Methods
We conducted a survey of six poultry farms and human contacts of affected farms in Nkawkaw. A suspected case-farm of HPAI was any farm in Nkawkaw with sudden death of bird(s), with or without clinical signs of HPAI from June 1 to July 10, 2018. Six bird carcasses were collected on affected farms for laboratory analysis. We interviewed owners of affected farms and assessed the farm environments, as well as clinical status of human contacts.