Global Epidemic of Ebola Virus Disease and the Importation Risk into China: An Assessment Based on the Risk Matrix Method

Objective To analyze the global epidemic status of the Ebola virus disease(EVD) and assess the importation risk into China.Methods Data from World Health Organization reports were used. We described the global epidemic status of EVD from 1976–2021, and assessed and ranked the importation risk of EVD from the diseaseoutbreaking countries into China using the risk matrix and Borda count methods, respectively.Results From 1976–2021, EVD mainly occurred in western and central Africa, with the highest cumulative number of cases(14,124 cases) in Sierra Leone, and the highest cumulative fatality rate(85%) in the Congo. Outbreaks of EVD have occurred in the Democratic Republic of the Congo and Guinea since 2018. The importation risk into China varies across countries with outbreaks of disease.The Democratic Republic of the Congo had an extremely high risk(23 Borda points), followed by Guinea and Liberia. Countries with a moderate importation risk were Nigeria, Uganda, Congo, Sierra Leone,Mali, and Gabon, while countries with a low importation risk included Sudan, Senegal, and Co te d’Ivoire.Conclusion China is under the risk of EVD importation with the globalization and severe epidemic status of EVD. Key attention need to be paid to the Democratic Republic of the Congo, Guinea, and Liberia. Therefore, it is necessary to prevent and prepare in advance for importation risk in China.

2022 Multiple-country Monkeypox Outbreak and Its Importation Risk into China:An Assessment Based on the Risk Matrix Method

Objective To analyze the 2022 multiple-country monkeypox outbreak and assess its importation risk into China.Methods Data was from United States Centers for Disease Control and Prevention.We described the global epidemic and calculated concentration index to measure economic-related inequality.Importation risk into China was evaluated and ranked by using risk matrix method and Borda count method,respectively.Results As of July 29,2022,of 79 countries or territories,39(49.37%,39/79),17(21.52%,17/79),6(7.59%,6/79),12(15.19%,12/79),and 5(6.33%,5/79)country or territories identified cases<10,10-,51-,101-,and>1,000.There were economic-related health disparities exist in the distribution of cases(the concentration index=0.42,P=0.027),and the inequality disadvantageous to the rich(pro-poor).There were 12(15.38%,12/78),15(19.23%,15/78),6(7.69%,6/78),and 45(57.69%,45/78)countries or territories with extremely high,high,moderate,and low importation risk.United States and France ranked first with the highest Borda points of 156,and counts of zero.Conclusion Of 78 countries or territories,the key attention need be paid to the United States and France,relatively.As the epidemic progresses,preparing prevention and control measures to further reduce importation risk was crucial.

The risk of mpox importation and subsequent outbreak potential in Chinese mainland: a retrospective statistical modelling study

Background The 2022-2023 mpox(monkeypox)outbreak has spread rapidly across multiple countries in the non-endemic region,mainly among men who have sex with men(MSM).In this study,we aimed to evaluate mpox's importation risk,border screening effectiveness and the risk of local outbreak in Chinese mainland.Methods We estimated the risk of mpox importation in Chinese mainland from April 14 to September 11,2022 using the number of reported mpox cases during this multi-country outbreak from Global.health and the international air-travel data from Official Aviation Guide.We constructed a probabilistic model to simulate the effectiveness of a border screening scenario during the mpox outbreak and a hypothetical scenario with less stringent quarantine requirement.And we further evaluated the mpox outbreak potential given that undetected mpox infections were introduced into men who have sex with men,considering different transmissibility,population immunity and population activity.Results We found that the reduced international air-travel volume and stringent border entry policy decreased about 94% and 69% mpox importations respectively.Under the quarantine policy,15-19% of imported infections would remain undetected.Once a case of mpox is introduced into active MSM population with almost no population immunity,the risk of triggering local transmission is estimated at 42%,and would rise to>95% with over six cases.Conclusions Our study demonstrates that the reduced international air-travel volume and stringent border entry policy during the COvID-19 pandemic reduced mpox importations prominently.However,the risk could be sub-stantially higher with the recovery of air-travel volume to pre-pandemic level.Mpox could emerge as a public health threat for Chinese mainland given its large MSM community.

Risk of COVID-19 variant importation-How useful are travel control measures?

We consider models for the importation of a new variant COVID-19 strain in a location already seeing propagation of a resident variant.By distinguishing contaminations generated by imported cases from those originating in the community,we are able to evaluate the contribution of importations to the dynamics of the disease in a community.We find that after an initial seeding,the role of importations becomes marginal compared to that of community-based propagation.We also evaluate the role of two travel control measures,quarantine and travel interruptions.We conclude that quarantine is an efficacious way of lowering importation rates,while travel interruptions have the potential to delay the consequences of importations but need to be applied within a very tight time window following the initial emergence of the variant.