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. 2013 Apr;19(4):581-8.
doi: 10.3201/eid1904.120903.

Predicting hotspots for influenza virus reassortment

Trevon L Fuller  1 , Marius Gilbert, Vincent Martin, Julien Cappelle, Parviez Hosseini, Kevin Y Njabo, Soad Abdel Aziz, Xiangming Xiao, Peter Daszak, Thomas B Smith
Affiliations

Predicting hotspots for influenza virus reassortment

Trevon L Fuller et al. Emerg Infect Dis. 2013 Apr.

Abstract

The 1957 and 1968 influenza pandemics, each of which killed ≈1 million persons, arose through reassortment events. Influenza virus in humans and domestic animals could reassort and cause another pandemic. To identify geographic areas where agricultural production systems are conducive to reassortment, we fitted multivariate regression models to surveillance data on influenza A virus subtype H5N1 among poultry in China and Egypt and subtype H3N2 among humans. We then applied the models across Asia and Egypt to predict where subtype H3N2 from humans and subtype H5N1 from birds overlap; this overlap serves as a proxy for co-infection and in vivo reassortment. For Asia, we refined the prioritization by identifying areas that also have high swine density. Potential geographic foci of reassortment include the northern plains of India, coastal and central provinces of China, the western Korean Peninsula and southwestern Japan in Asia, and the Nile Delta in Egypt.

Keywords: avian influenza; influenza; influenza A virus H3N2 subtype; influenza A virus H5N1 subtype; influenza in birds; reassortant viruses; viruses; zoonoses.

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Figures

Figure 1
Figure 1
Potential influenza reassortment areas in Egypt. Districts in red are predicted to have an above average number of cases of influenza subtype H5N1 virus in poultry and an above average human population density, which is a proxy for subtype H3N2 virus infections.
Figure 2
Figure 2
Influenza empirical data and occurrence maps for influenza virus subtypes H3N2 and H5N1. A) Observed cases of subtypes H3N2 and H5N1 in People’s Republic of China, according to outbreaks reported to the Chinese Ministry of Agriculture. B) Spatial model of the probability of subtype H3N2 at the prefecture scale predicted by using logistic regression. C) Risk for subtype H5N1 according to the outbreak dataset. See Technical Appendix Figure 2, for the corresponding map for the surveillance dataset.
Figure 3
Figure 3
Potential influenza reassortment areas in People’s Republic of China determined by using the influenza virus subtype H5N1 outbreak dataset. A) Density of swine. B) Spatial model of the risk for subtype H3N2 and H5N1 co-occurrence according to the outbreak dataset. C) Areas with a probability of subtype H5N1 and H3N2 co-occurrence >50% and above average swine density. D) Areas with a probability of subtype H5N1 and H3N2 co-occurrence >50% and above average human population density. See Technical Appendix Figure 3, for corresponding maps based on the subtype H5N1 surveillance dataset.
Figure 4
Figure 4
Reassortment areas elsewhere in Asia based on the People’s Republic of China model constructed from the influenza virus subtype H5N1 outbreak dataset. A) Probability of subtype H3N2 and H5N1 co-occurrence (according to the subtype H5N1 outbreak dataset). B) Areas with a probability of subtype H5N1 and H3N2 co-occurrence >50% and above average swine density. C) Areas with a probability of subtype H5N1 and H3N2 co-occurrence >50% and above average human population density. See Technical Appendix Figure 4, for corresponding models based on the surveillance dataset.
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