Effectiveness of travel restrictions in the rapid containment of human influenza: a systematic review
Open Access
- 29 September 2014
- journal article
- review article
- Published by WHO Press in Bulletin of the World Health Organization
- Vol. 92 (12), 868-880D
- https://doi.org/10.2471/blt.14.135590
Abstract
Objective To assess the effectiveness of internal and international travel restrictions in the rapid containment of influenza. Methods We conducted a systematic review according to the requirements of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Health-care data bases and grey literature were searched and screened for records published before May 2014. Data extraction and assessments of risk of bias were undertaken by two researchers independently. Results were synthesized in a narrative form. Findings The overall risk of bias in the 23 included studies was low to moderate. Internal travel restrictions and international border restrictions delayed the spread of influenza epidemics by one week and two months, respectively. International travel restrictions delayed the spread and peak of epidemics by periods varying between a few days and four months. Travel restrictions reduced the incidence of new cases by less than 3%. Impact was reduced when restrictions were implemented more than six weeks after the notification of epidemics or when the level of transmissibility was high. Travel restrictions would have minimal impact in urban centres with dense populations and travel networks. We found no evidence that travel restrictions would contain influenza within a defined geographical area. Conclusion Extensive travel restrictions may delay the dissemination of influenza but cannot prevent it. The evidence does not support travel restrictions as an isolated intervention for the rapid containment of influenza. Travel restrictions would make an extremely limited contribution to any policy for rapid containment of influenza at source during the first emergence of a pandemic virus.This publication has 29 references indexed in Scilit:
- Modeling the impact of air, sea, and land travel restrictions supplemented by other interventions on the emergence of a new influenza pandemic virusBMC Infectious Diseases, 2012
- Critical paths in a metapopulation model of H1N1: Efficiently delaying influenza spreading through flight cancellationPLoS Currents, 2012
- The feasibility of age-specific travel restrictions during influenza pandemicsTheoretical Biology and Medical Modelling, 2011
- Multiscale mobility networks and the spatial spreading of infectious diseasesProceedings of the National Academy of Sciences of the United States of America, 2009
- Combination strategies for pandemic influenza response - a systematic review of mathematical modeling studiesBMC Medicine, 2009
- Small islands and pandemic influenza: Potential benefits and limitations of travel volume reduction as a border control measureBMC Infectious Diseases, 2009
- A simple explanation for the low impact of border control as a countermeasure to the spread of an infectious diseaseMathematical Biosciences, 2008
- Strategies for mitigating an influenza pandemicNature, 2006
- Mitigation strategies for pandemic influenza in the United StatesProceedings of the National Academy of Sciences of the United States of America, 2006
- A mathematical model for the global spread of influenzaMathematical Biosciences, 1985