International Travelers as Sentinels for Sustained Influenza Transmission During the 2009 Influenza A(H1N1)pdm09 Pandemic

SUMMARYTravel in passenger cars is a ubiquitous aspect of the daily activities of many people. During the 2009 influenza A(H1N1) pandemic a case of probable transmission during car travel was reported in Australia, to which spread via the airborne route may have contributed. However, there are no data to indicate the likely risks of such events, and how they may vary and be mitigated. To address this knowledge gap, we estimated the risk of airborne influenza transmission in two cars (1989 model and 2005 model) by employing ventilation measurements and a variation of the Wells–Riley model. Results suggested that infection risk can be reduced by not recirculating air; however, estimated risk ranged from 59% to 99·9% for a 90-min trip when air was recirculated in the newer vehicle. These results have implications for interrupting in-car transmission of other illnesses spread by the airborne route.

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Impact assessment of non-pharmaceutical interventions against COVID-19 and influenza in Hong Kong: an observational study

10.1101/2020.03.12.20034660 ◽

2020 ◽

Cited By ~ 19

Author(s):

Benjamin J. Cowling ◽

Sheikh Taslim Ali ◽

Tiffany W. Y. Ng ◽

Tim K. Tsang ◽

Julian C. M. Li ◽

...

Keyword(s):

Hong Kong ◽

Influenza A ◽

Adult Population ◽

Substantial Reduction ◽

Influenza Surveillance ◽

Virus Infections ◽

Social Distancing ◽

Influenza A H1n1 ◽

General Adult Population ◽

Influenza Transmission

ABSTRACTBackgroundA range of public health measures have been implemented to delay and reduce local transmission of COVID-19 in Hong Kong, and there have been major changes in behaviours of the general public. We examined the effect of these interventions and behavioral changes on the incidence of COVID-19 as well as on influenza virus infections which may share some aspects of transmission dynamics with COVID-19.MethodsWe reviewed policy interventions and measured changes in population behaviours through two telephone surveys, on January 20-23 and February 11-14. We analysed data on laboratory-confirmed COVID-19 cases, influenza surveillance data in outpatients of all ages, and influenza hospitalisations in children. We estimated the daily effective reproduction number (Rt), for COVID-19 and influenza A(H1N1).FindingsCOVID-19 transmissibility has remained at or below 1, indicating successful containment to date. Influenza transmission declined substantially after the implementation of social distancing measures and changes in population behaviours in late January, with a 44% (95% confidence interval, CI: 34% to 53%) reduction in transmissibility in the community, and a 33% (95% CI: 24% to 43%) reduction in transmissibility based on paediatric hospitalization rates. In the two surveys we estimated that 74.5% and 97.5% of the general adult population wore masks when going out, and 61.3% and 90.2% avoided going to crowded places, respectively.ImplicationsContainment measures, social distancing measures and changes in population behaviour have successfully prevented spread of COVID-19. The social distancing measures and behavioural changes led to a substantial reduction in influenza transmission in early February 2020. However, it may be challenging to avoid fatigue and sustain these measures and population behaviours as COVID-19 continues to spread globally.FundingHealth and Medical Research Fund, Hong Kong

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