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The largest epidemic of Lassa fever in recent history occurred in Nigeria in 2018. We assessed the potential for cases of Lassa fever originating in Nigeria to arrive at international destinations via air travel using a probabilistic model. We estimated no exported cases in 62% of 1,000 model simulations. In 30% of simulations, a single exported case was projected. Greater than 40% of outbound travelers from Nigeria arrived in the United States, the United Kingdom, and Ghana, placing these countries at greatest risk for receiving an exported case. There was a wide range in the capacity of highly connected countries to respond to infectious disease threats, as measured by the Infectious Disease Vulnerability Index. Although we quantified a low probability of case exportation during this outbreak, countries with the greatest connectivity to Nigeria should be alert to the potential risks of Lassa fever importation and be prepared to manage infected individuals.
Address correspondence to Kamran Khan, Division of Infectious Disease, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada, E-mail: firstname.lastname@example.org or Isaac I. Bogoch, Divisions of General Internal Medicine and Infectious Diseases, Toronto General Hospital, 14EN-209, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada, E-mail: email@example.com.
Financial support: This study was supported in part by the Canadian Institutes of Health Research.
Disclosure: K. K. is the founder of BlueDot, a social enterprise that develops digital technologies for public health. A. R. T., A. W., and K. K. received employment or consulting income from BlueDot during this research. I. I. B. has consulted for BlueDot.
Authors’ addresses: Ashleigh R. Tuite, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada, and Dalla Lana School of Public Health, Toronto, Canada, E-mail: firstname.lastname@example.org. Alexander G. Watts, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada, E-mail: email@example.com. Moritz U. G. Kraemer, Boston Children’s Hospital, Boston, MA, and Department of Zoology, University of Oxford, Oxford, United Kingdom, E-mail: firstname.lastname@example.org. Kamran Khan, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada, and Division of Infectious Disease, Department of Medicine, University of Toronto, Toronto, Canada, E-mail: email@example.com. Isaac Bogoch, Divisions of General Internal Medicine and Infectious Diseases, Toronto General Hospital, Toronto, Canada, and Department of Medicine, University of Toronto, Toronto, Canada, E-mail: firstname.lastname@example.org.