Investigation into a Superspreading Event of the German 2020-2021 Avian Influenza Epidemic.

Between November 2020 and May 2021, Germany faced the largest highly pathogenic avian influenza (HPAI) epidemic recorded so far with 245 outbreaks in poultry and captive birds and more than 1000 diagnosed cases in wild birds. In March 2021, an HPAI outbreak of subtype H5N8 was confirmed in a holding rearing laying hens for sales. Disease introduction probably occurred via indirect contact with infected wild birds. Since the index farm sold chicken to customers including many smallholders, partly in travel trade, the primary outbreak triggered 105 known secondary outbreaks in five German federal states. An outbreak investigation was carried out with links between the involved farms retrieved from the German Animal Disease Notification System used for network analysis. In some cases, links were confirmed through sequence-based molecular analysis. Special emphasis was put on the estimation of the flock incubation period as a prerequisite of sound contact tracing. The unique circumstances of an outbreak farm with frequent direct trade contacts prior to disease suspicion enabled an assessment of the flock incubation period based on the consequences of contacts, further supported by molecular analysis and modeling of disease spread. In this case, the flock incubation period was at least 14 days.