Epidemiology and Infection

Forecasting the geographical spread of smallpox cases by air travel

R. F. GRAIS a1c1, J. H. ELLIS a1 and G. E. GLASS a2
a1 Department of Geography and Environmental Engineering, Johns Hopkins University, Baltimore, MD, USA
a2 W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA

Article author query
grais r   [PubMed][Google Scholar] 
ellis j   [PubMed][Google Scholar] 
glass g   [PubMed][Google Scholar] 


Instituting air travel restrictions to slow the geographical spread of smallpox cases would have significant consequences and present serious logistical concerns. Public health decision makers must weigh the potential benefits of such restrictions against their negative impact. The goal of this research is to provide a basic analytical framework to explore some of the issues surrounding the use of air travel restrictions as a part of an overall containment strategy. We report preliminary results of a compartmental model for the inter-city spread of smallpox cases resulting from US domestic air travel. Although air traffic can be halted within hours as was shown following the terrorist attacks of 11 September 2001, these results suggest that the consequences of halting domestic air travel may not be outweighed by public health benefits.

(Accepted April 10 2003)

c1 INSERM Unit 444, Epidemiology and Information Sciences, Faculty of Medicine, Saint-Antoine, 27 rue Chaligny, 75571 Paris, Cedex 12, France.