Swine flu’s spread tracked through air travel

updated 6:00 p.m. ET June 29, 2009

ATLANTA - In a startling measure of just how widely a new disease can spread, researchers accurately plotted swine flu’s course around the world by tracking air travel from Mexico.

The research was based on an analysis of flight data from March and April last year, which showed more than 2 million people flew from Mexico to more than 1,000 cities worldwide. Researchers said patterns of departures from Mexico in those months varies little from year to year; swine flu began its spread in March and April this year.

Passengers traveled to 164 countries, but four out of five of those went to the United States. That fits with the path of the epidemic a year later. The findings were reported Monday in the New England Journal of Medicine.

The research shows promise in forecasting how a new contagion might unfold, indicated one government health official who praised the work.

“We share a common interest in this issue: If we map the global airline distribution network, can we anticipate, once a virus emerges, where it is likely to show up next?” asked Dr. Martin Cetron of the U.S. Centers for Disease Control and Prevention. He leads CDC’s division of global migration and quarantine.

The new swine flu virus was first reported in the United States in mid-April, but the first large outbreak was in Mexico at about the same time. Health officials believe cases of the new virus were circulating in Mexico in March.

Forecasting a contagion's spread
Scientists have long assumed a relationship between air travel and spread of the virus. But the new research for the first time confirmed the relationship, said Dr. Kamran Khan, who led the study. He is a researcher at St. Michael’s Hospital in Toronto.

For years, Khan and his colleagues have been working on a system to use air travel information quickly to determine how a new contagion is likely to spread around the world.

Their data sources include the International Air Transport Association, an international trade association representing 230 airlines and the vast majority of scheduled international air traffic.

The study showed the majority of passengers flew to the United States, with Canada a distant second and France a more distant third.

More than 90 percent of the time, Khan and his colleagues accurately matched air traffic volumes to which countries did and did not suffer swine flu outbreaks as a result of air traffic.

Interactive map Infections around the world A country-by-country look at where the swine flu has spread. msnbc.com

The top 11 destination cities from Mexico were all in the United States. Los Angeles was the leader, receiving about 9 percent of all passengers from Mexico, and New York City was second, with about 5 percent.

In contrast, the only South American entry in the top 40 destination cities was Buenos Aires, at No. 22. Passengers were even fewer when it came to cities in neighboring Guatemala and other Central American countries.

The data show not only how disease spreads out of Mexico, but also that air travel is mainly among more industrialized countries, experts said.

A second study released by the journal found a sharp rise in pneumonia cases in non-elderly Mexicans from late March to late April. Normally, only about a third of severe pneumonia cases in Mexico are in people ages 5 to 59. But during the recent swine flu outbreak, more than 70 percent were in that younger age group.

The study seems to support plans to target swine flu prevention efforts to the young, experts said.

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