Unique duck rearing practice in irrigated rice paddy fields driving recurrent H5N1 avian influenza outbreaks in two districts of Kerala, India.

Highly pathogenic avian influenza (HPAI) outbreaks have repeatedly occurred in two districts of Kerala state, India, over the last few years. The outbreaks in the wetland areas coincided with the arrival of migratory birds. At the time, the factors responsible for local transmission in ducks were not known. This study aimed to identify the socio-economic factors responsible for spatial variation in the occurrence of HPAI outbreaks in the two districts using Bayesian network modelling (BNM) and Stochastic Partial Differential Equation (SPDE) model. Further, information was collected on the duck rearing practices in rice paddy fields to identify the risk factors for local - spread of the outbreaks. We found that the SPDE model without covariates explained variation in occurrence of outbreaks. The number of rice paddy fields used by the duck farmers was identified as risk factor. We concluded based on BNM and SPDE that the infected migratory birds were the source of infection for the first few duck farms in the wetland areas and subsequent transmission was driven by shifting of ducks from one rice paddy field to other fields. There is a probability of persistent and recurrent infections in the ducks and possible spill over to humans. Hence, it is important to have surveillance in ducks to prevent recurrent outbreaks in the region.