Abstract
In Bangladesh, the poultry industry is an economically and socially important sector, but is persistently threatened by the effects of H5N1 highly pathogenic avian influenza. Thus, identifying the optimal control policy in response to an emerging disease outbreak is a key challenge for policy-makers. To inform this aim, a common approach is to carry out simulation studies comparing plausible strategies, while accounting for known capacity restrictions. In this study we perform simulations of a previously developed H5N1 influenza transmission model framework, fitted to two separate historical outbreaks, to assess specific control objectives related to the burden or duration of H5N1 outbreaks among poultry farms in the Dhaka division in Bangladesh. In particular we explore the optimal implementation of ring culling, ring vaccination and active surveillance measures when presuming disease transmission predominately occurs from premises-to-premises, versus a setting requiring the inclusion of external factors. Additionally, we determine the sensitivity of the management actions under consideration to differing levels of capacity constraints and outbreaks with disparate transmission dynamics. While we find that reactive culling and vaccination control policies should pay close attention to these factors to ensure intervention targeting is optimised, targeted proactive active surveillance schemes appear to significantly outperform reactive surveillance procedures in all instances. Our findings may advise the type of control measure, plus its severity, that should be applied in the event of a re-emergent outbreak of H5N1 amongst poultry in the Dhaka division of Bangladesh.