Point of Entry/Exit Testing (#POET): An Ideal Screening and Testing Location

Introduction

In our interconnected world, travel and mobility are essential but also pose significant challenges for public health. The rapid movement of people can facilitate the spread of infectious diseases, making it crucial to implement effective monitoring and screening strategies. Point of Entry/Exit Testing (#POET) at travel and mobility hubs—such as airports, seaports, and border crossings—emerges as a critical intervention. Leveraging Lateral Flow Assay Rapid Diagnostic Tests (LFA-RDTs), POET provides an ideal disease control and prevention solution.

Travel and Mobility as Transmission Vectors

Yes, travel and mobility are significant transmission vectors for infectious diseases. The movement of people from one location to another can facilitate the spread of local and global pathogens. This phenomenon has been observed with numerous infectious diseases, including but not limited to influenza, SARS, Ebola, and COVID-19. Here are some key points illustrating how travel and mobility contribute to disease transmission:

Mechanisms of Transmission through Travel and Mobility:

Introduction of Pathogens to New Areas:

• Travelers can carry infectious agents from regions with high disease prevalence to areas where the disease is not yet present or is under control.
• Pathogens can be introduced to new populations with little immunity, leading to outbreaks.

Rapid Spread Across Distances:

• Air travel, in particular, enables pathogens to spread rapidly across continents within hours.
• Public transportation systems, such as buses, trains, and ships, can also facilitate the spread of diseases over shorter distances.

High Population Density and Close Contact:

• Airports, train stations, and other travel hubs often involve high population density and close contact among individuals, creating ideal conditions for transmission.
• Enclosed environments like airplanes and cruise ships can enhance the transmission of airborne and droplet-borne diseases.

Asymptomatic Carriers:

• Individuals who are infected but asymptomatic can unknowingly transmit diseases to others during travel.
• Screening and quarantine measures at entry/exit points are crucial to identifying and isolating such cases.

Examples of Travel and Mobility as Transmission Vectors:

COVID-19:

• The initial spread of COVID-19 from Wuhan, China, to the rest of the world was significantly facilitated by international travel.
• Travel restrictions and quarantine measures have been key strategies in controlling the spread of the virus.
• https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01897-3/fulltext

Ebola:

• The 2014-2016 West Africa Ebola outbreak spread to other countries through infected travellers, leading to cases in the United States, Spain, and other nations.
• Strict travel protocols and screening at entry points were implemented to prevent further spread.
• https://www.who.int/emergencies/situations/ebola-outbreak-2014-2016-West-Africa

Influenza:

• Seasonal influenza spreads globally each year, with international travel playing a major role in its dissemination.
• Monitoring and vaccination programs are essential to manage its impact.
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713810/

Strategic Importance of POET

1. Centralized Monitoring Points

Travel hubs are natural convergence points for travellers from diverse regions, offering a unique opportunity for centralized health monitoring. Screening at these locations allows health authorities to intercept potential disease carriers before they can spread infections within the broader community.

2. Rapid and Reliable Testing

LFA-RDTs are designed for quick and accurate disease detection. These tests deliver results within minutes, which is crucial for maintaining the flow of travellers while ensuring robust health security. The high sensitivity and specificity of LFA-RDTs make them reliable tools for identifying infectious diseases promptly.

3. Ease of Use and Deployment

One of the key advantages of LFA-RDTs is their simplicity and portability. These tests require minimal training and can be deployed in various environments, from bustling international airports to remote border crossings. This flexibility ensures that screening can be conducted consistently and effectively across different locations.

4. Cost-Effective Solutions

Compared to other diagnostic methods, LFA-RDTs are cost-effective, making them suitable for large-scale implementation, even in resource-limited settings. This affordability is crucial for sustaining testing operations, especially during prolonged public health emergencies.

5. Integration with Digital Health Systems

Modern LFA-RDTs can be paired with Rapid Diagnostic Readers (RDR) and cloud-based systems for real-time data collection and analysis. This integration supports immediate public health responses and enables better tracking and managing potential outbreaks.

Enhanced Public Health Measures

6. Comprehensive Screening Protocols

Combining LFA-RDTs with other health measures such as temperature checks, health declarations, and symptom questionnaires creates a robust screening protocol. Establishing quarantine facilities for symptomatic individuals at travel hubs ensures effective containment of potential cases.

7. Effective Public Health Messaging

Travel hubs can serve as platforms for disseminating public health information. Providing travellers with information on disease symptoms, preventive measures, and the importance of testing helps raise awareness and promotes health safety practices.

Strategies to Mitigate Transmission through Travel and Mobility

1. Point of Entry Testing (POET)

• Implementing rapid diagnostic testing at airports, seaports, and border crossings to identify and isolate infected individuals.
• Ensuring the availability of reliable and quick RDTs to facilitate these efforts.

2. Quarantine and Isolation

• Mandating quarantine for travellers from high-risk areas to prevent potential spread.
• Isolating confirmed cases to control transmission.

3. Travel Restrictions and Advisories

• Imposing travel bans or restrictions to and from areas with ongoing outbreaks.
• Issuing travel advisories to inform the public of risks and preventive measures.

4. Health Screenings

• Conducting temperature checks and health questionnaires for travellers.

5. Public Health Education

• Informing travellers about the risks and symptoms of infectious diseases.
• Promoting hygiene practices such as hand washing, mask-wearing, and physical distancing.

Conclusion

Point of Entry/Exit Testing (POET), supported by LFA-RDTs, represents a powerful strategy to enhance global health security. By implementing POET at travel and mobility hubs, we can effectively intercept and manage infectious diseases, protecting public health while maintaining the flow of people and goods.

Embrace POET to Ensure Safer Travel

Travel and mobility are intrinsic transmission vectors for infectious diseases due to the ease and speed with which people can move across regions and continents. Effective public health measures, including rapid diagnostic testing, quarantine protocols, travel restrictions, and public education, are essential to mitigate the risks associated with travel and mobility, thereby controlling the spread of infectious diseases.

Leveraging advanced diagnostic technologies at points of entry mitigates the spread of infectious diseases and strengthens our collective resilience against future pandemics. Together, we can make travel safer and our communities healthier. Let’s embrace POET and make a significant impact on global health outcomes.