COVID-19 passenger screening to reduce travel risk and translocation of disease.

Aviation passenger screening has been used worldwide to mitigate the translocation risk of SARS-CoV-2. We present a model that evaluates factors in screening strategies used in air travel and assess their relative sensitivity and importance in identifying infectious passengers. We use adapted Monte Carlo simulations to produce hypothetical disease timelines for the Omicron variant of SARS-CoV-2 for travelling passengers. Screening strategy factors assessed include having one or two RT-PCR and/or antigen tests prior to departure and/or post-arrival, and quarantine length and compliance upon arrival. One or more post-arrival tests and high quarantine compliance were the most important factors in reducing pathogen translocation. Screening that combines quarantine and post-arrival testing can shorten the length of quarantine for travelers, and variability and mean testing sensitivity in post-arrival RT-PCR and antigen tests decrease and increase with the greater time between the first and second post-arrival test, respectively. This study provides insight into the role various screening strategy factors have in preventing the translocation of infectious diseases and a flexible framework adaptable to other existing or emerging diseases. Such findings may help in public health policy and decision-making in present and future evidence-based practices for passenger screening and pandemic preparedness.

A snake in the grass: retroperitoneal abscess due to perforated appendicitis-management, approach and recommendations.

A perforated retrocecal appendix resulting in a retroperitoneal abscess is a rare complication of a common disease. The first description of this condition was published in 1948. We present a case involving a 50-year-old woman who presented with abdominal pain inconsistent with the typical presentation of acute appendicitis and was eventually found to have a perforated retrocecal appendix accompanied by a retroperitoneal abscess. The patient was diagnosed using CT and operated upon but unfortunately had a resistant inflammatory process that led to persistent pus drainage from the abdomen despite multiple evacuation attempts and a prolonged hospital stay. In such cases, if the source of this type of inflammatory process has not yet been controlled or even identified, we recommend a second surgical examination, with additional surgical examinations as needed, and offer other suggestions.