disease transmission via direct contact, indirect contact, and local-area spread; and disease detection, surveillance, and control were established through consultation with subject matter experts, a review of the current literature, and the use of several computational tools. The stochastic model constructed from these parameters produced simulated outbreaks ranging from 2 to 111 days in duration (median 25 days), during which 1 to 514 flocks were infected (median 28 flocks). Model results were particularly sensitive to the rate of indirect contact that occurs among flocks. The baseline model established in this study can be used in the future to evaluate various control strategies, as a tool for emergency preparedness and response planning, and to assess the costs associated with disease control and the economic consequences of a disease outbreak.