Lessons from the largest epidemic of avian influenza viruses in Taiwan, 2015

Ching Fen Chang, Chwan Chuen King*, Cho Hua Wan, Yun Cheng Chang, Ta Chien Chan, Chang Chun David Lee, Po Hao Borris Chou, Zheng Rong Tiger Li, Yao Tsun Li, Tzu Jung Tseng, Pei Fen Lee, Chuan Hsiung Chang

*Corresponding author for this work

Research output: Contribution to journalConference articlepeer-review

7 Scopus citations


The largest epidemic of avian influenza (AI) in history attacked poultry and wild birds throughout Taiwan starting January 6, 2015. This study analyzed surveillance results, epidemiologic characteristics, and viral sequences by using governmentreleased information, with the intention to provide recommendations to minimize future pandemic influenza. The H5 clade highly pathogenic AI viruses (HPAIVs) had not been detected in Taiwan before 2015. During this epidemic, four types of etiologic agents were identified: The three novel subtypes H5N2, H5N8, and H5N3 clade HPAIVs and one endemic chicken H5N2 subtype (Mexican-like lineage) of low pathogenic AI viruses. Cocirculation of mixed subtypes also occurred, with H5N2 clade HPAIVs accompanied by the H5N8 and H5N3 subtypes or old H5N2 viruses in the same farm. More than 90% of domestic geese died from this AI epidemic; geese were affected the most at the early outbreaks. The epidemic peaked in mid-January for all three novel H5 subtypes. Spatial epidemiology found that most affected areas were located in southwestern coastal areas. In terrestrial poultry (mostly chickens), different geographic distributions of AI virus subtypes were detected, with hot spots of H5N2 clade vs. past-endemic old H5N2 viruses in Changhwa (P 5 0.03) and Yunlin (P 5 0.007) counties, respectively, of central Taiwan. Phylogenetic and sequence analyses of all the early 10 Taiwan H5 clade isolates covering the three subtypes showed that they were very different from the HA of the past local H5 viruses from domestic ducks (75%- 80%) and chickens (70%-75%). However, they had the highest sequence identity percentages (99.53%-100%), with the HA of A/crane/Kagoshima/KU13/2014(H5N8) isolated on December 7, 2014, in Japan being higher than those of recent American and Korean H5 HPAIVs [A/Northern pintail/Washington/40964/2014 (H5N2) and A/gyrfalcon/Washington/41088-6/2014 (H5N8): 99.02%-99.54% and A/Baikal teal/Korea/Donglim3/2014 (H5N8): 98.61%-99.08%], implying a likely common ancestor of these H5 clade viruses. The multiple subtypes of H5 clade HPAIVs imply high viral reassortment. We recommend establishing an integrated surveillance system, involving clinical, virologic, and serologic surveillance in poultry and wild birds, swine and other mammals prevalent on multiple-Animal mixed-type traditional farms, and high-risk human populations, as a crucially important step to minimize future pandemic influenza.

Original languageEnglish
Pages (from-to)156-171
Number of pages16
JournalAvian Diseases
Issue number1
StatePublished - 1 May 2016
Event9th International Symposium on Avian Influenza, ISAI 2015 - Athens, United States
Duration: 12 Apr 201515 Apr 2016


  • Epidemiology
  • Highly pathogenic avian influenza H5 virus
  • Phylogenetic analysis
  • Prevention and control policy
  • Surveillance
  • Taiwan


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