The role of population heterogeneity and human mobility in the spread of pandemic influenza.

Little is known on how different levels of population heterogeneity and different patterns of human mobility affect the course of pandemic influenza in terms of timing and impact. By employing a large-scale spatially explicit individual-based model, founded on a highly detailed model of the European populations and on a careful analysis of air and railway transportation data, we provide quantitative measures of the influence of such factors at the European scale. Our results show that Europe has to be prepared to face a rapid diffusion of a pandemic influenza, because of the high mobility of the population, resulting in the early importation of the first cases from abroad and highly synchronized local epidemics. The impact of the epidemic in European countries is highly variable because of the marked differences in the sociodemographic structure of European populations. R(0), cumulative attack rate and peak daily attack rate depend heavily on sociodemographic parameters, such as the size of household groups and the fraction of workers and students in the population.