Nishiura Hiroshi, Wilson Nick, Baker Michael G
Theoretical Epidemiology, University of Utrecht, 3584 CL Utrecht, the Netherlands.
BMC Infect Dis. 2009 Mar 11;9:27. doi: 10.1186/1471-2334-9-27.
Although border quarantine is included in many influenza pandemic plans, detailed guidelines have yet to be formulated, including considerations for the optimal quarantine length. Motivated by the situation of small island nations, which will probably experience the introduction of pandemic influenza via just one airport, we examined the potential effectiveness of quarantine as a border control measure.
Analysing the detailed epidemiologic characteristics of influenza, the effectiveness of quarantine at the borders of islands was modelled as the relative reduction of the risk of releasing infectious individuals into the community, explicitly accounting for the presence of asymptomatic infected individuals. The potential benefit of adding the use of rapid diagnostic testing to the quarantine process was also considered.
We predict that 95% and 99% effectiveness in preventing the release of infectious individuals into the community could be achieved with quarantine periods of longer than 4.7 and 8.6 days, respectively. If rapid diagnostic testing is combined with quarantine, the lengths of quarantine to achieve 95% and 99% effectiveness could be shortened to 2.6 and 5.7 days, respectively. Sensitivity analysis revealed that quarantine alone for 8.7 days or quarantine for 5.7 days combined with using rapid diagnostic testing could prevent secondary transmissions caused by the released infectious individuals for a plausible range of prevalence at the source country (up to 10%) and for a modest number of incoming travellers (up to 8000 individuals).
Quarantine at the borders of island nations could contribute substantially to preventing the arrival of pandemic influenza (or at least delaying the arrival date). For small island nations we recommend consideration of quarantine alone for 9 days or quarantine for 6 days combined with using rapid diagnostic testing (if available).
尽管许多流感大流行预案中都包含边境检疫，但尚未制定详细指南，包括对最佳检疫时长的考量。鉴于小岛屿国家的情况，这些国家可能仅通过一个机场就会迎来大流行性流感的传入，我们研究了检疫作为一种边境管控措施的潜在效果。
通过分析流感的详细流行病学特征，将岛屿边境检疫的效果建模为向社区释放感染个体风险的相对降低，并明确考虑无症状感染个体的存在。还考虑了在检疫过程中增加使用快速诊断检测的潜在益处。
我们预测，检疫期分别超过4.7天和8.6天，可实现防止感染个体进入社区的有效性分别为95%和99%。如果将快速诊断检测与检疫相结合，实现95%和99%有效性所需的检疫期可分别缩短至2.6天和5.7天。敏感性分析表明，仅检疫8.7天或检疫5.7天并结合使用快速诊断检测，对于来源国合理的流行率范围（高达[X]%）和适度数量的入境旅行者（高达8000人），可防止由释放的感染个体引起的二次传播。
岛屿国家边境的检疫可极大有助于防止大流行性流感的传入（或至少推迟传入日期）。对于小岛屿国家，我们建议考虑单独检疫9天或检疫6天并结合使用快速诊断检测（如有）。 （注：原文中“up to 10%”和“up to 8000 individuals”处的[X]为原文缺失数据）
