Assessment of Sensitivity of Screening for Imported Notifiable Diseases at Port of Entry, Taiwan, 2012–2015

DOI: 10.6525/TEB.20170627.33(12).001

Sue-Hung Lin ^1＊, Yung-Ching Lin ², Pi-Fang Chen ¹ Li-Jue Wu ¹, Li-Li Ho ¹, Yi-Chun Wu ¹

2017 Vol.33 NO.12

Correspondence Author： Sue-Hung Lin ^1＊

Abstract：

Border quarantine is the frontline to prevent the importation of communicable diseases. In order to detect inbound symptomatic passengers and to prevent introduction of imported diseases, since SARS epidemic in 2003, Taiwan has set up remote-sensing infrared thermography at ports of entry for screening and tracing of febrile passengers. Previous studies did not consider that thermography could not capture those who developed symptoms when entering the border, which led to inadequate assessment of screening sensitivity. We aimed at evaluating the sensitivity of screening for inbound symptomatic passengers.

        We collected data of notifiable disease cases and inbound passengers from Notifiable Disease Surveillance System, Symptom Surveillance System, Foreign Labor Health Management Information System, Notifiable Disease Questionnaire System and official website for National Immigration Agency for 2012–2015. We calculated and compared corrected screening sensitivity by year, passenger identity, disease category, and country of origin.

        The number of inbound passengers was increasing while the corrected screening sensitivity remained at about 60% in 2012–2015. The sensitivity was higher among foreigners (82%) and foreign labors (65%). In the study period the major imported notifiable disease was dengue fever, with the general screening sensitivity of 70% and >85% among foreigners and foreign labors. The screening sensitivity for shigellosis decreased from 63% to 11%.

       Using infrared thermography, we could detect 60% of inbound symptomatic passengers with notifiable diseases. To further improve the sensitivity, we recommend that travel agencies to enhance health education and health authorities to raise awareness and willingness in active reporting of illness. We also recommend further cost-effectiveness analysis on fever screening at port of entry for refining our policies in disease prevention, control and quarantine.