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Modeling the impact of air, sea, and land travel restrictions supplemented by other interventions on the emergence of a new influenza pandemic virus.

ABSTRACT: BACKGROUND: During the early stages of a new influenza pandemic, travel restriction is an immediate and non-pharmaceutical means of retarding incidence growth. It extends the time frame of effective mitigation, especially when the characteristics of the emerging virus are unknown. In the present study, we used the 2009 influenza A pandemic as a case study to evaluate the impact of regulating air, sea, and land transport. Other government strategies, namely, antivirals and hospitalizations, were also evaluated. METHODS: Hong Kong arrivals from 44 countries via air, sea, and land transports were imported into a discrete stochastic Susceptible, Exposed, Infectious and Recovered (SEIR) host-flow model. The model allowed a number of latent and infectious cases to pass the border, which constitutes a source of local disease transmission. We also modeled antiviral and hospitalization prevention strategies to compare the effectiveness of these control measures. Baseline reproduction rate was estimated from routine surveillance data. RESULTS: Regarding air travel, the main route connected to the influenza source area should be targeted for travel restrictions; imposing a 99% air travel restriction delayed the epidemic peak by up to two weeks. Once the pandemic was established in China, the strong land connection between Hong Kong and China rendered Hong Kong vulnerable. Antivirals and hospitalization were found to be more effective on attack rate reductions than travel restrictions. Combined strategies (with 99% restriction on all transport modes) deferred the peak for long enough to establish a vaccination program. CONCLUSION: The findings will assist policy-makers with decisions on handling similar future pandemics. We also suggest regulating the extent of restriction and the transport mode, once restriction has been deemed necessary for pandemic control. Although travel restrictions have yet to gain social acceptance, they allow time for mitigation response when a new and highly intrusive virus emerges.

SUBMITTER: Chong KC

PROVIDER: S-EPMC3577649 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Modeling the impact of air, sea, and land travel restrictions supplemented by other interventions on the emergence of a new influenza pandemic virus.

Chong Ka Chun KC Ying Zee Benny Chung BC

BMC infectious diseases 20121119

<h4>Background</h4>During the early stages of a new influenza pandemic, travel restriction is an immediate and non-pharmaceutical means of retarding incidence growth. It extends the time frame of effective mitigation, especially when the characteristics of the emerging virus are unknown. In the present study, we used the 2009 influenza A pandemic as a case study to evaluate the impact of regulating air, sea, and land transport. Other government strategies, namely, antivirals and hospitalizations ...[more]

PMID: 23157818

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Project description:BackgroundPlanning for a possible influenza pandemic is an extremely high priority, as social and economic effects of an unmitigated pandemic would be devastating. Mathematical models can be used to explore different scenarios and provide insight into potential costs, benefits, and effectiveness of prevention and control strategies under consideration.Methods and findingsA stochastic, equation-based epidemic model is used to study global transmission of pandemic flu, including the effects of travel restrictions and vaccination. Economic costs of intervention are also considered. The distribution of First Passage Times (FPT) to the United States and the numbers of infected persons in metropolitan areas worldwide are studied assuming various times and locations of the initial outbreak. International air travel restrictions alone provide a small delay in FPT to the U.S. When other containment measures are applied at the source in conjunction with travel restrictions, delays could be much longer. If in addition, control measures are instituted worldwide, there is a significant reduction in cases worldwide and specifically in the U.S. However, if travel restrictions are not combined with other measures, local epidemic severity may increase, because restriction-induced delays can push local outbreaks into high epidemic season. The per annum cost to the U.S. economy of international and major domestic air passenger travel restrictions is minimal: on the order of 0.8% of Gross National Product.ConclusionsInternational air travel restrictions may provide a small but important delay in the spread of a pandemic, especially if other disease control measures are implemented during the afforded time. However, if other measures are not instituted, delays may worsen regional epidemics by pushing the outbreak into high epidemic season. This important interaction between policy and seasonality is only evident with a global-scale model. Since the benefit of travel restrictions can be substantial while their costs are minimal, dismissal of travel restrictions as an aid in dealing with a global pandemic seems premature.

Dataset Information

Modeling the impact of air, sea, and land travel restrictions supplemented by other interventions on the emergence of a new influenza pandemic virus.

Publications

Modeling the impact of air, sea, and land travel restrictions supplemented by other interventions on the emergence of a new influenza pandemic virus.

Similar Datasets

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