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Volume 26, Number 5—May 2020

Policy Review

Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings—International Travel-Related Measures

Sukhyun Ryu, Huizhi Gao, Jessica Y. Wong, Eunice Y.C. Shiu, Jingyi Xiao, Min Whui Fong, and Benjamin J. CowlingComments to Author 
Author affiliations: University of Hong Kong, Hong Kong, China (S. Ryu, H. Gao, J.Y. Wong, E.Y.C. Shiu, J. Xiao, M.W. Fong, B.J. Cowling); Konyang University, Daejeon, South Korea (S. Ryu)

Main Article

Table 2

Overall summary of effectiveness international travel-related non-pharmaceutical interventions for reducing influenza transmission

Objective Screening travelers Travel restriction Border closure
Delaying introduction of case
 • Likely delay by 4 d with detection rate of 37% travelers identified from the port of entry at the border (10)*
• Associated with mean additional delay of case importation (7–12 d, 95% CI 0–30days, 2009 H1N1 pandemic) (11)*
• Might delay 3 d reaching 20 infected cases at risk-country (R0 = 1.5 with 400 travelers/day) (12)
• Might delay importation of infected case-patientss (21–1555 d, 2009 H1N1 pandemic) (13)
 • The mean time delays for exporting the infected case is 5.3 d (80% restriction), 11.7 d (90%), and 131.7 d (99%) (R0 = 1.8 with implementation of 20 d from first case occurred) (20)*
• Among 17 Pacific Island countries and territories, with 99% restriction, 6 countries (with R0 = 1.5) and 4–5 countries (with R0 >2.25) would likely escape the pandemic influenza with >50% probability (implemented at very beginning of pandemic) (21)
• Full children-selective travel restriction might delay an epidemic by 19–35 d (R0 = 1.2), and less than 15 d (R0 = 1.6 and 2.0, implemented after pandemic declared) (22)
• Mean delay of the first imported case in influenza-unaffected countries was estimated <3 d (40% restriction), and ≈2 weeks (90% restriction) with R0 = 1.7 and implementation after pandemic declared (23)
• Likely delay interval between first global case and the importation of the first cases by 7–37 d (R0 = 1.4, 1.7, or 2; 90% or 99% restriction; implemented 30 d after first global case occurrence) (24)
• Might delay the first passage time of infected case-patient from 18 d to 31 d (outbreak originated from Hong Kong) and from 7 d to 27 d (from Sydney) with R0 = 1.7 (25)
• A 99% restriction of air-only, both air and land, and all modes of transportation might delay the interval between the first imported case and 100 infected case-patients passed the border by a week, 1–2 weeks, and 2 mo, respectively (R0 = 1.4; implemented on the day after the first global case reported) (26)
 • Arrival of influenza pandemic was significantly delayed and reduced compare with the other Pacific Island Jurisdictions (29)*
Delaying the epidemic peak
 • Not available
 • Imported infections might delay the epidemic peak of the United States by 1.5 wks (90% restriction), 3 wks (99%), or 6 wks (99.9%) with R0 = 1.4–2.0 (implemented 30 d into global pandemic) (19)
• Might delay pandemic peak by 6–39 d (R0 = 1.4, 1.7, or 2; 90% or 99% restriction; implemented 30 d after first global case occurrence) (24)
• Might delay epidemic peak by 2 wks (99% air travel restriction), 3.5 wks (99% air and land travel restriction), and 12 wks (99% all mode of transportation) with R0 = 1.4 (26)
• Might delay median epidemic peak by 7–102 d (R0 = 1.8–5; 50%–99.9% restriction) (27)
• Peak of influenza mortality delayed by 2 wks (27% international flight volume reduction) (28)
 • Not available
Reducing the size of the peak • Not available • Not available • Not available

*Epidemiology study.

Main Article

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