U.S. airport entry screening in response to pandemic influenza: Modeling and analysis
Background: A stochastic discrete event simulation model to assess the effectiveness of passenger screening for Pandemic Influenza (PI) at U.S. airport ports of entry was developed. Methods: International passengers arriving at 18 U.S. airports (AP) from Asia, Europe, South America, and Canada were assigned to one of three states: not infected, infected with PI, infected with other respiratory illness. Passengers passed through layered screening then exited the model. 80% screening effectiveness was assumed for symptomatic passengers; 6% asymptomatic passengers. Results: In the first 100 days of a global pandemic, U.S. AP screening would evaluate over 17M passengers with 800K secondary screenings. 11,570 PI infected passengers (majority asymptomatic) would enter the U.S. undetected from all 18 APs. Foreign airport departure screening significantly decreased the false negative (infected/undetected) passengers. U.S. attack rates: no screening (26.9% - 30.9%); screening (26.4% - 30.6%); however AP screening results in 800K to 1.8M less U.S. PI cases; 16K-35K less deaths (2% fatality rate). Antiviral medications for travel contact prophylaxis (10 contacts/ PI passenger) was high - 8.8M. False positives all 18 APs: 100-200/day. Conclusions: Foreign shore exit screening greatly reduces numbers of infected PI passengers. U.S. AP screening identifies 50% infected individuals; efficacy is limited by the asymptomatic PI infected. Screening will not significantly delay arrival of PI via international air transport, but reduce the number of US cases and deaths.
- Research Organization:
- Pacific Northwest National Lab. (PNNL), Richland, WA (United States)
- Sponsoring Organization:
- USDOE
- DOE Contract Number:
- AC05-76RL01830
- OSTI ID:
- 1331748
- Report Number(s):
- PNNL-SA-64200
- Journal Information:
- Travel Medicine and Infectious Disease, Vol. 7, Issue 4; ISSN 1477-8939
- Publisher:
- Elsevier
- Country of Publication:
- United States
- Language:
- English
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