Investigation of febrile passengers detected by infrared thermal scanning at an international airport

Objective: To determine the best approach for the evaluation of fever, detected by infrared thermal scanning, at an international airport. Methods: Arriving passengers with fever were divided into three groups: community evaluation by a GP, with or without cost compensation, or evaluation at the airport by a health practitioner. Uptake of offered evaluations was measured, diagnoses were recorded, and region-specific rates of fever measured. Observations were made on practical aspects of thermal screening. Results: Over a six-month period, 181,759 passengers were screened for fever at the Cairns international airport, Queensland, Australia. Fever was identified in 118 (0.06%) of the arriving passengers and 76 were enrolled in the study. Only 19 of these passengers (25%) voluntarily underwent further evaluation. No differences were observed in the three approaches. Conclusions: Public health surveillance of febrile passengers arriving at an international airport should not rely on voluntary passenger participation for the detection of imported contagious diseases.