Multiple outbreaks
for the same pandemic: Local transportation and social distancing
explain the different "waves" of A-H1N1pdm cases observed in
México during 2009
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1.
Mathematical, Computational, and Modeling Sciences Center, Physical Sciences A, P.O. Box, 871904, Tempe, AZ 85287-1904
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Received:
01 June 2010
Accepted:
29 June 2018
Published:
01 January 2011
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MSC :
Primary: 58F15, 58F17; Secondary: 53C35.
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Influenza outbreaks have been of relatively limited historical
interest in México. The 2009 influenza pandemic not only
changed México's health priorities but also brought to the
forefront some of the strengths and weaknesses of México's
epidemiological surveillance and public health system. A year
later, México's data show an epidemic pattern characterized by
three "waves''. The reasons this three-wave patterns are theoretically
investigated via models that incorporate México's general trends
of land transportation, public health measures, and the regular
opening and closing of schools during 2009. The role of vaccination
is also studied taking into account delays in access and limitations
in the total and daily numbers of vaccines available. The research
in this article supports the view that the thee epidemic "waves" are
the result of the synergistic interactions of three factors:
regional movement patterns of Mexicans, the impact and effectiveness
of dramatic social distancing measures imposed during the first
outbreak, and the summer release of school children followed by
their subsequent return to classes in the fall. The three "waves"
cannot be explained by the transportation patterns alone
but only through the combination of transport patterns and changes
in contact rates due to the use of explicit or scheduled social
distancing measures. The research identifies possible vaccination
schemes that account for the school calendar and whose effectiveness
are enhanced by social distancing measures. The limited impact of
the late arrival of the vaccine is also analyzed.
Citation: Marco Arieli Herrera-Valdez, Maytee Cruz-Aponte, Carlos Castillo-Chavez. Multiple outbreaks for the same pandemic: Local transportation and social distancing explain the different 'waves' of A-H1N1pdm cases observed in México during 2009[J]. Mathematical Biosciences and Engineering, 2011, 8(1): 21-48. doi: 10.3934/mbe.2011.8.21
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Abstract
Influenza outbreaks have been of relatively limited historical
interest in México. The 2009 influenza pandemic not only
changed México's health priorities but also brought to the
forefront some of the strengths and weaknesses of México's
epidemiological surveillance and public health system. A year
later, México's data show an epidemic pattern characterized by
three "waves''. The reasons this three-wave patterns are theoretically
investigated via models that incorporate México's general trends
of land transportation, public health measures, and the regular
opening and closing of schools during 2009. The role of vaccination
is also studied taking into account delays in access and limitations
in the total and daily numbers of vaccines available. The research
in this article supports the view that the thee epidemic "waves" are
the result of the synergistic interactions of three factors:
regional movement patterns of Mexicans, the impact and effectiveness
of dramatic social distancing measures imposed during the first
outbreak, and the summer release of school children followed by
their subsequent return to classes in the fall. The three "waves"
cannot be explained by the transportation patterns alone
but only through the combination of transport patterns and changes
in contact rates due to the use of explicit or scheduled social
distancing measures. The research identifies possible vaccination
schemes that account for the school calendar and whose effectiveness
are enhanced by social distancing measures. The limited impact of
the late arrival of the vaccine is also analyzed.
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