What was one of the major challenges for the response to the 2015 HPAI outbreak in the United States?

• A. The wide geographic distribution of the outbreak and coordination of teams across the country
• B. The carrier state of the disease in the wild waterfowl; surveillance could not keep up with movement
• C. Because of the high risk for human infections, responders had to be put on prophylactic antivirals before they could help
• D. Depopulation of large numbers of laying hens in cages and cleanup exceeded the capabilities of the responders

Answer: (D)

The big challenge tested here was the sheer scale of depopulating and cleaning up after vast numbers of birds. In the 2015 HPAI outbreak, tens of millions of laying hens housed in cages had to be culled to stop the spread, and the resulting carcass disposal and site cleanup had to be done across many farms and states very quickly. That volume strained everything: manpower, euthanasia and disposal equipment, disposal capacity (composting, incineration, and transport), and the ability to maintain biosecurity during all steps. The logistics of coordinating depopulation at such a scale, while protecting workers and the food supply, proved to be the most limiting bottleneck. While wild-bird surveillance and other factors posed challenges, they did not define the response the way the massive depopulation and cleanup did.