Evaluation of risk-based antigen and antibody surveillance strategies and their association with HPAI outbreaks in South Korean duck farms.

Abstract

INTRODUCTION: Highly pathogenic avian influenza (HPAI) continues to threaten the poultry industry, particularly in duck farms, where early detection is critical to preventing widespread outbreaks. In South Korea, risk-based antigen and antibody surveillance strategies have been implemented to enhance early warning capabilities. However, the effectiveness of these strategies-especially in terms of testing frequency, timing, and spatial alignment with outbreak risks-remains under-evaluated. METHODS: This study analyzed antigen and antibody surveillance data from South Korean duck farms between 2019 and 2022. Testing frequencies and intervals were assessed across high-risk (October-May) and low-risk (June-September) periods, as well as during non-epidemic (2019-2020) and epidemic (2020-2021 and 2021-2022) seasons. Spatial hotspot analysis (Getis-Ord Gi*) and negative binomial regression were applied to evaluate associations between test patterns and HPAI outbreak occurrence. Additionally, test-to-outbreak intervals were calculated to assess the timeliness of detection. RESULTS: Antigen testing frequencies were significantly associated with HPAI outbreaks during high-risk periods (coefficient = 0.56, IRR = 1.75,&#x202f;<&#x202f;0.001). Hot-spot analysis revealed that cold spots received disproportionately more antigen testing than outbreak hotspots (&#x202f;<&#x202f;0.001), indicating a misalignment in surveillance priorities. Despite intensified testing during epidemic seasons, no significant reductions were observed in the time intervals between the last diagnostic test and outbreak onset (&#x202f;>&#x202f;0.05), suggesting limited improvement in early detection. DISCUSSION: The findings highlight both the strengths and limitations of South Korea's current HPAI surveillance strategy in duck farms. While antigen testing serves as a useful predictor of outbreak risk, the spatial and temporal mismatch between surveillance intensity and actual outbreak distribution undermines its effectiveness. A more adaptive and geographically targeted testing approach is needed to enhance outbreak preparedness and response. These results provide a foundation for optimizing future surveillance strategies to minimize the economic and public health impacts of HPAI.