title: A loophole in international quarantine procedures disclosed during the SARS crisis.
abstract: This study describes a loophole in the international quarantine system during the recent Asian severe acute respiratory syndrome (SARS) outbreak. Specifically, that of travelers disguising symptoms of respiratory tract infection at international airports, in order to board aircraft to return to their home countries-notwithstanding the infection risks this involves to others. High medical fees for treatment to non-residents in epidemic areas were found to be the main cause for this behaviour. This phenomenon revealed a loophole in the control mechanisms of international quarantine procedures, letting travelers carrying a highly contagious virus slip by undetected and causing possible multi-country outbreaks of communicable diseases. Clinical evidence collected from medical records at medical centers can highlight this oversight.
authors.affiliation: The Graduate Institute of Clinical Medical Sciences of the Chang Gung University, Taiwan. chiweilee1964@yahoo.com
authors.forename: Chi-Wei
authors.initials: CW
authors.lastname: Lee
authors.forename: Yen-Shuo
authors.initials: YS
authors.lastname: Tsai
authors.forename: Tai-Wai
authors.initials: TW
authors.lastname: Wong
authors.forename: Chor-Chiu
authors.initials: CC
authors.lastname: Lau
mesh_terms: D000328:Adult; D000368:Aged; D000401:Aircraft; D002675:Child, Preschool; D008192:Deception; D004196:Disease Outbreaks / Q000517:prevention & control*; D005251:Fees, Medical; D005260:Female; D014943:Global Health; D017048:Health Care Costs; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D011790:Quarantine / Q000523:psychology / Q000592:standards*; D012306:Risk; D045169:Severe Acute Respiratory Syndrome / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014195:Travel