Assessing the Use of Different Surveillance Components to Detect Highly Pathogenic Avian Influenza Outbreaks in Poultry in the Netherlands in Low- and High-Risk Years.

Avian influenza (AI) is a highly contagious zoonotic disease primarily affecting birds with clinical manifestation depending on bird species and virus subtype. Globally, outbreaks have had a large socioeconomic impact. Moreover, highly pathogenic AI virus (HPAIv) outbreaks can pose a public health risk. Detection of AIv, particularly HPAIv, mainly relies on passive surveillance, risking underreporting and delayed detection. This study describes and compares the contribution of passive and active surveillance components on HPAI detection in poultry flocks in years with different HPAIv introduction risk (free, seasonal outbreaks, and year round) in the Netherlands. We drafted a flowchart representing the flow of information and samples between farmers and veterinarians, the competent authority (CA), the national reference lab (NRL), and the private organization Royal GD and identified four different surveillance components and derived the use of each of these components during 2016 (reference), 2019 (low risk), and 2022 (high risk). The first component, "notification of suspicion," where farmers and veterinarians directly report suspicions to the CA, accounted for 88.4% of farm visits and detected 98.1% of all HPAIv outbreaks. The second component, "testing to exclude" (TTE), consisting postmortem/sample submission and contact with the veterinary helpdesk of GD detected 2% of the cases in 2022. The third and active surveillance component, "protection zone screening," screens farms closely to a positively detected farm. No outbreaks were detected, suggesting limited between-farm transmission. The last and active surveillance component, mandatory national serological surveillance detected two low pathogenic AI outbreaks. Analysis between years for the passive surveillance components "notification of suspicion" and "TTE," using chi-square test of independency and odd ratios, showed increased use and farm visits in the high-risk year. However, postmortem-related submissions for TTE were increased in the disease-free year. All components combined detected HPAI or provided valuable information across different risk periods.