Effect of air travel on the spread of an avian influenza pandemic to the United States

Abstract The highly pathogenic avian influenza (HPAI) strain H5N1, which first appeared in Hong Kong in 1997, achieved bird-to-human transmission, causing a severe disease with high mortality to humans [18]. According to the World Health Organization (WHO), a total of 637 cases were reported in fifteen countries, including 378 deaths, corresponding to a case fatality rate of nearly 60% [19]. Avian influenza continues to be one of the deadliest diseases that jumps from animals to humans. Epidemiologists believe that it is likely to cause the next major global pandemic that could kill millions of people. The 2002 outbreak of severe acute respiratory syndrome (SARS) demonstrated that international air travel can significantly influence the global spread of an infectious disease. This paper studies the effects of air travel on the spread of avian influenza from Asian and Australian cities to the United States. A two-city mathematical model involving a pandemic strain is used to derive the basic reproduction number ( R 0 ), which determines if the disease will spread and persist ( R 0 > 1 ) or go extinct ( R 0 < 1 ). Real air travel data is used to model the disease spread by individuals who are susceptible to or are infected with pandemic avian influenza. Analysis of the two-city model helps understand the dynamics of the spread of pandemic influenza when the cities are connected by air travel. Understanding these effects can help public health officials and policy-makers select the appropriate disease control measures. Also, it can provide guidance to decision-makers on where to implement control measures while conserving precious resources.