Revisiting the Need for Vigilance Concerning Children and International Travel

This is an econometric analysis of demand for travel to Cyprus by Britons. We examined the competitive and complementary relations between travel to Cyprus and other well-established travel destinations in the Mediterranean basin. Because many package tours include several countries in their destinations within a given journey, and because individual travelers find it more advantageous to visit more than one country in a single trip, it may be meaningful to examine international travel within the contest of groups of countries rather than a single country competing for international travelers. Specifically, we provide an analysis of the competitive and complementary relations existing between the tourism sectors of Cyprus and that of Greece, Spain and Portugal for British travelers. We provide estimates of income and relative price elasticities based of export demand equations upon annual data from 1980-2016. We tested for the stationarity of the variables and derived estimates of the Vector Error Correction Model (VECM). These tests confirm a strong association between the incomes of Britons and their decision to travel to Cyprus. Furthermore, we show the relative prices between Cyprus and other competing destinations in the Mediterranean to play an important role in determining British travel to Cyprus.

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State Intervention During Public Health Emergencies: Is the United States Prepared for an Ebola Outbreak?

Journal of Homeland Security and Emergency Management ◽

10.1515/jhsem-2015-0007 ◽

2015 ◽

Vol 12 (2) ◽

Cited By ~ 1

Author(s):

Marie-Helen Maras ◽

Michelle D. Miranda

Keyword(s):

Public Health ◽

State Intervention ◽

The United States ◽

International Travel ◽

American Government ◽

Training And Education ◽

Public Health Emergencies ◽

The Us ◽

Bioterrorism Agent ◽

Legal Guidelines

AbstractIn the fall of 2014, the US was faced with the reality that a deadly, foreign virus had entered its borders. Ebola, a disease thought to be of little threat to the US yet classified as a major bioterrorism agent, became a reality for the American government and its citizens. The introduction of Ebola unveiled many deficiencies in the country’s health care system, international travel policies, and ability to control or restrict the movement of exposed individuals in order to protect the larger population. The need to review and establish legal guidelines and policies to deal with these deficiencies is paramount: the inherent lack of training and education; weaknesses in monitoring, maintenance, and treatment; and the lack of uniform guidelines to isolate international travelers have all demonstrated that the country may not be able to control a larger-scale threat in the future.

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Impact of risk aversion, reactance proneness and risk appraisal on travel destination risk perception

Journal Of Vacation Marketing ◽

10.1177/1356766720987868 ◽

2021 ◽

pp. 135676672098786

Author(s):

Melvin Prince ◽

Young Kim

Keyword(s):

Risk Perception ◽

Risk Aversion ◽

Risk Perceptions ◽

Structural Model ◽

International Travel ◽

Kuala Lumpur ◽

Risk Appraisal ◽

Travel Destination ◽

The Past ◽

Subjective Estimates

The aim of the study is to investigate the motivational effects of tourist traits and risk appraisal on tourist destination risk perception. Risk appraisal involves subjective estimates of vulnerability to a threat and the threat’s consequential severity. Fear levels influence both of these elements of risk appraisal. Individual differences in reactance proneness and risk aversion are introduced into the study model to more fully account for differences in travel destination risk perceptions. The study design involves US adults, who have used their passports for international travel in the past 5 years. Travel risk assessments were studied for four destination sites: London, Tokyo, Kuala Lumpur and Istanbul. A general structural model is developed to test hypotheses about antecedents and consequents of risk appraisal and destination risk perception.

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Parasitic infections in Swiss children: Are we overtesting?

BMC Gastroenterology ◽

10.1186/s12876-021-01619-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Corinne Légeret ◽

Céline Rüttimann ◽

Hans Fankhauser ◽

Henrik Köhler

Keyword(s):

Retrospective Study ◽

Positive Result ◽

Pediatric Patients ◽

Intestinal Parasites ◽

Gastrointestinal Symptoms ◽

International Travel ◽

Parasitic Infections ◽

Stool Samples ◽

Stool Specimens

Abstract Background A wide variation of causes can lead to gastrointestinal symptoms in children- an infection with parasites is one of them. The expansion of international travel might lead to an increase in testing children for a correspondent infection. Currently there are no guidelines available, which patients should be tested for a possible parasitical infection. The aim of the study was to characterize Swiss children suffering from intestinal parasites, in order to provide more knowledge for the clinician who should be tested. Methods This is a retrospective study of Swiss pediatric patients, whose stools have been tested for parasites and helminths. Results A total of 1855 stool samples, belonging to 572 different children with an average age of 7.9 years, were tested within a 10-year period. The prevalence of a positive result was 4.2%, of which all were positive for Blastocystis, and 12.5% had a co-infection with Endolimax nana. Conclusion Immigrants, immune compromised children with diarrhea and pediatric patients with bloody or protracted diarrhea should have 2 different stool specimens examined for a possible parasitical infection.

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Surge of severe acute respiratory syndrome coronavirus 2 infections linked to single introduction of a virus strain in Myanmar, 2020

Scientific Reports ◽

10.1038/s41598-021-89361-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Myat Htut Nyunt ◽

Hnin Ohnmar Soe ◽

Kay Thi Aye ◽

Wah Wah Aung ◽

Yi Yi Kyaw ◽

...

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Early Phase ◽

International Travel ◽

Health Concern ◽

Whole Genome ◽

Genome Sequences ◽

Genomic Epidemiology ◽

Local Spread ◽

Control And Prevention ◽

Local Transmission

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a major health concern globally. Genomic epidemiology is an important tool to assess the pandemic of coronavirus disease 2019 (COVID-19). Several mutations have been reported by genome analysis of the SARS-CoV-2. In the present study, we investigated the mutational and phylogenetic analysis of 30 whole-genome sequences for the virus's genomic characteristics in the specimens collected in the early phase of the pandemic (March–June, 2020) and the sudden surge of local transmission (August–September, 2020). The four samples in the early phase of infection were B.6 lineage and located within a clade of the samples collected at the same time in Singapore and Malaysia, while five returnees by rescue flights showed the lineage B. 1.36.1 (three from India), B.1.1 (one from India) and B.1.80 (one from China). However, there was no evidence of local spread from these returnees. Further, all 19 whole-genome sequences collected in the sudden surge of local transmission showed lineage B.1.36. The surge of the second wave on SARS-CoV-2 infection was linked to the single-introduction of a variant (B.1.36) that may result from the strict restriction of international travel and containment efforts. These genomic data provides the useful information to disease control and prevention strategy.

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A partisan pandemic: state government public health policies to combat COVID-19 in Brazil

BMJ Global Health ◽

10.1136/bmjgh-2021-005223 ◽

2021 ◽

Vol 6 (6) ◽

pp. e005223

Author(s):

Michael Touchton ◽

Felicia Marie Knaul ◽

Héctor Arreola-Ornelas ◽

Thalia Porteny ◽

Mariano Sánchez ◽

...

Keyword(s):

Public Space ◽

State Government ◽

Public Transportation ◽

National Level ◽

International Travel ◽

School Closure ◽

Population Mobility ◽

Mato Grosso ◽

First Case ◽

National Response

IntroductionTo present an analysis of the Brazilian health system and subnational (state) variation in response to the COVID-19 pandemic, based on 10 non-pharmaceutical interventions (NPIs).Materials and methodsWe collected daily information on implementation of 10 NPI designed to inform the public of health risks and promote distancing and mask use at the national level for eight countries across the Americas. We then analyse the adoption of the 10 policies across Brazil’s 27 states over time, individually and using a composite index. We draw on this index to assess the timeliness and rigour of NPI implementation across the country, from the date of the first case, 26 February 2020. We also compile Google data on population mobility by state to describe changes in mobility throughout the COVID-19 pandemic.ResultsBrazil’s national NPI response was the least stringent among countries analysed. In the absence of a unified federal response to the pandemic, Brazilian state policy implementation was neither homogenous nor synchronised. The median NPI was no stay-at-home order, a recommendation to wear masks in public space but not a requirement, a full school closure and partial restrictions on businesses, public transportation, intrastate travel, interstate travel and international travel. These restrictions were implemented 45 days after the first case in each state, on average. Rondônia implemented the earliest and most rigorous policies, with school closures, business closures, information campaigns and restrictions on movement 24 days after the first case; Mato Grosso do Sul had the fewest, least stringent restrictions on movement, business operations and no mask recommendation.ConclusionsThe study identifies wide variation in national-level NPI responses to the COVID-19 pandemic. Our focus on Brazil identifies subsequent variability in how and when states implemented NPI to contain COVID-19. States’ NPIs and their scores on the composite policy index both align with the governors’ political affiliations: opposition governors implemented earlier, more stringent sanitary measures than those supporting the Bolsonaro administration. A strong, unified national response to a pandemic is essential for keeping the population safe and disease-free, both at the outset of an outbreak and as communities begin to reopen. This national response should be aligned with state and municipal implementation of NPI, which we show is not the case in Brazil.

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Country-level determinants of the severity of the first global wave of the COVID-19 pandemic: an ecological study

BMJ Open ◽

10.1136/bmjopen-2020-042034 ◽

2021 ◽

Vol 11 (2) ◽

pp. e042034

Author(s):

Tiberiu A Pana ◽

Sohinee Bhattacharya ◽

David T Gamble ◽

Zahra Pasdar ◽

Weronika A Szlachetka ◽

...

Keyword(s):

Mortality Rate ◽

Vaccination Coverage ◽

Urban Areas ◽

Ecological Study ◽

Environmental Parameters ◽

The Philippines ◽

International Travel ◽

Bcg Vaccination ◽

Country Level ◽

The Mean

ObjectiveWe aimed to identify the country-level determinants of the severity of the first wave of the COVID-19 pandemic.DesignEcological study of publicly available data. Countries reporting >25 COVID-19 related deaths until 8 June 2020 were included. The outcome was log mean mortality rate from COVID-19, an estimate of the country-level daily increase in reported deaths during the ascending phase of the epidemic curve. Potential determinants assessed were most recently published demographic parameters (population and population density, percentage population living in urban areas, population >65 years, average body mass index and smoking prevalence); economic parameters (gross domestic product per capita); environmental parameters (pollution levels and mean temperature (January–May); comorbidities (prevalence of diabetes, hypertension and cancer); health system parameters (WHO Health Index and hospital beds per 10 000 population); international arrivals; the stringency index, as a measure of country-level response to COVID-19; BCG vaccination coverage; UV radiation exposure; and testing capacity. Multivariable linear regression was used to analyse the data.Primary outcomeCountry-level mean mortality rate: the mean slope of the COVID-19 mortality curve during its ascending phase.ParticipantsThirty-seven countries were included: Algeria, Argentina, Austria, Belgium, Brazil, Canada, Chile, Colombia, the Dominican Republic, Ecuador, Egypt, Finland, France, Germany, Hungary, India, Indonesia, Ireland, Italy, Japan, Mexico, the Netherlands, Peru, the Philippines, Poland, Portugal, Romania, the Russian Federation, Saudi Arabia, South Africa, Spain, Sweden, Switzerland, Turkey, Ukraine, the UK and the USA.ResultsOf all country-level determinants included in the multivariable model, total number of international arrivals (beta 0.033 (95% CI 0.012 to 0.054)) and BCG vaccination coverage (−0.018 (95% CI −0.034 to –0.002)), were significantly associated with the natural logarithm of the mean death rate.ConclusionsInternational travel was directly associated with the mortality slope and thus potentially the spread of COVID-19. Very early restrictions on international travel should be considered to control COVID-19 outbreaks and prevent related deaths.

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Maintaining paediatric cardiac services during the COVID-19 pandemic in a developing country in sub-Saharan Africa: guidelines for a “scale up” in the face of a global “scale down”

Cardiology in the Young ◽

10.1017/s1047951120003650 ◽

2020 ◽

Vol 30 (11) ◽

pp. 1588-1594

Author(s):

Ogochukwu J. Sokunbi ◽

Ogadinma Mgbajah ◽

Augustine Olugbemi ◽

Bassey O. Udom ◽

Ariyo Idowu ◽

...

Keyword(s):

Scale Up ◽

Global Scale ◽

International Travel ◽

Sub Saharan Africa ◽

African Continent ◽

Tertiary Centre ◽

The Face ◽

Scale Down ◽

Sub Saharan ◽

International Experts

AbstractThe COVID-19 pandemic is currently ravaging the globe and the African continent is not left out. While the direct effects of the pandemic in regard to morbidity and mortality appear to be more significant in the developed world, the indirect harmful effects on already insufficient healthcare infrastructure on the African continent would in the long term be more detrimental to the populace. Women and children form a significant vulnerable population in underserved areas such as the sub-Saharan region, and expectedly will experience the disadvantages of limited healthcare coverage which is a major fall out of the pandemic. Paediatric cardiac services that are already sparse in various sub-Saharan countries are not left out of this downsizing. Restrictions on international travel for patients out of the continent to seek medical care and for international experts into the continent for regular mission programmes leave few options for children with cardiac defects to get the much-needed care.There is a need for a region-adapted guideline to scale-up services to cater for more children with congenital heart disease (CHD) while providing a safe environment for healthcare workers, patients, and their caregivers. This article outlines measures adapted to maintain paediatric cardiac care in a sub-Saharan tertiary centre in Nigeria during the COVID-19 pandemic and will serve as a guide for other institutions in the region who will inadvertently need to provide these services as the demand increases.

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