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Article: The feasibility of age-specific travel restrictions during influenza pandemics

TitleThe feasibility of age-specific travel restrictions during influenza pandemics
Authors
Issue Date2011
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.tbiomed.com/home/
Citation
Theoretical Biology And Medical Modelling, 2011, v. 8, article no. 44 How to Cite?
AbstractBackground: Epidemiological studies have shown that imposing travel restrictions to prevent or delay an influenza pandemic may not be feasible. To delay an epidemic substantially, an extremely high proportion of trips (∼99%) would have to be restricted in a homogeneously mixing population. Influenza is, however, strongly influenced by age-dependent transmission dynamics, and the effectiveness of age-specific travel restrictions, such as the selective restriction of travel by children, has yet to be examined. Methods. A simple stochastic model was developed to describe the importation of infectious cases into a population and to model local chains of transmission seeded by imported cases. The probability of a local epidemic, and the time period until a major epidemic takes off, were used as outcome measures, and travel restriction policies in which children or adults were preferentially restricted were compared to age-blind restriction policies using an age-dependent next generation matrix parameterized for influenza H1N1-2009. Results: Restricting children from travelling would yield greater reductions to the short-term risk of the epidemic being established locally than other policy options considered, and potentially could delay an epidemic for a few weeks. However, given a scenario with a total of 500 imported cases over a period of a few months, a substantial reduction in the probability of an epidemic in this time period is possible only if the transmission potential were low and assortativity (i.e. the proportion of contacts within-group) were unrealistically high. In all other scenarios considered, age-structured travel restrictions would not prevent an epidemic and would not delay the epidemic for longer than a few weeks. Conclusions: Selectively restricting children from traveling overseas during a pandemic may potentially delay its arrival for a few weeks, depending on the characteristics of the pandemic strain, but could have less of an impact on the economy compared to restricting adult travelers. However, as long as adults have at least a moderate potential to trigger an epidemic, selectively restricting the higher risk group (children) may not be a practical option to delay the arrival of an epidemic substantially. © 2011 Lam et al; licensee BioMed Central Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/151758
ISSN
2015 Impact Factor: 1.033
2015 SCImago Journal Rankings: 0.444
ISI Accession Number ID
Funding AgencyGrant Number
MedImmune Inc.
Food and Health Bureau, Government of the Hong Kong Special Administrative RegionHK-11-04-01
Harvard Center for Communicable Disease Dynamics from the National Institute of General Medical SciencesU54 GM088558
Hong Kong University Grants CommitteeAoE/M-12/06
JST PRESTO
Funding Information:

BJC reports receiving research grant funding from MedImmune Inc., a manufacturer of influenza vaccines. All other authors declare that they have no competing interests.

References
Grants

 

DC FieldValueLanguage
dc.contributor.authorLam, EHYen_US
dc.contributor.authorCowling, BJen_US
dc.contributor.authorCook, ARen_US
dc.contributor.authorWong, JYTen_US
dc.contributor.authorLau, MSYen_US
dc.contributor.authorNishiura, Hen_US
dc.date.accessioned2012-06-26T06:27:55Z-
dc.date.available2012-06-26T06:27:55Z-
dc.date.issued2011en_US
dc.identifier.citationTheoretical Biology And Medical Modelling, 2011, v. 8, article no. 44en_US
dc.identifier.issn1742-4682en_US
dc.identifier.urihttp://hdl.handle.net/10722/151758-
dc.description.abstractBackground: Epidemiological studies have shown that imposing travel restrictions to prevent or delay an influenza pandemic may not be feasible. To delay an epidemic substantially, an extremely high proportion of trips (∼99%) would have to be restricted in a homogeneously mixing population. Influenza is, however, strongly influenced by age-dependent transmission dynamics, and the effectiveness of age-specific travel restrictions, such as the selective restriction of travel by children, has yet to be examined. Methods. A simple stochastic model was developed to describe the importation of infectious cases into a population and to model local chains of transmission seeded by imported cases. The probability of a local epidemic, and the time period until a major epidemic takes off, were used as outcome measures, and travel restriction policies in which children or adults were preferentially restricted were compared to age-blind restriction policies using an age-dependent next generation matrix parameterized for influenza H1N1-2009. Results: Restricting children from travelling would yield greater reductions to the short-term risk of the epidemic being established locally than other policy options considered, and potentially could delay an epidemic for a few weeks. However, given a scenario with a total of 500 imported cases over a period of a few months, a substantial reduction in the probability of an epidemic in this time period is possible only if the transmission potential were low and assortativity (i.e. the proportion of contacts within-group) were unrealistically high. In all other scenarios considered, age-structured travel restrictions would not prevent an epidemic and would not delay the epidemic for longer than a few weeks. Conclusions: Selectively restricting children from traveling overseas during a pandemic may potentially delay its arrival for a few weeks, depending on the characteristics of the pandemic strain, but could have less of an impact on the economy compared to restricting adult travelers. However, as long as adults have at least a moderate potential to trigger an epidemic, selectively restricting the higher risk group (children) may not be a practical option to delay the arrival of an epidemic substantially. © 2011 Lam et al; licensee BioMed Central Ltd.en_US
dc.languageengen_US
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.tbiomed.com/home/en_US
dc.relation.ispartofTheoretical Biology and Medical Modellingen_US
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshAge Factors-
dc.subject.meshAircraft-
dc.subject.meshInfluenza, Human - epidemiology - prevention and control-
dc.subject.meshPandemics-
dc.subject.meshTravel-
dc.titleThe feasibility of age-specific travel restrictions during influenza pandemicsen_US
dc.typeArticleen_US
dc.identifier.emailCowling, BJ:bcowling@hku.hken_US
dc.identifier.emailNishiura, H:nishiura@hku.hken_US
dc.identifier.authorityCowling, BJ=rp01326en_US
dc.identifier.authorityNishiura, H=rp01488en_US
dc.description.naturepublished_or_final_versionen_US
dc.identifier.doi10.1186/1742-4682-8-44en_US
dc.identifier.pmid22078655-
dc.identifier.scopuseid_2-s2.0-81055150385en_US
dc.identifier.hkuros200039-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-81055150385&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume8en_US
dc.identifier.isiWOS:000300496300002-
dc.publisher.placeUnited Kingdomen_US
dc.relation.projectControl of Pandemic and Inter-pandemic Influenza-
dc.identifier.scopusauthoridLam, EHY=54389283300en_US
dc.identifier.scopusauthoridCowling, BJ=8644765500en_US
dc.identifier.scopusauthoridCook, AR=23392022000en_US
dc.identifier.scopusauthoridWong, JYT=54390180800en_US
dc.identifier.scopusauthoridLau, MSY=37034365900en_US
dc.identifier.scopusauthoridNishiura, H=7005501836en_US
dc.identifier.citeulike10020949-

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