SARS-CoV-2 screening strategies for returning international travellers: Evaluation of a rapid antigen test approach

Int J Infect Dis. 2022 May:118:126-131. doi: 10.1016/j.ijid.2022.02.045. Epub 2022 Mar 2.

Abstract

Background: International travel poses the risk of importing SARS-CoV-2 infections and introducing new viral variants into the country of destination. Established measures include mandatory quarantine with the opportunity to abbreviate it with a negative rapid antigen test (RAT).

Methods: A total of 1,488 returnees were tested for SARS-CoV-2 with both PCR and RAT no earlier than 5 days after arrival. We assessed the sensitivity and specificity of the RAT. Positive samples were evaluated for infectivity in vitro in a cell culture outgrowth assay. We tracked if participants who tested negative were reported positive within 2 weeks of the initial test.

Results: Potential infectiousness was determined based on symptom onset analysis, resulting in a sensitivity of the antigen test of 89% in terms of infectivity. The specificity was 100%. All positive outgrowth assays were preceded by a positive RAT, indicating that all participants with proven in vitro infectivity were correctly identified. None of the negative participants tested positive during the follow-up.

Conclusions: RAT no earlier than the 5th day after arrival was a reliable method for detecting infectious travellers and can be recommended as an appropriate method for managing SARS-CoV-2 travel restrictions. Compliance to the regulations and a high standard of test quality must be ensured.

Keywords: Antigen test; Quarantine; SARS-CoV-2 testing; Travel regulations.

MeSH terms

  • COVID-19* / diagnosis
  • Humans
  • Quarantine
  • SARS-CoV-2*
  • Sensitivity and Specificity
  • Travel