Timing of influenza A(H5N1) in poultry and humans and seasonal influenza activity worldwide, 2004-2013

Lizette O Durand, Patrick Glew, Diane Gross, Matthew Kasper, Susan Trock, Inkyu K Kim, Joseph S Bresee, Ruben Donis, Timothy M Uyeki, Marc-Alain Widdowson, Eduardo Azziz-Baumgartner

Research output: Contribution to journalA1: Web of Science-articlepeer-review


Co-circulation of influenza A(H5N1) and seasonal influenza viruses among humans and animals could lead to co-infections, reassortment, and emergence of novel viruses with pandemic potential. We assessed the timing of subtype H5N1 outbreaks among poultry, human H5N1 cases, and human seasonal influenza in 8 countries that reported 97% of all human H5N1 cases and 90% of all poultry H5N1 outbreaks. In these countries, most outbreaks among poultry (7,001/11,331, 62%) and half of human cases (313/625, 50%) occurred during January-March. Human H5N1 cases occurred in 167 (45%) of 372 months during which outbreaks among poultry occurred, compared with 59 (10%) of 574 months that had no outbreaks among poultry. Human H5N1 cases also occurred in 59 (22%) of 267 months during seasonal influenza periods. To reduce risk for co-infection, surveillance and control of H5N1 should be enhanced during January-March, when H5N1 outbreaks typically occur and overlap with seasonal influenza virus circulation.

Original languageEnglish
JournalEmerging Infectious Diseases
Issue number2
Pages (from-to)202-208
Number of pages7
Publication statusPublished - 2015


  • Animals
  • Disease Outbreaks
  • Geography, Medical
  • Global Health
  • History, 21st Century
  • Humans
  • Influenza A Virus, H5N1 Subtype
  • Influenza in Birds/epidemiology
  • Influenza, Human/epidemiology
  • Poultry
  • Seasons
  • Time Factors


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