571. Air Port of Entry Surveillance: Passive or Active?
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Modern travel has led to rapid globalization of emerging infectious diseases, leading to debate regarding optimal risk-based border screening. The Hawaii Department of Health implemented passive influenza-like illness (ILI) surveillance among passengers on international flights arriving at Honolulu International Airport (HNL) in October 2005. In June 2008, active ILI screening of passengers on selected HNL arriving international flights was piloted.
Methods: Existing requirements for passenger illness reporting by flight crews and airport medical response were used for passive ILI surveillance; respiratory specimens are collected for influenza testing including RT-PCR and viral culture from any reported passenger with ILI. For active surveillance, 3 flights were selected. Before arrival, passengers completed a questionnaire collecting basic demographics, recent travel and illness history. Arriving passengers passed through health screening to review questionnaires and assess for illness. Passengers reporting fever history or presenting with illness were referred to secondary assessment. Influenza testing was to be offered to passengers with ILI.
Results: Passive surveillance required 2 people on site and utilized existing staff and responsibilities. Reviewing data from June 2008-April 2009, 7 people were identified as having ILI. Of these, 3 (43%) were positive for influenza (2 A[H3] ,1 B). Active surveillance required 31-47 people on site plus interpretation services and one month preparation per each airline/flight. Of the 3 flights (range 161-454 persons/flight; total, 889), 7 persons were referred for secondary medical assessment. None fulfilled ILI criteria.
Conclusion: Point of entry screening may contribute to regional influenza surveillance and indicate virus introduction. Passive surveillance enhances existing responsibilities and requires minimal resources but relies on actual illness observation. Active screening enables more sensitive detection but is resource intensive. Neither are disease entry barriers. Both contribute potentially valuable information regarding traveler epidemiology and influenza virus introduction.
Joe Elm, MS1, Sarah Park, MD, FAAP2, Ranjani Rajan, MPH1, Hirokazu Toiya, MPH1 and  S. Y. Park, None..
R. Rajan, None..
H. Toiya, None..
J. L. Elm, None., (1)Hawaii Dept of Health, Honolulu, HI, (2)Hawaii Department of Health, Honolulu, HI