{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T16:03:52Z","timestamp":1771430632929,"version":"3.50.1"},"reference-count":62,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01CK000490"],"award-info":[{"award-number":["U01CK000490"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01CK000633"],"award-info":[{"award-number":["U01CK000633"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005294","name":"Massachusetts General Hospital","doi-asserted-by":"publisher","award":["James and Audrey Foster MGH Research Scholar Award"],"award-info":[{"award-number":["James and Audrey Foster MGH Research Scholar Award"]}],"id":[{"id":"10.13039\/100005294","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,21]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"\n Objectives<\/jats:title>\n To examine outcomes from respiratory pathogens containment strategies focused on international travellers.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n \n We developed a compartmental model generalisable to respiratory infectious diseases, in which international travellers interact with each other and airline\/airport workers during transit. We used SARS-CoV-2 Omicron surge data (basic reproduction number (R\n 0<\/jats:sub>\n ): 9.5) as a case example and performed sensitivity and scenario analyses, including varying the R\n 0<\/jats:sub>\n for different respiratory pathogens.\n <\/jats:p>\n <\/jats:sec>\n \n Settings<\/jats:title>\n A US high-volume airport.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Simulated international travellers and airline\/airport workers.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n \n Projection of new and imported SARS-CoV-2 infections without intervention (\n No Intervention<\/jats:italic>\n ); pre-travel screening for travellers who intend to travel (intended travellers) with PCR (\n Pre-travel PCR<\/jats:italic>\n ); or antigen testing (\n Pre-travel Ag<\/jats:italic>\n ); mask-wearing guidance for travellers and workers (\n Mask-wearing<\/jats:italic>\n ); and a\n Combined<\/jats:italic>\n strategy (\n Pre-travel PCR & Mask-wearing<\/jats:italic>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Outcome measures<\/jats:title>\n The number of new and imported respiratory disease infections over the 90-day simulation period.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Over the 90-day simulation, the number of infected travellers entering the USA would be: 1\u2009155\u2009580 (27.2% of 4.2\u2009million (M) intended travellers) with\n No Intervention<\/jats:italic>\n ; 709 560\/4.2M (16.7%) with\n Pre-travel PCR<\/jats:italic>\n ; 862 330\/4.2M (20.3%) with\n Pre-travel Ag<\/jats:italic>\n ; 1033 820\/4.2M (24.4%) with\n Mask-wearing<\/jats:italic>\n ; and 650 480\/4.2M (15.3%) with\n Combined<\/jats:italic>\n . The number of new infections among airline\/airport workers would be: 25\u2009670 (73.3% of 35\u2009000 workers) with\n No Intervention<\/jats:italic>\n ; 25\u2009260 (72.2%) in\n Pre-travel PCR<\/jats:italic>\n ; 25\u2009590 (73.1%) in\n Pre-travel Ag<\/jats:italic>\n ; 24\u2009630 (70.4%) in\n Mask-wearing<\/jats:italic>\n ; and 18\u2009770 (53.6%) in\n Combined<\/jats:italic>\n . In scenario analyses, the most impactful parameters were R\n 0<\/jats:sub>\n of the respiratory pathogen and population immunity level.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n A\n Combined<\/jats:italic>\n strategy of pre-travel PCR testing and mask-wearing would most effectively reduce respiratory infection among international travellers and airline\/airport workers, but would still allow a substantial number of infections to enter the USA, especially when the pathogen is highly transmissible.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-105013","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T15:10:24Z","timestamp":1771427424000},"page":"e105013","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of containment strategies for respiratory diseases on infections imported via international travel to the USA: a modelling study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7542-1801","authenticated-orcid":false,"given":"Satoshi","family":"Koiso","sequence":"first","affiliation":[{"name":"Medical Practice Evaluation Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Lee","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Institute for Technology Assessment, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea L","family":"Ciaranello","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth A","family":"Freedberg","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA"},{"name":"Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward T","family":"Ryan","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA"},{"name":"Traveler's Advice and Immunization Center, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6769-2732","authenticated-orcid":false,"given":"Mohammad S","family":"Jalali","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Institute for Technology Assessment, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regina C","family":"LaRocque","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Traveler's Advice and Immunization Center, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8721-106X","authenticated-orcid":false,"given":"Emily P","family":"Hyle","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Boston, Massachusetts, USA"},{"name":"Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Traveler's Advice and Immunization Center, Massachusetts General Hospital, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"2026021807100978000_16.2.e105013.1","doi-asserted-by":"publisher","DOI":"10.1007\/s13337-020-00628-5"},{"key":"2026021807100978000_16.2.e105013.2","doi-asserted-by":"crossref","unstructured":"Huremovi\u0107 D . 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