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Background  Intercontinental migratory waterfowl are the primary vectors for dispersion of H5N1 viruses and have been implicated in several zoonotic epidemics and pandemics. Recent investigations have established that with a single mutation, the virus gains the ability to transmit between humans. Consequently, there is a heightened urgency to identify innovative approaches to proactively mitigate emergent epidemics. Accordingly, a novel methodology combining temporo-geospatial epidemiology and phylogeographic analysis of viral strains is proposed to identify critical epicenters and epidemic pathways along with high risk candidate regions for increased surveillance.    Results  Epidemiological analysis was used to identify 91,245 candidate global infection transmission pathways between 22 high risk waterfowl species. Dominant infection pathways (25,625 and 54,500 in summering and wintering zones) were identified through annotation using phylogeographical data computed from the phylogram of 2417 H5N1 HA isolates (from GISAID EpiFlu database). Annotation of infection pathways in turn delineated 23 influential clades out of 130 clades in the phylogram.    Conclusions  The phylogeographic analyses provides strong cross-validation of epidemic pathways and identifies the dominant pathways for use in other epidemiological and prophylactic studies. The temporo-geospatial characteristics of infection transmission provides corroborating, but novel evidence for rapid genesis of H5N1 lineages in S.E. Asia. The proposed method pinpoints several regions, particularly in the southern hemisphere, as candidates for increased surveillance.

Enhancing epidemiological analysis of intercontinental dispersion of H5N1 viral strains by migratory waterfowl using phylogeography