U.S. airport entry screening in response to pandemic influenza

Modeling and analysis

John D. Malone, Robert Brigantic, George A. Muller, Ashok Gadgil, Woody Delp, Benjamin H. McMahon, Russell Lee, Jim Kulesz, Fabian Mihelic

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: 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.

Original languageEnglish (US)
Pages (from-to)181-191
Number of pages11
JournalTravel Medicine and Infectious Disease
Volume7
Issue number4
DOIs
StatePublished - Jul 1 2009

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Airports
Pandemics
Human Influenza
South America
Canada
Antiviral Agents
Air

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

U.S. airport entry screening in response to pandemic influenza : Modeling and analysis. / Malone, John D.; Brigantic, Robert; Muller, George A.; Gadgil, Ashok; Delp, Woody; McMahon, Benjamin H.; Lee, Russell; Kulesz, Jim; Mihelic, Fabian.

In: Travel Medicine and Infectious Disease, Vol. 7, No. 4, 01.07.2009, p. 181-191.

Research output: Contribution to journalArticle

Malone, JD, Brigantic, R, Muller, GA, Gadgil, A, Delp, W, McMahon, BH, Lee, R, Kulesz, J & Mihelic, F 2009, 'U.S. airport entry screening in response to pandemic influenza: Modeling and analysis', Travel Medicine and Infectious Disease, vol. 7, no. 4, pp. 181-191. https://doi.org/10.1016/j.tmaid.2009.02.006
Malone, John D. ; Brigantic, Robert ; Muller, George A. ; Gadgil, Ashok ; Delp, Woody ; McMahon, Benjamin H. ; Lee, Russell ; Kulesz, Jim ; Mihelic, Fabian. / U.S. airport entry screening in response to pandemic influenza : Modeling and analysis. In: Travel Medicine and Infectious Disease. 2009 ; Vol. 7, No. 4. pp. 181-191.
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