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      Infectious disease implications of large-scale migration of Venezuelan nationals

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          Abstract

          Background

          The ongoing economic and political crisis in Venezuela has resulted in a collapse of the healthcare system and the re-emergence of previously controlled or eliminated infectious diseases. There has also been an exodus of Venezuelan international migrants in response to the crisis. We sought to describe the infectious disease risks faced by Venezuelan nationals and assess the international mobility patterns of the migrant population.

          Methods

          We synthesized data on recent infectious disease events in Venezuela and among international migrants from Venezuela, as well as on current country of residence among the migrant population. We used passenger-level itinerary data from the International Air Transport Association to evaluate trends in outbound air travel from Venezuela over time. We used two parameter-free mobility models, the radiation and impedance models, to estimate the expected population flows from Venezuelan cities to other major Latin American and Caribbean cities.

          Results

          Outbreaks of measles, diphtheria and malaria have been reported across Venezuela and other diseases, such as HIV and tuberculosis, are resurgent. Changes in migration in response to the crisis are apparent, with an increase in Venezuelan nationals living abroad, despite an overall decline in the number of outbound air passengers. The two models predicted different mobility patterns, but both highlighted the importance of Colombian cities as destinations for migrants and also showed that some migrants are expected to travel large distances. Despite the large distances that migrants may travel internationally, outbreaks associated with Venezuelan migrants have occurred primarily in countries proximate to Venezuela.

          Conclusions

          Understanding where international migrants are relocating is critical, given the association between human mobility and the spread of infectious diseases. In data-limited situations, simple models can be useful for providing insights into population mobility and may help identify areas likely to receive a large number of migrants.

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          Most cited references26

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          The role of the airline transportation network in the prediction and predictability of global epidemics

          The systematic study of large-scale networks has unveiled the ubiquitous presence of connectivity patterns characterized by large-scale heterogeneities and unbounded statistical fluctuations. These features affect dramatically the behavior of the diffusion processes occurring on networks, determining the ensuing statistical properties of their evolution pattern and dynamics. In this article, we present a stochastic computational framework for the forecast of global epidemics that considers the complete worldwide air travel infrastructure complemented with census population data. We address two basic issues in global epidemic modeling: (i) we study the role of the large scale properties of the airline transportation network in determining the global diffusion pattern of emerging diseases; and (ii) we evaluate the reliability of forecasts and outbreak scenarios with respect to the intrinsic stochasticity of disease transmission and traffic flows. To address these issues we define a set of quantitative measures able to characterize the level of heterogeneity and predictability of the epidemic pattern. These measures may be used for the analysis of containment policies and epidemic risk assessment.
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            Health problems of newly arrived migrants and refugees in Europe.

            The number of migrants and refugees in Europe in the past few years has increased dramatically due to war, violence or prosecutions in their homeland. Migration may affect physical, mental and social health. The objective of this article is to assess migrants and refugees' health problems, and to recommend appropriate interventions.
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              A gravity model analysis of international migration to North America

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                Author and article information

                Journal
                J Travel Med
                J Travel Med
                jtm
                Journal of Travel Medicine
                Oxford University Press
                1195-1982
                1708-8305
                2018
                18 September 2018
                18 September 2018
                : 25
                : 1
                : tay077
                Affiliations
                [1 ]Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
                [2 ]BlueDot, Toronto, Canada
                [3 ]Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
                [4 ]Department of Medicine, Division of Infectious Diseases, University of Toronto, Toronto, Canada
                [5 ]Divisions of General Internal Medicine and Infectious Diseases, University Health Network, Toronto, Canada
                Author notes
                To whom correspondence should be addressed. Ashleigh Tuite, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, Ontario M5B 1T8, Canada; Email: ashleigh.tuite@ 123456utoronto.ca
                Author information
                http://orcid.org/0000-0002-4373-9337
                Article
                tay077
                10.1093/jtm/tay077
                6142906
                30192972
                bf370d05-579b-4660-96a5-22e10104e225
                © International Society of Travel Medicine, 2018. Published by Oxford University Press.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@ 123456oup.com

                History
                : 30 June 2018
                : 21 August 2018
                : 4 September 2018
                Page count
                Pages: 8
                Funding
                Funded by: Centers for Disease Control and Prevention 10.13039/100000030
                Award ID: CK000433-01
                Categories
                Original Article
                Editor's Choice

                migration, infectious disease,vaccine-preventable disease,mobility,venezuela

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