Journal of Preventive Medicine and Public Health

Original Article

Air Passengers’ Risk of SARS-CoV-2 Infection With a 14-Day Quarantine and Accuracy Assessment of a Symptom-based Screening System at an Airport: Toonlaya Direkwutthikun, Chanapong Rojanaworarit, Isabella Andrade, Bhanasut Hunsajarupan, Nuttawoot Photisan, Pattarasuda Sookchom, Thawabhorn Jannok, Rome Buathong; J Prev Med Public Health. 2025;58(1):72-82. Published online November 3, 2024; DOI: https://doi.org/10.3961/jpmph.24.517

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to validate the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, identify infection risk factors among air passengers subject to a 14-day mandatory quarantine, and evaluate the accuracy of mass symptom-based screening criteria at an airport.
Methods
This retrospective cohort study analyzed data from 116 004 air passengers who entered Thailand through Suvarnabhumi Airport in Bangkok from April 2020 to September 2020. The incidence of SARS-CoV-2 infection, risk characteristics, and accuracy indices of symptom-based screening were calculated.
Results
The overall incidence of SARS-CoV-2 was 0.5%, or 540 infections per 100 000 air passengers. Identified risk factors included sex, nationality, continent of departure, on-arrival screening results, and month of travel. Positive screening results indicated a higher risk and positive likelihood ratio for SARS-CoV-2 infection. However, the on-arrival screening criteria demonstrated low sensitivity and area under the receiver operating characteristic curve.
Conclusions
The current study confirms previous findings that the risk of SARS-CoV-2 infection during air travel is low. However, this might result from strict pre-departure screening and the SARS-CoV-2 test requirement for arriving passengers. The symptom-based screening criteria used upon arrival showed a low probability of identifying positive cases, suggesting that incorporating additional criteria could help detect asymptomatic infections. The integrated screening and quarantine model proved effective in preventing the spread of the virus into local communities.

Summary

Key Message
The risk of SARS-CoV-2 infection during air travel is low given a strict pre-departure screening and the SARS-CoV-2 test requirement. The symptom-based screening criteria used upon arrival showed a low probability of identifying positive cases. The integrated screening and quarantine model proved effective in preventing the spread of the virus into local communities.

Citations

Citations to this article as recorded by

Synergizing CRISPR diagnostics and interpretive biosensing into smart urban health systems for pandemic-resilient cities
Jacob Tizhe Liberty
Sustainable Cities and Society.2026; 142: 107332. CrossRef

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