Open Access Highly Accessed Debate

Minimizing the threat of pandemic emergence from avian influenza in poultry systems

Kim M Pepin12, James O Lloyd-Smith13, Colleen T Webb12, Karen Holcomb2, Huachen Zhu4, Yi Guan4* and Steven Riley15

Author Affiliations

1 Research and Policy in Disease Dynamics Program, Fogarty International Center, Bethesda, MD, USA

2 Department of Biology, Colorado State University, Fort Collins, CO, USA

3 Department of Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, CA, USA

4 State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Pokfulam, SAR, PRC Hong Kong

5 MRC Centre for Outbreak Analysis and Disease Modelling, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK

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BMC Infectious Diseases 2013, 13:592  doi:10.1186/1471-2334-13-592

Published: 16 December 2013



Live-animal markets are a culturally important feature of meat distribution chains in many populations, yet they provide an opportunity for the maintenance and transmission of potentially emergent zoonotic pathogens. The ongoing human outbreak of avian H7N9 in China highlights the need for increased surveillance and control in these live-bird markets (LBMs).


Closure of retail markets in affected areas rapidly decreased human cases to rare, sporadic occurrence, but little attention has been paid thus far to the role of upstream elements of the poultry distribution chain such as wholesale markets. This could partly explain why transmission in poultry populations has not been eliminated more broadly. We present surveillance data from both wholesale live-bird markets (wLBMs) and rLBMs in Shantou, China (from 2004–2006), and call on disease-dynamic theory to illustrate why closing rLBMs has only minor effects on the overall volume of transmission. We show that the length of time birds stay in rLBMs can severely limit transmission there, but that the system-wide effect may be reduced substantially by high levels of transmission upstream of retail markets.


Management plans that minimize transmission throughout the entire poultry supply chain are essential for minimizing exposure to the public. These include reducing stay-time of birds in markets to 1 day, standardizing poultry supply chains to limit transmission in pre-retail settings, and monitoring strains with epidemiological traits that pose a high risk of emergence. These actions will further limit human exposure to extant viruses and reduce the likelihood of the emergence of novel strains by decreasing the overall volume of transmission.

Avian influenza; Live-bird markets; Efficacy of controls; Environmental transmission; Wholesale markets