Purpose: The recent coronavirus disease 2019 (COVID-19) pandemic, which spread across the globe in a very short period of time, revealed that the transmission control of disease is a crucial step to prevent an outbreak and effective screening for viral infectious diseases is necessary. Since the severe acute respiratory syndrome (SARS) outbreak in 2003, infrared thermography (IRT) has been considered a gold standard method for screening febrile individuals at the time of pandemics. The objective of this review is to evaluate the efficacy of IRT for screening infectious diseases with specific applications to COVID-19.
Approach: A literature review was performed in Google Scholar, PubMed, and ScienceDirect to search for studies evaluating IRT screening from 2002 to present using relevant keywords. Additional literature searches were done to evaluate IRT in comparison to traditional core body temperature measurements and assess the benefits of measuring additional vital signs for infectious disease screening.
Results: Studies have reported on the unreliability of IRT due to poor sensitivity and specificity in detecting true core body temperature and its inability to identify asymptomatic carriers. Airport mass screening using IRT was conducted during occurrences of SARS, Dengue, Swine Flu, and Ebola with reported sensitivities as low as zero. Other studies reported that screening other vital signs such as heart and respiratory rates can lead to more robust methods for early infection detection.
Conclusions: Studies evaluating IRT showed varied results in its efficacy for screening infectious diseases. This suggests the need to assess additional physiological parameters to increase the sensitivity and specificity of non-invasive biosensors.
We developed a wearable system for wireless monitoring of oxygenation of deep tissues such as liver and lung during exercise. It is also useful where subcutaneous fat thickness is high. Our system utilizes Continuous Wave Near Infrared Spectroscopy (CW NIRS) with source-detector distances from 10mm to 60mm. This allows us to observe tissues at various depths. To mitigate the interference of the overlaying tissue layers such as skin, fat and muscle, we developed a multi-layer Monte Carlo model for photon diffusion. Flexible structure of our device helps achieve better skin contact and expand its usability to most body parts.
Dynamic Full-Field Optical Coherence Tomography (D-FFOCT) is a high transverse resolution version of OCT that records signal at the output of the interferometer as a movie over a few seconds. Analyzing the temporal variation of the signals reveals intracellular contrast which gives D-FFOCT the capability of identifying dynamic metabolic changes. We use D-FFOCT to identify oxygen induced changes in cellular metabolism at ambient (22%) oxygenation and at hypoxia (1%). Signal strength, calculated as an integral of the raw FFT spectrum, is significantly higher for 1% samples compared to 22% indicating that D-FFOCT is sensitive to changes in cell metabolism.
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