Reconstructing the COVID-19 incidence in India using airport screening data in Japan.

BACKGROUND: A major epidemic of COVID-19 caused by the Delta variant (B.1.617.2) occurred in India from March to July 2021, resulting in 19 million documented cases. Given the limited healthcare and testing capacities, the actual number of infections is likely to have been greater than reported, and several modelling studies and excess mortality research indicate that this epidemic involved substantial morbidity and mortality. METHODS: To estimate the incidence during this epidemic, we used border entry screening data in Japan to estimate the daily incidence and cumulative incidence of COVID-19 infection in India. Analysing the results of mandatory testing among non-Japanese passengers entering Japan from India, we calculated the prevalence and then backcalculated the incidence in India from February 28 to July 3, 2021. RESULTS: The estimated number of infections ranged from 448 to 576 million people, indicating that 31.8% (95% confidence interval (CI): 26.1, 37.7) - 40.9% (95% CI: 33.5, 48.4) of the population in India had experienced COVID-19 infection from February 28 to July 3, 2021. In addition to obtaining cumulative incidence that was consistent with published estimates, we showed that the actual incidence of COVID-19 infection during the 2021 epidemic in India was approximately 30 times greater than that based on documented cases, giving a crude infection fatality risk of 0.47%. Adjusting for test-negative certificate before departure, the quality control of which was partly questionable, the cumulative incidence can potentially be up to 2.3-2.6 times greater than abovementioned estimates. CONCLUSIONS: Our estimate of approximately 32-41% cumulative infection risk from February 28 to July 3, 2021 is roughly consistent with other published estimates, and they can potentially be greater, given an exit screening before departure. The present study results suggest the potential utility of border entry screening data to backcalculate the incidence in countries with limited surveillance capacity owing to a major surge in infections.

Assessment of fever screening at airports in detecting domestic passengers infected with SARS-CoV-2, 2020-2022, Okinawa prefecture, Japan.

BACKGROUND: While airport screening measures for COVID-19 infected passengers at international airports worldwide have been greatly relaxed, observational studies evaluating fever screening alone at airports remain scarce. The purpose of this study is to retrospectively assess the effectiveness of fever screening at airports in preventing the influx of COVID-19 infected persons. METHODS: We conducted a retrospective epidemiological analysis of fever screening implemented at 9 airports in Okinawa Prefecture from May 2020 to March 2022. The number of passengers covered during the same period was 9,003,616 arriving at 9 airports in Okinawa Prefecture and 5,712,983 departing passengers at Naha Airport. The capture rate was defined as the proportion of reported COVID-19 cases who would have passed through airport screening to the number of suspected cases through fever screening at the airport, and this calculation used passengers arriving at Naha Airport and surveillance data collected by Okinawa Prefecture between May 2020 and March 2021. RESULTS: From May 2020 to March 2021, 4.09 million people were reported to pass through airports in Okinawa. During the same period, at least 122 people with COVID-19 infection arrived at the airports in Okinawa, but only a 10 suspected cases were detected; therefore, the capture rate is estimated to be up to 8.2% (95% CI: 4.00-14.56%). Our result of a fever screening rate is 0.0002% (95%CI: 0.0003-0.0006%) (10 suspected cases /2,971,198 arriving passengers). The refusal rate of passengers detected by thermography who did not respond to temperature measurements was 0.70% (95% CI: 0.19-1.78%) (4 passengers/572 passengers). CONCLUSIONS: This study revealed that airport screening based on thermography alone missed over 90% of COVID-19 infected cases, indicating that thermography screening may be ineffective as a border control measure. The fact that only 10 febrile cases were detected after screening approximately 3 million passengers suggests the need to introduce measures targeting asymptomatic infections, especially with long incubation periods. Therefore, other countermeasures, e.g. preboarding RT-PCR testing, are highly recommended during an epidemic satisfying World Health Organization (WHO) Public Health Emergency of International Concern (PHEIC) criteria with pathogen characteristics similar or exceeding SARS-CoV-2, especially when traveling to rural cities with limited medical resources.

Presence of micronuclei and nuclear abnormalities in Caracara (Polyborus) plancus living in an airport area in southern Brazil.

The aviation sector is believed to be responsible for considerable environmental damage attributed to emission of a large number and amount of pollutants. Airports are often surrounded by forest fragments and humid areas that attract birds of prey and hence may potentially serve as useful bioindicators. The aim of the present study was to examine genotoxic potential in raptors exposed to airport pollution using the micronucleus (MN) test and morphological changes as evidenced by bilateral symmetry. This investigation was conducted at Salgado Filho International Airport of Porto Alegre - RS as well as in private and zoological breeding grounds. The presence of metals was measured in the blood cells of the collected birds. Seventeen birds (Caracara (Polyborus) plancus) were used in this study 11 from exposed and 6 from non-exposed group. The nuclear alterations clearly indicate that organisms exposed to airport pollution exhibited a significantly higher frequency of genetic damage compared to non-exposed birds. Further, manganese and chromium were detected exclusively in the blood of the exposed group. In contrast, the analysis of bilateral symmetry did not detect any significant morphologic differences between the two groups. Therefore, data indicate that blood genotoxic stress occurs in birds of prey living in civil aviation areas as evidenced by MN frequency increase and presence of manganese and chromium.

Investigation of an airport-associated cluster of falciparum malaria in Frankfurt, Germany, 2022.

Airport malaria is uncommon but increasing in Europe and often difficult to diagnose. We describe the clinical, epidemiological and environmental investigations of a cluster of airport malaria cases and measures taken in response. Three Frankfurt International Airport employees without travel histories to malaria-endemic areas were diagnosed with Plasmodium falciparum malaria in Germany in 2022. Two cases were diagnosed within 1 week, and the third one after 10 weeks. Two cases had severe disease, all three recovered fully. The cases worked in separate areas and no specific location for the transmissions could be identified. No additional cases were detected among airport employees. In June and July, direct flights from Equatorial Guinea, Nigeria and Angola and one parcel originating in Ghana arrived at Frankfurt airport. No vector-competent mosquitoes could be trapped to identify the source of the outbreak. Whole genome sequencing of P. falciparum genomes showed a high genetic relatedness between samples of the three cases and suggested the geographical origin closest to Ghana. A diagnosis of airport malaria should prompt appropriate and comprehensive outbreak investigations to identify the source and to prevent severe forms of falciparum malaria.

The impact of Chinese airport infrastructure on airline pollutant emissions: A hybrid stochastic-neural network approach based on utility functions.

With China being the world's largest emitter of greenhouse gases and its aviation sector burgeoning, the environmental performance of Chinese airlines has global significance. Amidst rising demands for eco-friendly practices from both customers and regulators, the interplay between airport infrastructure and environmental performance becomes pivotal. This research offers an innovative methodology to gauge the environmental performance of Chinese airlines, emphasizing the distance traveled between airports using weighted additive utility functions. Leveraging neural networks, the study investigates the impact of various airport infrastructural characteristics on environmental performance. Noteworthy findings indicate that ground control measures, automatic information services at origin airports, surface concrete on runways at both ends, and a centerline lighting system in destination airports positively influence environmental performance. In contrast, longer and wider runways at origin airports, increased distances to control towers, and asphalt runways at destination airports adversely affect it. These insights not only underscore the importance of strategic infrastructure enhancements for reducing carbon footprints but also hold profound policy implications. As global climate change remains at the forefront, fostering sustainable airport infrastructure in China can significantly contribute to worldwide mitigation efforts.

Early Detection of Severe Acute Respiratory Syndrome Coronavirus 2 Variants Using Traveler-based Genomic Surveillance at 4 US Airports, September 2021-January 2022.

We enrolled arriving international air travelers in a severe acute respiratory syndrome coronavirus 2 genomic surveillance program. We used molecular testing of pooled nasal swabs and sequenced positive samples for sublineage. Traveler-based surveillance provided early-warning variant detection, reporting the first US Omicron BA.2 and BA.3 in North America.

Detection of Monkeypox Virus DNA in Airport Wastewater, Rome, Italy.

Environmental surveillance can be a complementary tool for detecting pathogens circulating in communities. We detected monkeypox virus DNA in wastewater from Italy's largest airport by using real-time PCR assays targeting the G2R region and F3L and N3R genes and sequencing. Wastewater surveillance can be quickly adapted to investigate emerging threats.

Effect of Predeparture Testing on Postarrival SARS-CoV-2-Positive Test Results Among International Travelers - CDC Traveler-Based Genomic Surveillance Program, Four U.S. Airports, March-September 2022.

Beginning December 6, 2021, all international air passengers boarding flights to the United States were required to show either a negative result from a SARS-CoV-2 viral test taken ≤1 day before departure or proof of recovery from COVID-19 within the preceding 90 days (1). As of June 12, 2022, predeparture testing was no longer mandatory but remained recommended by CDC (2,3). Various modeling studies have estimated that predeparture testing the day before or the day of air travel reduces transmission or importation of SARS-CoV-2 by 31%-76% (4-7). Postarrival SARS-CoV-2 pooled testing data from CDC's Traveler-based Genomic Surveillance program were used to compare SARS-CoV-2 test results among volunteer travelers arriving at four U.S. airports during two 12-week periods: March 20-June 11, 2022, when predeparture testing was required, and June 12-September 3, 2022, when predeparture testing was not required. In a multivariable logistic regression model, pooled nasal swab specimens collected during March 20-June 11 were 52% less likely to be positive for SARS-CoV-2 than were those collected during June 12-September 3, after adjusting for COVID-19 incidence in the flight's country of origin, sample pool size, and collection airport (adjusted odds ratio [aOR] = 0.48, 95% CI = 0.39-0.58) (p<0.001). These findings support predeparture testing as a tool for reducing travel-associated SARS-CoV-2 transmission and provide important real-world evidence that can guide decisions for future outbreaks and pandemics.

Impact of airline network on the global importation risk of mpox, 2022.

From 1 January 2022 to 4 September 2022, a total of 53 996 mpox cases were confirmed globally. Cases are predominantly concentrated in Europe and the Americas, while other regions are also continuously observing imported cases. This study aimed to estimate the potential global risk of mpox importation and consider hypothetical scenarios of travel restrictions by varying passenger volumes (PVs) via airline travel network. PV data for the airline network, and the time of first confirmed mpox case for a total of 1680 airports in 176 countries (and territories) were extracted from publicly available data sources. A survival analysis technique in which the hazard function was a function of effective distance was utilised to estimate the importation risk. The arrival time ranged from 9 to 48 days since the first case was identified in the UK on 6 May 2022. The estimated risk of importation showed that regardless of the geographic region, most locations will have an intensified importation risk by 31 December 2022. Travel restrictions scenarios had a minor impact on the global airline importation risk against mpox, highlighting the importance to enhance local capacities for the identification of mpox and to be prepared to carry out contact tracing and isolation.

Airport Deicers: An Unrecognized Source of Phosphorus Loading in Receiving Waters.

Airport ice control products contributed to total phosphorus (TP) loadings in a study of surface water runoff at a medium-sized airport from 2015 to 2021. Eleven airport ice control products had TP concentrations from 1-807 mg L-1 in liquid formulas, while solid pavement deicer had a TP concentration of 805 mg kg-1. Product application data, formula TP concentrations, and surface water sampling results were used to estimate TP concentration and loading contributions from these ice control products to receiving streams. Airport ice control products were found to contribute to TP in 84% of the water samples collected at downstream sites during deicing events, and TP concentrations at those sites exceeded aquatic life benchmarks in 70% of samples collected during deicing. A receiving stream 6 km downstream had TP attributed to airport ice control sources in 78% of the samples. TP loadings at an upstream site and the receiving stream site were greatest during the largest runoff events as is typical in urban runoff, but this pattern was not always followed at airport outfall sites due to the influence of TP in deicer products. Products analyzed in this study are used at airports across the United States and abroad, and findings suggest that airport deicers could represent a previously unrecognized source of phosphorus to adjacent waterways.

Assessing the impact of aircraft arrival on ambient ultrafine particle number concentrations in near-airport communities in Boston, Massachusetts.

Aircraft emissions contribute to overall ambient air pollution, including ultrafine particle (UFP) concentrations. However, accurately ascertaining aviation contributions to UFP is challenging due to high spatiotemporal variability along with intermittent aviation emissions. The objective of this study was to evaluate the impact of arrival aircraft on particle number concentration (PNC), a proxy for UFP, across six study sites 3-17 km from a major arrival aircraft flight path into Boston Logan International Airport by utilizing real-time aircraft activity and meteorological data. Ambient PNC at all monitoring sites was similar at the median but had greater variation at the 95th and 99th percentiles with more than two-fold increases in PNC observed at sites closer to the airport. PNC was elevated during the hours with high aircraft activity with sites closest to the airport exhibiting stronger signals when downwind from the airport. Regression models indicated that the number of arrival aircraft per hour was associated with measured PNC at all six sites, with a maximum contribution of 50% of total PNC at a monitor 3 km from the airport during hours with arrival activity on the flight path of interest (26% across all hours). Our findings suggest strong but intermittent contributions from arrival aircraft to ambient PNC in communities near airports.

Wastewater-based SARS-CoV-2 airport surveillance: key trends at the Cape Town International Airport.

Monitoring of SARS-CoV-2 RNA in wastewater has revealed the role of mobility in the transmission of coronavirus disease (COVID-19), and the surveillance of airport wastewater in cities across the world has demonstrated how travel entry points can give an indication of trends in transmission. This study undertook wastewater surveillance at the Cape Town International Airport (CTIA) to assess the use of a WBE approach to provide supplementary information on the presence of COVID-19 at a key air travel entry point in South Africa. Grab wastewater samples (n = 55) were collected from the CTIA wastewater pump station and analysed using quantitative real-time polymerase chain reaction (qRT-PCR) method. The study found a correlation between the wastewater data and clinical cases reported in the City of Cape Town during various time periods and during the peak of a COVID-19 wave. Highly elevated viral loads in the wastewater were observed at times there was increased mobility through the airport. The study also revealed elevated viral load levels at the airport despite the stricter restrictions and through the lower restrictions. The study findings indicate wastewater surveillance and airports can provide supplementary information to airport authorities to assess the impacts of imposed travel restrictions.

Airport-based pharmacies: Products, services and challenges essential for patients in a global travel landscape.

The role of airport pharmacies has grown in recent years to provide a range of services to travelers, including over-the-counter and prescription medicines, as well as advice on prevention of infectious and other diseases. Prevention, including protective equipment, is especially important during pandemics, as seen with the recent coronavirus disease-2019 (COVID-19) pandemic. In addition, offering vaccinations where appropriate. However, this is not universal, and there are currently no acknowledged guidelines for pharmacists operating within airports. In addition, research into their role as well as potential ways to improve this is lacking. This is a concern with community pharmacists playing a valuable role during the COVID-19 pandemic. Potential ways forward include greater research into their activities to enhance their role and address challenges. These include issues of brand names and language, as well as encouraging travel pharmacy in future university curricula. In addition, producing guidelines for their activities and monitoring their implementation. This can help build a greater role for their services, benefiting airport staff and travelers in the future.

Preparing for the Next Pandemic: An After-Action Review of Infection Prevention and Control Audit Strategies Within Airport and Hotel Quarantine Program.

BACKGROUND: Effective infection prevention and control (IPAC) practices within the New South Wales (NSW) Airport Operations and Hotel Quarantine Program (Quarantine Program) were required to mitigate the risk of COVID-19 being transmitted to staff, other guests, contractors, and the community. METHOD: The Quarantine Program relied on complex logistical arrangements and an end-to-end process that included all steps from the time travelers boarded the returning flight until completion of the quarantine period. This required compliance with relevant IPAC standards historically reserved for health care and the implementation of a quality assurance audit framework. RESULTS: The Clinical Excellence Commission (CEC) as the NSW Health Pillar for quality and safety and the lead in IPAC provided training and resources coupled with an IPAC quality audit framework after program commencement. CONCLUSION: This approach ensured a clear governance structure and a regular review process to minimize risk and support continuous improvement within the program.

A new approach for sensitivity analysis of the StormWater Management Model applied in an airport.

Sensitivity analysis of urban flood model parameters is important for efficient and accurate flood simulation. In order to explore the problems of large sampling parameters and nonlinear correlation between input and output variables, this paper proposed a new correlation analysis approach. The type, strength, and the order of sensitive parameters to the four outputs are analyzed using the proposed approach. The results show that the R values of Manning-N are biggest, its distribution is linear in heat maps, and the Manning-N has a strong linear correlation with Average Depth, Hour of Maximum Flooding, and Time to Peak. For Average Depth, the second sensitive parameter is Conductivity. For Hour of Maximum Flooding, the second and third more sensitive parameters are Conductivity and N-perv; however, there are certain nonlinear correlations from heat maps. For Total Inflow, the R values of each parameter are between 0.021 and 0.534. Most sensitive parameters are none; however, the more sensitive parameters are Conductivity, N-perv, and initial deficit. For Time to Peak, the second and third more sensitive parameters are N-perv and N-Imperv; however, there are certain non-linear correlations from heat maps. The results can provide theoretical guidance for application and parameter calibration of SWMM in airport.

Meteorological data source comparison-a case study in geospatial modeling of potential environmental exposure to abandoned uranium mine sites in the Navajo Nation.

Meteorological (MET) data is a crucial input for environmental exposure models. While modeling exposure potential using geospatial technology is a common practice, existing studies infrequently evaluate the impact of input MET data on the level of uncertainty on output results. The objective of this study is to determine the effect of various MET data sources on the potential exposure susceptibility predictions. Three sources of wind data are compared: The North American Regional Reanalysis (NARR) database, meteorological aerodrome reports (METARs) from regional airports, and data from local MET weather stations. These data sources are used as inputs into a machine learning (ML) driven GIS Multi-Criteria Decision Analysis (GIS-MCDA) geospatial model to predict potential exposure to abandoned uranium mine sites in the Navajo Nation. Results indicate significant variations in results derived from different wind data sources. After validating the results from each source using the National Uranium Resource Evaluation (NURE) database in a geographically weighted regression (GWR), METARs data combined with the local MET weather station data showed the highest accuracy, with an average R2 of 0.74. We conclude that local direct measurement-based data (METARs and MET data) produce a more accurate prediction than the other sources evaluated in the study. This study has the potential to inform future data collection methods, leading to more accurate predictions and better-informed policy decisions surrounding environmental exposure susceptibility and risk assessment.

Ambient air quality assessment at the airports based on a meteorological perspective.

Natural mineral dust episodes elevate particle concentrations and eventually decrease air quality. Air pollutant emissions from aircraft, airport ground operations, and long-range dust transport are producing problems for the aviation sector. Dust transport from the Sahara Desert, one of the primary dust sources globally, significantly affects the eastern Mediterranean basin, including Türkiye. This study investigates the effect of long-range dust transport on particulate matter (PM) concentrations at Turkish airports. Three different approaches were used to analyse dust episodes in the study area. Firstly, routine reports of meteorological conditions at the airports were investigated. For this purpose, airport routine meteorological reports (Metar) and aviation-selected special weather report (Speci) codes, recorded at 11 airports from 2012 to 2021, were used to determine the dust episode days. Secondly, the hourly PM measurement dataset was analyzed from the closest air quality monitoring stations to the airports. Finally, regional atmospheric model results and backward-trajectory analysis were used to validate the dust episodes and determine the dust origin. Results showed that 163 dust episodes occurred during the study period, 17% from North Africa and 12% from the Mediterranean region.

An investigation of the effects of sand and dust storms in the North East Sahara Desert on Turkish airports and PM10 values: 7 and 8 April, 2013 events.

Between April 7 and April 10, 2013, a cyclone with a value of 995 hPa that developed in the central Mediterranean transported dust from the Sahara Desert towards Turkey. At 13 airports in Turkey, dust haze and widespread dust were seen during different occasions in this period and caused the observation of so-called "Blowing dust events." This cyclone blew dust towards the Cappadocia airport, and the prevailing visibility decreased to 3800 m, making it the lowest value measured during the transition of this cyclone. In this study, Aviation Routine Weather Report (Metar) and Aviation Selected Special Weather Report (Speci) observations of airports in North Africa and Turkey were evaluated for the period between April 3 and April 11, 2013. With this cyclone the prevailing visibility at Benina Airport in Libya decreased to 50 m on April 6, 2013. This study aims to evaluate long-distance dust transport's effects on meteorological visibility at airports in Turkey and examine the episodic changes of PM10 values measured by air quality monitoring stations. Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model outputs were used to determine the trajectories of long-distance dust particles. Powder red, green, and blue (RGB) and Moderate Resolution Imaging Spectroradiometer (MODIS) satellite images, Cloud-Aerosol LIDAR Infrared Pathfinder Satellite Observations (CALIPSO) images, the Barcelona Supercomputing Center-Dust Regional Atmosphere Model (BSC-DREAM8b) outputs, and Global Forecast System (GFS) synoptic maps were used for analysis. In addition, PM10 values obtained from air quality monitoring stations were examined. According to the data obtained from the CALIPSO images, the dust concentration on the Eastern Mediterranean reaches up to 5 km. The episodic values obtained from certain air quality measurement stations are Adana 701, Gaziantep 629, Karaman 900, Nevsehir 1343, and Yozgat 782 µg/m3 on an hourly average.

Evidence of aircraft activity impact on local air quality: A study in the context of uncommon airport operation.

Wuhan Tianhe International Airport (WUH) was suspended to contain the spread of COVID-19, while Shanghai Hongqiao International Airport (SHA) saw a tremendous flight reduction. Closure of a major international airport is extremely rare and thus represents a unique opportunity to straightforwardly observe the impact of airport emissions on local air quality. In this study, a series of statistical tools were applied to analyze the variations in air pollutant levels in the vicinity of WUH and SHA. The results of bivariate polar plots show that airport SHA and WUH are a major source of nitrogen oxides. NOx, NO2 and NO diminished by 55.8%, 44.1%, 76.9%, and 40.4%, 33.3% and 59.4% during the COVID-19 lockdown compared to those in the same period of 2018 and 2019, under a reduction in aircraft activities by 58.6% and 61.4%. The concentration of NO2, SO2 and PM2.5 decreased by 77.3%, 8.2%, 29.5%, right after the closure of airport WUH on 23 January 2020. The average concentrations of NO, NO2 and NOx scatter plots at downwind of SHA after the lockdown were 78.0%, 47.9%, 57.4% and 62.3%, 34.8%, 41.8% lower than those during the same period in 2018 and 2019. However, a significant increase in O3 levels by 50.0% and 25.9% at WUH and SHA was observed, respectively. These results evidently show decreased nitrogen oxides concentrations in the airport vicinity due to reduced aircraft activities, while amplified O3 pollution due to a lower titration by NO under strong reduction in NOx emissions.

Epidemiology and Risk of Coronavirus Disease 2019 Among Travelers at Airport and Port Quarantine Stations Across Japan: A Nationwide Descriptive Analysis and an Individually Matched Case-Control Study.

BACKGROUND: The epidemiology and risk of coronavirus disease 2019 (COVID-19) among travelers at international borders remain unclear. METHODS: We conducted descriptive and individually matched case-control studies using a nationwide register for COVID-19 testing of travelers from 3 August to 31 October 2020 at airport/port quarantine stations across Japan. Case patients, defined as travelers positive for COVID-19 on arrival, were individually matched with 4 controls for arrival date and airport or port. We assessed associations between test positivity and traveler characteristics using conditional logistic regression analysis. RESULTS: Overall, 157 507 travelers arriving from 146 countries/areas at 17 quarantine stations across Japan were tested for COVID-19. The percentage of test positivity during the study period was 0.35%. In the case-control study, with 536 case patients and 2144 controls, we found evidence of lower test positivity in travelers aged 3-19 years, female travelers, and travel corridor users (adjusted odds ratio [95% confidence interval], 0.36 [.22-.60], 0.71 [.56-.89], and 0.48 [.30-.77], respectively), whereas higher positivity was associated with arrival from South-East Asia (1.88 [1.33-2.65]) or lower-middle- or low-income countries (2.46 [1.69-3.58] and 7.25 [2.22-23.66], respectively), any symptom (4.08 [1.43-11.65]), and nasopharyngeal compared with saliva sampling (2.75 [1.85-4.09]). A higher 14-day average incidence in the countries of stay was also associated with higher test positivity (1.64 [1.16-2.33] and 3.13 [1.88-5.23] for those from countries and areas where the 14-day average incidence was from 10 to <100 and ≥100 cases per million, respectively). CONCLUSIONS: These findings justify travel restrictions based on the epidemic situation in countries of stay, although underestimation of the epidemic in lower-income countries should be considered. A strict travel corridor could also reduce the risk of COVID-19 importation.