Exit and Entry Screening Practices for Infectious Diseases among Travelers at Points of Entry: Looking for Evidence on Public Health Impact

As global mobility increases, screening measures at airports, ports, and ground crossings are frequently implemented to contain the spread of infectious diseases during public health emergencies. This review evaluated the effectiveness, practices, and outcomes of entry and exit screening measures for travelers over the past 15 years, analyzing data from the SARS, H1N1 pandemic, and Ebola virus disease (EVD) outbreaks.

The authors conducted a comprehensive search of PubMed, Scopus, and grey literature from international and national health agencies. The methodology involved both a scoping search and a systematic bibliographic review. Inclusion criteria focused on documents published from 2003 to May 2018 regarding national routine or ad hoc screening measures at points of entry for serious cross-border health events. Researchers assessed the degree of success in identifying ill or exposed travelers, the limitations encountered, and the reported concomitant effects (both beneficial and adverse).

The review suggests that screening measures, while often required by policy, have historically struggled to achieve their primary goal of detecting and prohibiting travel for ill or incubating individuals. For instance, screening during the SARS and EVD outbreaks detected almost no confirmed cases. Even during the H1N1 pandemic, detection rates were extremely low.

Despite the lack of direct success in case detection, the authors identified several vital secondary benefits. These include educating travelers, establishing contact channels for later health monitoring, and maintaining public confidence in the safety of air travel. Furthermore, these measures can discourage travel among symptomatic individuals and help governments manage the political and economic pressures associated with potential pandemics. The paper concludes that screening is most effective when integrated into a comprehensive outbreak management strategy—including contact tracing, vaccination, and robust epidemiological surveillance—rather than functioning as a standalone barrier.