Geographic Concentration of Genomic Surveillance for Highly Pathogenic Avian Influenza A(H5), South Asia, 2015-2025
Hasnain, N.; Shihab, S. F.; Islam, M. A.; Rahman, M. A.; Masum, M. A.
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Early detection of mammalian adaptation in highly pathogenic avian influenza A(H5) depends on genomic surveillance, yet its distribution across high-burden regions is poorly characterized. We quantified open-access (GenBank/INSDC) H5 genomic coverage relative to reported outbreak burden across nine South Asian countries during 2015-2025, linking isolates to FAO EMPRES-i/WOAH events. Of 919 H5 isolates, 814 (89%) came from one country (Bangladesh); the other eight contributed 105. India, with the largest burden (322 events), yielded only 42 isolates (13 per 100); Nepal, 2 of 78; Afghanistan, none of 5. Concentration was extreme (Gini 0.83) and unchanged by adding restricted GISAID records (1,297 combined isolates; Bangladesh 89%) or by normalizing to poultry or human population. Because reported outbreaks track reporting effort, these coverage ratios are directional, not rates. This single-country dependency, deepest where burden is highest, is a regional early-warning vulnerability.
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