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Int. J. Environ. Res. Public Health 2019, 16(2), 222; https://doi.org/10.3390/ijerph16020222

Roles of Different Transport Modes in the Spatial Spread of the 2009 Influenza A(H1N1) Pandemic in Mainland China

1
Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, Tsinghua University, Beijing 100084, China
2
Joint Center for Global Change Studies, Beijing 100875, China
3
Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
4
School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
5
State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing 100875, China
*
Author to whom correspondence should be addressed.
Received: 29 November 2018 / Revised: 4 January 2019 / Accepted: 9 January 2019 / Published: 14 January 2019
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Abstract

There is increasing concern about another influenza pandemic in China. However, the understanding of the roles of transport modes in the 2009 influenza A(H1N1) pandemic spread across mainland China is limited. Herein, we collected 127,797 laboratory-confirmed cases of influenza A(H1N1)pdm09 in mainland China from May 2009 to April 2010. Arrival days and peak days were calculated for all 340 prefectures to characterize the dissemination patterns of the pandemic. We first evaluated the effects of airports and railway stations on arrival days and peak days, and then we applied quantile regressions to quantify the relationships between arrival days and air, rail, and road travel. Our results showed that early arrival of the virus was not associated with an early incidence peak. Airports and railway stations in prefectures significantly advanced arrival days but had no significant impact on peak days. The pandemic spread across mainland China from the southeast to the northwest in two phases that were split at approximately 1 August 2009. Both air and road travel played a significant role in accelerating the spread during phases I and II, but rail travel was only significant during phase II. In conclusion, in addition to air and road travel, rail travel also played a significant role in accelerating influenza A(H1N1)pdm09 spread between prefectures. Establishing a multiscale mobility network that considers the competitive advantage of rail travel for mid to long distances is essential for understanding the influenza pandemic transmission in China. View Full-Text
Keywords: China; 2009 influenza A(H1N1) pandemic; transport modes; rail travel; spatial spread; quantile regression China; 2009 influenza A(H1N1) pandemic; transport modes; rail travel; spatial spread; quantile regression
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Cai, J.; Xu, B.; Chan, K.K.Y.; Zhang, X.; Zhang, B.; Chen, Z.; Xu, B. Roles of Different Transport Modes in the Spatial Spread of the 2009 Influenza A(H1N1) Pandemic in Mainland China. Int. J. Environ. Res. Public Health 2019, 16, 222.

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