The health care providers emphasized that people who lived in the rural part of Dogubeyazit and the suburban areas of Van that gather migrants lacked basic needs such as health, education and infrastructure. According to the interviewees, the outbreak in Turkey was influenced by factors closely related to traditional poultry farming and poverty-line economics, as was the case in Asian countries [22] . According to the health personnel who participated in our study, the infection spread rapidly because domestic birds belonging to neighbourhood backyards were able to walk around freely. It is possible that wild migrant birds may be in contact with poultry in the area for food or water. Family-based small-scale poultry farming is a major source of income and nutrition for the region.