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Title: U.S. airport entry screening in response to pandemic influenza: Modeling and analysis

Abstract

A stochastic discrete event simulation model was developed to assess the effectiveness of passenger screening for Pandemic Influenza (PI) at U.S. airport foreign entry. Methods: International passengers arriving at 18 U.S. airports 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. airport screening would evaluate over 17 M passengers with 800 K secondary screenings. 11,570 PI infected passengers (majority asymptomatic) would enter the U.S. undetected from all 18 airports. 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 airport screening results in 800 K-1.8 M less U.S. PI cases; 16 K-35 K less deaths (2% fatality rate). Antiviral medications for travel contact prophylaxis (10 contacts/PI passenger) were high - 8.8 M. False positives from all 18 airports: 100-200/day. Conclusions: Foreign shore exit screening greatly reduces numbers of PI infected passengers. U.S. airport screening identifies 50% infected individuals; efficacy is limited by the asymptomaticmore » PI infected. Screening will not significantly delay arrival of PI via international air transport, but will reduce the rate of new US cases and subsequent deaths. (C) 2009 Elsevier Ltd. All rights reserved.« less

Authors:
 [1];  [2];  [2];  [3];  [3];  [4];  [5];  [6];  [6]
  1. Uniformed Services University of the Health Sciences (USUHS)
  2. Pacific Northwest National Laboratory (PNNL)
  3. Lawrence Berkeley National Laboratory (LBNL)
  4. Los Alamos National Laboratory (LANL)
  5. ORNL
  6. Oak Ridge National Laboratory (ORNL)
Publication Date:
Research Org.:
Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)
Sponsoring Org.:
Work for Others (WFO)
OSTI Identifier:
1027844
DOE Contract Number:  
AC05-00OR22725
Resource Type:
Journal Article
Journal Name:
Travel Medicine and Infectious Disease
Additional Journal Information:
Journal Volume: 7; Journal Issue: 4; Journal ID: ISSN 1477-8939
Publisher:
Elsevier
Country of Publication:
United States
Language:
English
Subject:
59 BASIC BIOLOGICAL SCIENCES; 99 GENERAL AND MISCELLANEOUS//MATHEMATICS, COMPUTING, AND INFORMATION SCIENCE; AIR TRANSPORT; AIRPORTS; INFLUENZA; OCCUPANTS; PREVENTIVE MEDICINE; SHORES; SIMULATION

Citation Formats

Malone, John D., Brigantic, Robert, Muller, G., Gadgil, Ashok, Delp, Woody, McMahon, Benjamin H., Lee, Russell, Kulesz, Jim, and Mihelic, F. Matthew. U.S. airport entry screening in response to pandemic influenza: Modeling and analysis. United States: N. p., 2009. Web. doi:10.1016/j.tmaid.2009.02.006.
Malone, John D., Brigantic, Robert, Muller, G., Gadgil, Ashok, Delp, Woody, McMahon, Benjamin H., Lee, Russell, Kulesz, Jim, & Mihelic, F. Matthew. U.S. airport entry screening in response to pandemic influenza: Modeling and analysis. United States. https://doi.org/10.1016/j.tmaid.2009.02.006
Malone, John D., Brigantic, Robert, Muller, G., Gadgil, Ashok, Delp, Woody, McMahon, Benjamin H., Lee, Russell, Kulesz, Jim, and Mihelic, F. Matthew. 2009. "U.S. airport entry screening in response to pandemic influenza: Modeling and analysis". United States. https://doi.org/10.1016/j.tmaid.2009.02.006.
@article{osti_1027844,
title = {U.S. airport entry screening in response to pandemic influenza: Modeling and analysis},
author = {Malone, John D. and Brigantic, Robert and Muller, G. and Gadgil, Ashok and Delp, Woody and McMahon, Benjamin H. and Lee, Russell and Kulesz, Jim and Mihelic, F. Matthew},
abstractNote = {A stochastic discrete event simulation model was developed to assess the effectiveness of passenger screening for Pandemic Influenza (PI) at U.S. airport foreign entry. Methods: International passengers arriving at 18 U.S. airports 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. airport screening would evaluate over 17 M passengers with 800 K secondary screenings. 11,570 PI infected passengers (majority asymptomatic) would enter the U.S. undetected from all 18 airports. 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 airport screening results in 800 K-1.8 M less U.S. PI cases; 16 K-35 K less deaths (2% fatality rate). Antiviral medications for travel contact prophylaxis (10 contacts/PI passenger) were high - 8.8 M. False positives from all 18 airports: 100-200/day. Conclusions: Foreign shore exit screening greatly reduces numbers of PI infected passengers. U.S. airport 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 will reduce the rate of new US cases and subsequent deaths. (C) 2009 Elsevier Ltd. All rights reserved.},
doi = {10.1016/j.tmaid.2009.02.006},
url = {https://www.osti.gov/biblio/1027844}, journal = {Travel Medicine and Infectious Disease},
issn = {1477-8939},
number = 4,
volume = 7,
place = {United States},
year = {Thu Jan 01 00:00:00 EST 2009},
month = {Thu Jan 01 00:00:00 EST 2009}
}