H5N1, a highly pathogenic avian influenza (H5N1 HPAI), is an endemic disease
that is significant for public health in Egypt. Live bird markets (LBMs) are widespread
in Egypt and play an important role in HPAI disease dynamics. The aim of
the study was to evaluate the H5N1 HPAI prevalence in representative LBMs from
2009 to 2014, assess the effects of other variables and evaluate past outbreaks and
human cases. It was found that ducks and geese are high-risk species and that the
prevalence of H5N1 HPAI was higher immediately after the political crises of
2011. The end of a calendar year (June to December) was a high-risk period for
positive samples, and the risk in urban LBMs was twice the risk in rural LBMs.
Winter and political unrest was associated with higher H5N1 HPAI prevalence.
Both human and poultry populations will continue to rise in Egypt, so continued
poultry outbreaks are likely to be linked to more human cases. LBMs will continue
to play a role in the dynamics of poultry disease in Egypt, and there is a need
to reorganize markets in terms of biosecurity and traceability. It may also be beneficial
to reduce inter-governorate inter-regional movements associated with poultry
trade through promotion of regional trade or in the alternative provide
sanitary features along the poultry market chain to reduce the speed of H5N1
HPAI infections. Policy formulation, design and enforcement must be pro-poor,
and consideration of the sociocultural and economic realities in Egypt is important.
The LBMs provide ideal platforms to carry out sound surveillance plans and
mitigate zoonotic risks of H5N1 HPAI to humans.
Data S1. Multivariable analyses of factors analysed for highly pathogenic avian inﬂuenza H5N1 in livebird markets, Egypt.