Airline networks and the international diffusion of severe acute respiratory syndrome (SARS)

Abstract

In fewer than four months in 2003, severe acute respiratory syndrome (SARS) spread from China to 25 countries and Taiwan, becoming the first new, easily transmissible infectious disease of the twenty‐first century. The role of air transport in the diffusion of the disease became obvious early in the crisis; to assess that role more carefully, this study relates the spatial‐temporal pattern of the SARS outbreak to a measure of airline network accessibility. Specifically, the accessibility from those countries that were infected by SARS, beginning with China, to other countries was measured using airline schedules. The country‐pair accessibility measure, along with other country‐level factors relevant to the disease, were tested as determinants of the speed with which SARS arrived in infected countries as well as its failure to arrive in most countries. The analyses indicate that airline network accessibility was an especially influential variable but also that the importance of this variable diminished in the latter weeks of the outbreak. The latter finding is partly attributable to public health measures, particularly health screening in airports. The timing and geography of those measures are reviewed using data from media reports and interim World Health Organization (WHO) documents during the outbreak. The uneven effort to curtail the international diffusion of SARS suggests further planning is needed to develop a concerted response to contain future epidemics.

Global spatial organisation of air transport: The definition of functional airline regions

“…This day was not affected by vis major, such as volcanic eruptions, the threat of infectious disease, or major terrorist attacksall of which have historically had an influence on air transport (Bowen & Laroe, 2006;Kvizda & Seidenglanz, 2014;Lawyer, 2016). In order to capture regular movements on the global scale, it is assumed that Wednesday is little affected by irregular journeys.…”

Safeguarding public health at UK airports: an examination of current health security practices

“…As the SARS epidemic of 2003 and, more recently, the 2009 H1N1 'swine flu' epidemic, demonstrated, the movement of infectious diseases by air can have profound implications for human health and international mobility (Pang and Guindon, 2004;Bowen and Laroe, 2006;Ali and Keil, 2006). Indeed, numerous scholars (Royal and McCoubrey, 1989;Gerard, 2002;Mangili and Gendreau, 2005;Singer, 2005;Colizza et al, 2006;Tatem et al, 2006;and Tatem and Hay, 2007) have attested to air travel's important role in the global spread of infectious disease.…”

'Value', 'Cost' and Ethics: UK Airports and the Governance of Pandemic H1n1 Risk

“…However, while globalisation has improved opportunities for travel and trade and enabled us to visit overseas countries and experience foreign cultures with relative ease, this interdependency is increasing the opportunities for the international spread of infectious diseases. Numerous medical and scientific studies have established clear relationships between the spatialities of the commercial aviation network and the global transmission of infectious disease (Royal and McCoubrey, 1989;Gerard, 2002;Mangili and Gendreau, 2005;Singer, 2005;Bowen and Laroe, 2006;Colizza et al, 2006;House of Lords, 2007), and recent research by Budd, Bell and Brown (2009) While international efforts to control the spread of infectious disease date back to the use of quarantine in the fourteenth and fifteenth centuries, the development of regular long-haul air travel during the twentieth century necessitated the formation of new sanitary measures specifically targeted at aviation (see Budd et al, 2009). These regulations, which developed as a result of provisions contained within the First Sanitary Convention for Aerial Navigation of 1933, progressively defined new approaches for the identification and management of the threats posed by the 'classic' pestilential disease of cholera, smallpox, yellow fever, plague, and typhus to prevent their spread by air.…”