Mass screening for infectious disease containment and pandemic outbreaks: misconceptions

Author: Dr. Peter Leando
American College of Clinical Thermology Inc. (United States)
Posted at: Spie Digital Library

Manuscript Mass Screening for infectious Disease SPIE 2015 Authors copy

SPIE | Proceeding | Mass screening for infectious disease containment and pandemic outbreaks: misconceptions

From Conference Volume 9485
  • Thermosense: Thermal Infrared Applications XXXVII
  • Sheng-Jen (Tony) Hsieh; Joseph N. Zalameda
  • Baltimore, Maryland, United States | April 20, 2015

Abstract
IR imaging in mass screening for the containment of pandemic disease is based on detecting a febril (fever) state in individuals. The ability to use IR affectively for this is dependent on a good understanding of the physiology and physics related to the pathology that we are trying to screen for and is not restricted to temperature measurements alone. The radiometric thermal data processed during real-time imaging must include calibrated reference sources, thermal pattern recognition and comparative analysis between individual people being screened. A screening test should have high ‘sensitivity’ rather than ‘specificity’ and to be effective the false negative rate must be very low. To achieve this the false positive rate will be higher by necessity and so a ‘secondary’ level of screening can be implemented to bring the false positive rate to within a manageable level by the higher ‘specificity’ secondary level of screening. © (2015) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.
Citation

Peter Leando
” Mass screening for infectious disease containment and pandemic outbreaks: misconceptions “, Proc. SPIE 9485, Thermosense: Thermal Infrared Applications XXXVII, 94851I (May 12, 2015); doi:10.1117/12.2177095;
http://dx.doi.org/10.1117/12.2177095

Meditherm Fever Screen 520 systems

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Fever Screening as part of the containment and prevention of the current Ebola outbreak.

DITI (Digital Infrared Thermal Imaging) in mass screening for the containment of pandemic disease is based on detecting a febril (fever) state in individuals.

ebola-virus1The design for DITI to be effective for fever screening is dependent on a good understanding of the physiology and physics related to the specific pathologies that we are trying to screen for and is not restricted to temperature measurements alone.

Additionally, the technology must be simple and easy to install and operate.

The radiometric thermal data processed during real-time imaging must include calibrated reference sources, thermal pattern recognition and comparative analysis between individual people being screened.

A screening test should have high ‘sensitivity’ rather than ‘specificity’ and to be effective the false negative rate must be very low.

To achieve this the false positive rate will be higher by necessity and so a ‘secondary’ level of screening should be implemented to bring the false positive rate to within a manageable level by the higher ‘specificity’ secondary level of screening.

Our current knowledge and experience of fever screening has evolved significantly since the 2002 Severe Acute Respiratory Syndrome (SARS) outbreak which was followed by a number of other pandemics such as H5N1 (Avian Flu), H1N1 (Swine Flu) and Coronavirus infections, all of which contributed to our experience based screening and operational protocols (operational problems and challenges), as well as software assisted systems and operator / technician training.

The ongoing future of IR screening as part of containment strategies for pandemic outbreaks will continue to benefit and evolve from what we can now learn from this Ebola outbreak.

Why use fever screening?

The utility and justification for using thermal imaging in the containment of Ebola is based on a proactive and preventative strategy.

Thermal imaging as a fever screening tool is used as a first level mass screening test that is sensitive and accurate at identifying all individuals that are above normal temperature and have a systemic fever.

The first level screening (primary screening) provides little or no inconvenience or interruption of movement for the majority of people being screened. Continue reading

Contagious Diseases – Fever screening to Contain

By Dr. Peter Leando

fever-screening1The primary response to new outbreaks of contagious diseases like the latest H5N1 virus, MERS-CoVis, and Ebola is containment and this is not always easy in today’s age of rapid transport and globalized commerce.

Wherever there are high density populations there is potential for the fast spread of contagious diseases and any infected individual can be on the other side of the world (potentially in another high density population) in a matter of hours.

We have been given the opportunity to practice our methods of containment and response with these (so far) relatively low grade viruses but it is inevitable that we will eventually encounter new and more aggressive strains of virus that will demand more serious responses. The current Ebola outbreak with its virulent ‘zaire’ strain is giving healthcare professionals an opportunity to implement and adapt strategies for containment and management of serious future pandemic outbreaks which will be inevitable ……… but we do have the opportunity to reduce the risk of pandemic spread of these new resistant strains of viruses.

The basic infrastructure is already in place, having been setup as a response to global terrorism.

fever-screening2Travel choke points such as airport security and immigration, train stations, toll booths, ship and ferry embarkation points and many other locations where people pass through to travel.

Travel is the key to containment of pandemic outbreaks of disease.

We can’t stop all travel otherwise the economies and infrastructures of the world would grind to a halt. We can take precautions to make travel safer and reduce the risk of spreading disease.

Disease causes the physiological response of the body to increase the core temperature and increased core temperature can be detected with sensitive Infrared detectors that are designed and calibrated to operate in the human physiological range.

We cannot measure the internal core temperature by imaging the skin surface (there are too many variables) but we can detect neurological abnormalities at the skin surface which are highly indicative of fever (elevated temperature) related to disease.

Fever screening at travel checkpoints has proven efficient if conducted properly but useless if the wrong equipment is used or the systems are not operated properly. Continue reading

The Meditherm 520 Fever Screen Range of Systems

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520 system options

Meditherm cameras are designed and built exclusively for medical / clinical applications including mass fever screening. Meditherm has over 17 years experience in this specialized industry.

Meditherm’s advantage is our experience in physiological testing. The depth of research that has gone into the development of our cameras and the design criteria specific to human testing cannot be matched by any other manufacturer.  Our system is easier to use with minimal training.  We also provide superior customer support and the operating manual is simple and easy to understand.

Continue reading

Fever screening to contain contagious disease

Written by: Dr Peter Leando

The primary response to new outbreaks of contagious diseases like the latest H7N9 virus is containment and this is not always easy in today’s age of rapid transport and globalized commerce.af_7

Wherever there are high density populations there is potential for the fast spread of contagious diseases and any infected individual can be on the other side of the world (potentially in another high density population) in a matter of hours.

We have been given the opportunity to practice our methods of containment and response with these (so far) relatively low grade viruses but it is inevitable that we will eventually encounter new and more aggressive strains of virus that will demand more serious responses.

Continue reading

Temperature Screening for Travelers

Fever Screening in the containment of pandemic outbreaks of Ebola, MERS-CoV, H5N1 (Avian Flu) and SARS

meditherm_520_system_with_sThe Meditherm temperature screening system is a turn-key package. It includes the Meditherm real-time Radiometric IR camera, Camera stand, Computer, Software, and Touch-screen Flat Panel user interface/screen. The system monitors temperatures, displays thermal images and has an adjustable temperature threshold to provide an alarm when a temperature exceeds the chosen threshold. The camera operates at real-time update rates, and displays images in color on a flat panel display. Temperature resolution is <0.25°C. Ambient temperature compensation assures readings are accurate as room temperatures change. The system is totally portable, compact, rugged, and is designed to operate 24/7. If needed, a weatherproof option is available. The touch-screen interface assures non-technical users can quickly learn to operate the system.

View pdf version of this document (1062K)
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