Hand-hygiene mitigation strategies against global disease spreading through the air transportation network

Abstract

Hand hygiene is considered as an efficient and cost-effective way to limit the spread of diseases and, as such, it is recommended by both the World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC). While the effect of hand washing on individual transmissibility of a disease has been studied through medical and public-health research, its potential as a mitigation strategy against a global pandemic has not been fully explored yet. In this study, we investigate contagion dynamics through the world air transportation network and analyze the impact of hand-hygiene behavioural changes of airport population against the spread of infectious diseases worldwide. Using a granular dataset of the world air transportation traffic, we build a detailed individual mobility model that controls for the correlated and recurrent nature of human travel and the waiting-time distributions of individuals at different locations. We perform a Monte-Carlo simulation study to assess the impact of different hand-washing mitigation strategies at the early stages of a global epidemic. From the simulation results we find that increasing the hand cleanliness homogeneously at all airports in the world can inhibit the impact of a potential pandemic by 24 to 69%. By quantifying and ranking the contribution of the different airports to the mitigation of an epidemic outbreak, we identify ten key airports at the core of a cost-optimal deployment of the hand-washing strategy: increasing the engagement rate at those locations alone could potentially reduce a world pandemic by 8 to 37%. This research provides evidence of the effectiveness of hand hygiene in airports on the global spread of infectious diseases, and has important implications for the way public-health policymakers may design new effective strategies to enhance hand hygiene in airports through behavioral changes.All rights reserved. No reuse allowed without permission.The copyright holder for this preprint (which was not peer-reviewed) is the author/funder. . https://doi.org/10.1101/530618 doi: bioRxiv preprint continents 5, 6 . The H1N1 flu, which caused around 300,000 deaths worldwide 7 , had a similar timeline. The first confirmed case of H1N1 was reported in Veracruz, Mexico on April 2009, while within few days the infection migrated to the US and Europe, and two months later the World Health Organisation (WHO) and the Centers for Disease Control and Prevention (CDC) declared the disease as a global pandemic.Bacteria, pathogens and viruses are also transmitted easily at airports or during flights, causing infections and bacterial diseases that can expand to global epidemics. The pathogens are transmitted through the air 8 , resulting in the contagion of airborne diseases, or through physical contact between individuals. The transmission is accelerated when a dense population of people is concentrated in a confined area 9 like an airport, with lack of good hygiene and efficient air ventilation. After an outbreak, infections diffuse while infected individ...

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