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Effectiveness of travel restrictions in the rapid containment of human influenza: a systematic review

Mateus, Ana; Otete, Harmony E.; Beck, Charles R.; Dolan, Gayle P.; Nguyen-Van-Tam, Jonathan S.

Authors

Ana Mateus

Harmony E. Otete

Charles R. Beck

Gayle P. Dolan

Jonathan S. Nguyen-Van-Tam jvt@nottingham.ac.uk



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 databases 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.

Journal Article Type Article
Journal Bulletin of the World Health Organization
Print ISSN 0042-9686
Electronic ISSN 1564-0604
Publisher World Health Organization
Peer Reviewed Peer Reviewed
Volume 92
Issue 12
Article Number 868-880d
APA6 Citation Mateus, A., Otete, H. E., Beck, C. R., Dolan, G. P., & Nguyen-Van-Tam, J. S. (in press). Effectiveness of travel restrictions in the rapid containment of human influenza: a systematic review. Bulletin of the World Health Organization, 92(12), https://doi.org/10.2471/blt.14.135590
DOI https://doi.org/10.2471/blt.14.135590
Publisher URL http://www.who.int/bulletin/volumes/92/12/14-135590.pdf
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0
Additional Information © 2014 Ana L.P. Mateus, Harmony E. Otete, Charles R. Beck, Gayle P. Dolanc & Jonathan S. Nguyen-Van-Tam; licensee the World Health Organization

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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