Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak.
Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak.
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DOI：
10.1016/s0140-6736(14)61828-6
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发表时间：
2015-01-03
期刊：
影响因子：
168.9
通讯作者：
Khan, Kamran
中科院分区：
文献类型：
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作者：
Bogoch, Isaac I.;Creatore, Maria I.;Cetron, Martin S.;Brownstein, John S.;Pesik, Nicki;Miniota, Jennifer;Tam, Theresa;Hu, Wei;Nicolucci, Adriano;Ahmed, Saad;Yoon, James W.;Berry, Isha;Hay, Simon I.;Anema, Aranka;Tatem, Andrew J.;MacFadden, Derek;German, Matthew;Khan, Kamran
鉴于埃博拉疫情有可能进一步在国际上传播，世卫组织宣布2014年西非埃博拉疫情为国际关注的突发公共卫生事件。世界各地的决策者都需要经验数据来提供信息和实施应急措施。我们的目标是评估埃博拉病毒通过商业航空旅行跨越国际边界传播的可能性，并评估在商业机场对旅客进行出境和入境检查的相对效率。我们分析了国际航空运输协会2014年9月1日至2014年12月31日期间全球航班时刻表的数据，以及2013年以来的历史旅客航班行程数据，以描述通过商业航空离开几内亚、利比里亚和塞拉利昂的预期全球人口流动。结合埃博拉病毒监测数据，我们模拟了国际出口埃博拉病毒感染的预期数量、航空旅行限制的潜在影响，以及在国际出入境口岸进行机场旅客筛查的效率。我们认为，在这三个国家内的任何国内或国际机场开始旅行的个人都可能接触到埃博拉病毒。我们认为所有其他旅行者都没有接触埃博拉病毒的重大风险。根据疫情情况和截至2014年9月1日往返几内亚、利比里亚和塞拉利昂的国际航班限制(利比里亚乘客座位减少51%，几内亚乘客座位减少66%，塞拉利昂乘客座位减少85%)，我们的模型预计，平均每个月有2·8名感染埃博拉病毒的旅客通过商业航班离开上述三个国家。91 547(%)在所有离开几内亚、利比里亚和塞拉利昂的航空旅客中，预期目的地为低收入和中低收入国家。对从三个机场出发的国际旅客进行筛查，将能够对所有感染埃博拉病毒风险最高的旅客进行健康评估。决策者必须仔细权衡对有埃博拉病毒活动的国家实施的旅行限制的潜在危害，以及任何可能降低埃博拉病毒输入风险的可能性。在几内亚、利比里亚和塞拉利昂的机场对旅客进行出境检查将是评估面临埃博拉病毒风险的旅客健康状况的最有效前沿，然而，这一干预措施可能需要国际支持才能有效实施。加拿大卫生研究院。
The WHO declared the 2014 west African Ebola epidemic a public health emergency of international concern in view of its potential for further international spread. Decision makers worldwide are in need of empirical data to inform and implement emergency response measures. Our aim was to assess the potential for Ebola virus to spread across international borders via commercial air travel and assess the relative efficiency of exit versus entry screening of travellers at commercial airports. We analysed International Air Transport Association data for worldwide flight schedules between Sept 1, 2014, and Dec 31, 2014, and historic traveller flight itinerary data from 2013 to describe expected global population movements via commercial air travel out of Guinea, Liberia, and Sierra Leone. Coupled with Ebola virus surveillance data, we modelled the expected number of internationally exported Ebola virus infections, the potential effect of air travel restrictions, and the efficiency of airport-based traveller screening at international ports of entry and exit. We deemed individuals initiating travel from any domestic or international airport within these three countries to have possible exposure to Ebola virus. We deemed all other travellers to have no significant risk of exposure to Ebola virus. Based on epidemic conditions and international flight restrictions to and from Guinea, Liberia, and Sierra Leone as of Sept 1, 2014 (reductions in passenger seats by 51% for Liberia, 66% for Guinea, and 85% for Sierra Leone), our model projects 2·8 travellers infected with Ebola virus departing the above three countries via commercial flights, on average, every month. 91 547 (64%) of all air travellers departing Guinea, Liberia, and Sierra Leone had expected destinations in low-income and lower-middle-income countries. Screening international travellers departing three airports would enable health assessments of all travellers at highest risk of exposure to Ebola virus infection. Decision makers must carefully balance the potential harms from travel restrictions imposed on countries that have Ebola virus activity against any potential reductions in risk from Ebola virus importations. Exit screening of travellers at airports in Guinea, Liberia, and Sierra Leone would be the most efficient frontier at which to assess the health status of travellers at risk of Ebola virus exposure, however, this intervention might require international support to implement effectively. Canadian Institutes of Health Research.