Controlling pandemic flu: the value of international air travel restrictions.
Controlling pandemic flu: the value of international air travel restrictions.
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DOI：
10.1371/journal.pone.0000401
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发表时间：
2007-05-02
期刊：
影响因子：
3.7
通讯作者：
Bobashev GV
中科院分区：
文献类型：
--
作者：
Epstein JM;Goedecke DM;Yu F;Morris RJ;Wagener DK;Bobashev GV
为可能发生的流感大流行做好规划是当务之急，因为大流行若得不到缓解，其社会和经济影响将是毁灭性的。数学模型可用于探索不同的场景，并深入了解正在考虑的预防和控制策略的潜在成本、收益和有效性。基于方程的随机流行病模型用于研究大流行性流感的全球传播，包括旅行限制和疫苗接种的影响。干预的经济成本也被考虑在内。假设最初爆发的不同时间和地点，研究了美国的首次通过时间（FPT）分布以及全球大都市地区的感染人数。仅国际航空旅行限制就会导致飞往美国的 FPT 出现小幅延误。如果在源头采取其他遏制措施并结合旅行限制，延误时间可能会更长。如果再加上在全球范围内采取控制措施，全球范围内的病例会大幅减少，特别是在美国。但是，如果旅行限制不与其他措施结合起来，当地疫情的严重程度可能会增加，因为限制导致的延误可能会将当地疫情推入疫情高发季节。国际和主要国内航空旅客旅行限制每年给美国经济造成的损失很小：约为国民生产总值的 0.8%。国际航空旅行限制可能会对大流行的传播造成微小但重要的延迟，特别是如果在规定时间内实施其他疾病控制措施的话。但如果不采取其他措施，延误可能会使地区疫情恶化，将疫情推入流行高季。政策和季节性之间的这种重要相互作用只有在全球规模的模型中才能显现出来。由于旅行限制的好处可能很大，而成本却微乎其微，因此取消旅行限制作为应对全球大流行病的辅助手段似乎还为时过早。
Planning 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. A 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. International 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.
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DOI：
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发表时间：
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影响因子：
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