The effects of control measures on the economic burden associated with epidemics of avian influenza in Italy

In 1999, Italy experienced a devastating epidemic of high-pathogenicity avian influenza (HPAI) caused by an H7N1 virus subtype. After this epidemic, a ministerial decree was passed to implement control measures for low-pathogenicity avian influenza (LPAI) due to H5 and H7 subtypes. We investigated whether these control measures have decreased the public expenditure associated with epidemics of LPAI and HPAI by comparing the direct and consequential losses of the 1999 epidemic to the losses associated with successive epidemics. The estimated total economic burden of the epidemics was about €650 million (€217 million in direct losses and €433 million in consequential losses). The 1999 epidemic accounted for most of these losses (€507 million: €112 million in direct losses and €395 million in consequential losses), whereas the total economic burden for the 5 successive LPAI was €143 million (€105 million in direct losses and €38 million in consequential losses). These results demonstrate that the implementation of a coordinated set of diseasecontrol measures, which included both emergency and prophylactic vaccination, was able to reduce the overall costs associated with avian influenza epidemics. The results also show that the application of adequate LPAI control measures may limit the risk of emergence of an HPAI virus in an area with a high poultry density, allowing the complete disruption of the poultry market and its huge associated costs to be avoided.