Highly pathogenic avian influenza (H5N1 HPAI) spread in the Middle East: risk assessment

T his risk assessment provides an estimate of the likelihood of introduction of H5N1 HPAI from recently infected countries (Lebanon and Iraq) to other countries in the Middle East region and neighbouring territories as a result of the movement of live poultry (both legal and illegal), poultry-related products and the migration of wild birds. The preliminary assessment based on the available information and uncertainties associated indicate that the risk of introduction of H5N1 HPAI for each of the nine regional and neighbouring countries or territories varies and is as follows: • High: Iran (Islamic Republic of), Israel, Jordan, the Syrian Arab Republic and Turkey • Medium: Gaza Strip, Kuwait, Saudi Arabia and The West Bank • Low: Armenia, Azerbaijan and Georgia • Negligible: Cyprus The situation in the region is of concern given the existing poultry populations at risk and the potential for spread between countries. Given the presence of civil unrest and active civil war in some countries of the region, investment in agriculture and livestock is reduced, including limitations to public veterinary services. Underreporting of animal disease events is a significant challenge given the lack of reporting systems in those areas with ongoing conflict. It is therefore possible that, in addition to Iraq and Lebanon, the disease is already present in the Syrian Arab Republic. The cause of the recent incursions into the region is currently unknown but a combination of wild birds seeding infection1 and trade with neighbouring countries is likely. Poultry and poultry-related trade and movements play an important role in national and cross-border spread. The overall risk for the region in terms of potential spread to uninfected countries ranges from negligible to high depending on the country with Iran (Islamic Republic of), Israel, Jordan, the Syrian Arab Republic and Turkey being at highest risk of incursion. The current H5N1 HPAI epizootic is expected to have a potential impact on food security, human health and poultry-dependent livelihoods in a region which is already suffering from political unrest and deteriorated public and animal health services.