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The Emergence and Decennary Distribution of Clade HPAI H5Nx
Open AccessArticle

Highly Pathogenic Avian Influenza A(H5N1) Outbreaks in West Java Indonesia 2015–2016: Clinical Manifestation and Associated Risk Factors

Department of Farm Animal Health, Faculty of Veterinary Medicine Utrecht University, 3584 CL Utrecht, The Netherlands
Centre for Diagnostic Standard of Indonesian Agricultural Quarantine Agency, Ministry of Agriculture, Jakarta 13220, Indonesia
Center for Tropical Animal Studies, Institute of Research and Community Empowerment, Bogor Agricultural University, Bogor 16129, Indonesia
ProLab Diagnostic Laboratory, PT. Sierad Produce, Tbk, Bogor 16340, Indonesia
Livestock and Animal Health Agency of District Subang, Subang 41214, Indonesia
West Java Province Animal Health Agency, Bandung 40135, Indonesia
Eijkman Institute for Molecular Biology, Jakarta 10430, Indonesia
Wageningen Bioveterinary Research, 8221 RA Lelystad, The Netherlands
Author to whom correspondence should be addressed.
Microorganisms 2019, 7(9), 327;
Received: 4 June 2019 / Revised: 20 August 2019 / Accepted: 5 September 2019 / Published: 6 September 2019
(This article belongs to the Special Issue Recent Advances in Avian Influenza Virus Research)
Knowledge of outbreaks and associated risk factors is helpful to improve control of the Highly Pathogenic Avian Influenza A(H5N1) virus (HPAI) in Indonesia. This study was conducted to detect outbreaks of HPAI H5N1 in endemically infected regions by enhanced passive surveillance, to describe the clinical manifestation of these outbreaks and identify associated risk factors. From November 2015 to November 2016, HPAI outbreak investigations were conducted in seven districts of West Java. In total 64 outbreaks were confirmed out of 75 reported suspicions and outbreak characteristics were recorded. The highest mortality was reported in backyard chickens (average 59%, CI95%: 49–69%). Dermal apoptosis and lesions (64%, CI95%: 52–76%) and respiratory signs (39%, CI95%: 27–51%) were the clinical signs observed overall most frequently, while neurological signs were most frequently observed in ducks (68%, CI95%: 47–90%). In comparison with 60 non-infected control farms, the rate of visitor contacts onto a farm was associated with the odds of HPAI infection. Moreover, duck farms had higher odds of being infected than backyard farms, and larger farms had lower odds than small farms. Results indicate that better external biosecurity is needed to reduce transmission of HPAI A(H5N1) in Indonesia. View Full-Text
Keywords: HPAI (H5N1); risk factors; West Java; outbreak investigation; case-control HPAI (H5N1); risk factors; West Java; outbreak investigation; case-control
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Karo-karo, D.; Diyantoro; Pribadi, E.S.; Sudirman, F.X.; Kurniasih, S.W.; Sukirman; Indasari, I.; Muljono, D.H.; Koch, G.; Stegeman, J.A. Highly Pathogenic Avian Influenza A(H5N1) Outbreaks in West Java Indonesia 2015–2016: Clinical Manifestation and Associated Risk Factors. Microorganisms 2019, 7, 327.

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