Infectious disease implications of large-scale migration of Venezuelan nationals

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.

Figure 1.

Trends in outbound air travel from Venezuela, 2007–17. (A) Monthly number of outbound passengers to all international destinations (points). The solid line represents the locally weighted smoothing interpolation to the data points (LOESS) and the grey-shaded area shows the 95% confidence interval. (B) Proportionate distribution of destination countries for outbound passengers from Venezuela over time.

Figure 2.

Comparison of impedance (A, C) and radiation (B, D) mobility model predictions of migrant flows to major Latin American and Caribbean cities. Results are shown for the origin cities of Caracas (A, B) and Ciudad Guayana (C, D). Points are proportionate to the probability of travel to a given city. Cities with probability less than 0.01 are not shown.