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

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

Emily Layer  1 , Sebastian Hoehl  2 , Marek Widera  2 , Denisa Bojkova  2 , Tim Westphal  3 , Rene Gottschalk  3 , Boris Boeddinghaus  3 , Joscha Schork  3 , Sandra Ciesek  4 , Udo Goetsch  5
Affiliations

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

Emily Layer et al. Int J Infect Dis. 2022 May.

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.

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Figures

Figure 1
Figure 1
Simplified world map. Countries from which study participants departed before their arrival in Frankfurt are depicted light. Countries from which at least 1 study participant with a positive test departed are marked dark.
Figure 2
Figure 2
Rapid antigen test analysis results for rRT-PCR-positive samples. Positive (filled data point symbols) and negative (empty data point symbols) Ag-RDT results and corresponding CT-values (ORF-1). Ag-RDT, antigen rapid diagnostic test; CT, cycle threshold; rRT-PCR, real-time reverse-transcriptase PCR.
Figure 3
Figure 3
Flow diagram of the distribution of participants and nonparticipants.
See this image and copyright information in PMC

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