1603b Travel and the spread of infectious diseases

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IntroductionOver three billion passengers fly internationally each year, including executives, professionals and workers employed in many industries. Government and non-government organisations such as the US Centres for Disease Control (CDC), the International Civil Aviation Organisation (ICAO) and its Collaborative Arrangement for the Prevention and Management of Public Health Events in Civil Aviation (CAPSCA), and the World Health Organisation (WHO), working individually and together, have recommended interventions to prevent the occurrence of infectious disease outbreaks resulting from travel, particularly air travel.MethodsMeasures recommended to prevent the spread of infectious diseases associated with travel were reviewed, and preventive interventions recommended for individual infectious diseases were assessed with respect to their effectiveness.ResultPublic travel information and monitoring of exposed travellers are the most cost effective measures for preventing the spread of travel-related infectious diseases. Handwashing and the use of face masks may reduce transmission to others, but have limited value as protective measures for individual travellers. Entry and exit screening are commonly used and have some effectiveness, particularly with respect to alerting the public of specific infectious disease risks, but are expensive, and will miss cases in the incubation period when there are no symptoms or fever. Contact tracing may be of benefit particularly with respect to monitoring of exposed passengers, but can also be expensive, passenger manifests may be incomplete, and exposed passengers may be difficult to locate several days after arrival at their destination. Control of animals and fomites (baggage, cargo, etc.) has limited value. Travel restriction is of limited effectiveness and politically controversial. Quarantine is costly, and compliance difficult to enforce.DiscussionPreventive measures are used to prevent or delay the spread of infectious diseases resulting from travel, but are of variable effectiveness. Public travel information and monitoring of exposed travellers are the most effective control measures.

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