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Ben Said S, Jaballah R, Yaakoubi H, Ben Salah H, Youssef R, Mzid N, Kacemi M, Trabelsi I, Ben Ayed A, Ben Ayed S, Boukadida L, Zorgati A, Boukef R. Canine olfactory detection and its relevance for the medical identification of patients with COVID-19. Infect Dis (Lond) 2024:1-7. [PMID: 38889329 DOI: 10.1080/23744235.2024.2363887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 05/29/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION The assessment of Volatile Organic Compounds (VOCs) in exhaled breath or sweat represents a potential non-invasive and rapid diagnostic tool for respiratory diseases. OBJECTIVE To determine if trained dogs can reliably identify the odour associated with COVID19. METHODS This is a monocentric prospective study carried out in the Emergency Department (ED) of a university hospital fromJulyto November 2021.Axillary sweat samples from all patients were collected bytwo trained health care professionals. The samples were collected in the form of sterile gauze swabs placed under the armpits for at least 4 h for each patient.Then, Tubes wereshiftedto the double-blind dog training centre for VOC detection by two individuals. RESULTS Dogs were tested using a total of 129 axillary sweat samples; 69 of the 107 patients who tested positive for COVID-19 based on their odours had a positive PCR/Antigen test and 19 of the 22 patients who were tested negative for COVID-19 by the dogs had a negative PCR test. The sniffer dog infection detection method had a sensitivity of 95.83% and a specificity of 33.33%. The PPV was 64.49% and the NPVwas 86.36%. The measurement of the intensity of the connection between the two variables (disease/sign) was very strong (Q = 0.84). This link is statistically significant (X2 = 19.13) with a probability p ≤ 0.001. CONCLUSION Overall, the use of trained detection dogs as a screening method for SARS-CoV-2 is an interesting avenue of research that warrants further exploration and validation.
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Affiliation(s)
- Salma Ben Said
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Rahma Jaballah
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Hajer Yaakoubi
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Houda Ben Salah
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Rym Youssef
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Nouhel Mzid
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Marouen Kacemi
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Imen Trabelsi
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Ali Ben Ayed
- K9 Dog Center Security And Training, sousse, Tunisia
| | - Saed Ben Ayed
- K9 Dog Center Security And Training, sousse, Tunisia
| | - Lotfi Boukadida
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Asma Zorgati
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
| | - Riadh Boukef
- Emergency Department, Sahloul University Hospital, Sousse, Tunisia
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Wellford SA, Moseman EA. Olfactory immunology: the missing piece in airway and CNS defence. Nat Rev Immunol 2024; 24:381-398. [PMID: 38097777 DOI: 10.1038/s41577-023-00972-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 12/23/2023]
Abstract
The olfactory mucosa is a component of the nasal airway that mediates the sense of smell. Recent studies point to an important role for the olfactory mucosa as a barrier to both respiratory pathogens and to neuroinvasive pathogens that hijack the olfactory nerve and invade the CNS. In particular, the COVID-19 pandemic has demonstrated that the olfactory mucosa is an integral part of a heterogeneous nasal mucosal barrier critical to upper airway immunity. However, our insufficient knowledge of olfactory mucosal immunity hinders attempts to protect this tissue from infection and other diseases. This Review summarizes the state of olfactory immunology by highlighting the unique immunologically relevant anatomy of the olfactory mucosa, describing what is known of olfactory immune cells, and considering the impact of common infectious diseases and inflammatory disorders at this site. We will offer our perspective on the future of the field and the many unresolved questions pertaining to olfactory immunity.
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Affiliation(s)
- Sebastian A Wellford
- Department of Integrative Immunobiology, Duke University School of Medicine, Durham, NC, USA
| | - E Ashley Moseman
- Department of Integrative Immunobiology, Duke University School of Medicine, Durham, NC, USA.
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Turunen S, Paavilainen S, Vepsäläinen J, Hielm-Björkman A. Scent Detection Threshold of Trained Dogs to Eucalyptus Hydrolat. Animals (Basel) 2024; 14:1083. [PMID: 38612322 PMCID: PMC11010826 DOI: 10.3390/ani14071083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Dogs' (Canis lupus familiaris) sense of smell is based on a unique anatomy and physiology that enables them to find and differentiate low concentrations of odor molecules. This ability is exploited when dogs are trained as search, rescue, or medical detection dogs. We performed a three-part study to explore the scent detection threshold of 15 dogs to an in-house-made Eucalyptus hydrolat. Here, decreasing concentrations of the hydrolat were tested using a three-alternative forced-choice method until the first incorrect response, which defined the limit of scent detection for each tested dog. Quantitative proton nuclear magnetic resonance spectroscopy was used to identify and measure the contents of ten commercial Eucalyptus hydrolats, which are used in a dog scent training sport called "nose work". In this study, the dogs' limit of detection initially ranged from 1:104 to 1:1023 but narrowed down to 1:1017-1:1021 after a training period. The results show that, with training, dogs learn to discriminate decreasing concentrations of a target scent, and that dogs can discriminate Eucalyptus hydrolat at very low concentrations. We also detected different concentrations of eucalyptol and lower alcohols in the hydrolat products and highlight the importance of using an identical source of a scent in training a dog for participation in canine scent sport competitions and in olfactory research.
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Affiliation(s)
- Soile Turunen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, 70211 Kuopio, Finland; (S.T.); (J.V.)
| | - Susanna Paavilainen
- Wise Nose-Finnish Odor Separation Association, 00790 Helsinki, Finland;
- Nose Academy Ltd., 70780 Kuopio, Finland
| | - Jouko Vepsäläinen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, 70211 Kuopio, Finland; (S.T.); (J.V.)
| | - Anna Hielm-Björkman
- DogRisk Research Group, Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, 00014 Helsinki, Finland
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Dickey T, Junqueira H. COVID-19 scent dog research highlights and synthesis during the pandemic of December 2019-April 2023. J Osteopath Med 2023; 123:509-521. [PMID: 37452676 DOI: 10.1515/jom-2023-0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023]
Abstract
CONTEXT This review was undertaken to provide information concerning the advancement of research in the area of COVID-19 screening and testing during the worldwide pandemic from December 2019 through April 2023. In this review, we have examined the safety, effectiveness, and practicality of utilizing trained scent dogs in clinical and public situations for COVID-19 screening. Specifically, results of 29 trained scent dog screening peer-reviewed studies were compared with results of real-time reverse-transcription polymerase chain reaction (RT-PCR) and rapid antigen (RAG) COVID-19 testing methods. OBJECTIVES The review aims to systematically evaluate the strengths and weaknesses of utilizing trained scent dogs in COVID-19 screening. METHODS At the time of submission of our earlier review paper in August 2021, we found only four peer-reviewed COVID-19 scent dog papers: three clinical research studies and one preprint perspective paper. In March and April 2023, the first author conducted new literature searches of the MEDLINE/PubMed, Google Scholar, and Cochrane Library websites. Again, the keyword phrases utilized for the searches included "COVID detection dogs," "COVID scent dogs," and "COVID sniffer dogs." The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 Checklist was followed to ensure that our review adhered to evidence-based guidelines for reporting. Utilizing the results of the reviewed papers, we compiled statistics to intercompare and summarize basic information concerning the scent dogs and their training, the populations of the study participants, the types of sampling methods, the comparative tests utilized, and the effectiveness of the scent dog screening. RESULTS A total of 8,043 references were identified through our literature search. After removal of duplicates, there were 7,843 references that were screened. Of these, 100 were considered for full-text eligibility, 43 were included for qualitative synthesis, and 29 were utilized for quantitative analysis. The most relevant peer-reviewed COVID-19 scent dog references were identified and categorized. Utilizing all of the scent dog results provided for this review, we found that 92.3 % of the studies reached sensitivities exceeding 80 and 32.0 % of the studies exceeding specificities of 97 %. However, 84.0 % of the studies reported specificities above 90 %. Highlights demonstrating the effectiveness of the scent dogs include: (1) samples of breath, saliva, trachea-bronchial secretions and urine as well as face masks and articles of clothing can be utilized; (2) trained COVID-19 scent dogs can detect presymptomatic and asymptomatic patients; (3) scent dogs can detect new SARS-CoV-2 variants and Long COVID-19; and (4) scent dogs can differentiate SARS-CoV-2 infections from infections with other novel respiratory viruses. CONCLUSIONS The effectiveness of the trained scent dog method is comparable to or in some cases superior to the real-time RT-PCR test and the RAG test. Trained scent dogs can be effectively utilized to provide quick (seconds to minutes), nonintrusive, and accurate results in public settings and thus reduce the spread of the COVID-19 virus or other viruses. Finally, scent dog research as described in this paper can serve to increase the medical community's and public's knowledge and acceptance of medical scent dogs as major contributors to global efforts to fight diseases.
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Affiliation(s)
- Tommy Dickey
- Distinguished Professor Emeritus, Geography Department, University of California Santa Barbara, Santa Barbara, CA, USA
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Inglis TJJ. MARGINAL NOTES, August, 2023. Something in the air. J Med Microbiol 2023; 72. [PMID: 37675841 DOI: 10.1099/jmm.0.001752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
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Roquencourt C, Salvator H, Bardin E, Lamy E, Farfour E, Naline E, Devillier P, Grassin-Delyle S. Enhanced real-time mass spectrometry breath analysis for the diagnosis of COVID-19. ERJ Open Res 2023; 9:00206-2023. [PMID: 37727677 PMCID: PMC10505950 DOI: 10.1183/23120541.00206-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/21/2023] [Indexed: 09/21/2023] Open
Abstract
Background Although rapid screening for and diagnosis of coronavirus disease 2019 (COVID-19) are still urgently needed, most current testing methods are long, costly or poorly specific. The objective of the present study was to determine whether or not artificial-intelligence-enhanced real-time mass spectrometry breath analysis is a reliable, safe, rapid means of screening ambulatory patients for COVID-19. Methods In two prospective, open, interventional studies in a single university hospital, we used real-time, proton transfer reaction time-of-flight mass spectrometry to perform a metabolomic analysis of exhaled breath from adults requiring screening for COVID-19. Artificial intelligence and machine learning techniques were used to build mathematical models based on breath analysis data either alone or combined with patient metadata. Results We obtained breath samples from 173 participants, of whom 67 had proven COVID-19. After using machine learning algorithms to process breath analysis data and further enhancing the model using patient metadata, our method was able to differentiate between COVID-19-positive and -negative participants with a sensitivity of 98%, a specificity of 74%, a negative predictive value of 98%, a positive predictive value of 72% and an area under the receiver operating characteristic curve of 0.961. The predictive performance was similar for asymptomatic, weakly symptomatic and symptomatic participants and was not biased by COVID-19 vaccination status. Conclusions Real-time, noninvasive, artificial-intelligence-enhanced mass spectrometry breath analysis might be a reliable, safe, rapid, cost-effective, high-throughput method for COVID-19 screening.
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Affiliation(s)
| | - Hélène Salvator
- Exhalomics, Hôpital Foch, Suresnes, France
- Service de Pneumologie, Hôpital Foch, Suresnes, France
- Laboratoire de Recherche en Pharmacologie Respiratoire – VIM Suresnes, UMR 0892, Université Paris-Saclay, Suresnes, France
| | - Emmanuelle Bardin
- Exhalomics, Hôpital Foch, Suresnes, France
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Département de Biotechnologie de la Santé, Montigny le Bretonneux, France
- Institut Necker Enfants Malades, U1151, Paris, France
| | - Elodie Lamy
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Département de Biotechnologie de la Santé, Montigny le Bretonneux, France
| | - Eric Farfour
- Service de Biologie Clinique, Hôpital Foch, Suresnes, France
| | | | - Philippe Devillier
- Exhalomics, Hôpital Foch, Suresnes, France
- Laboratoire de Recherche en Pharmacologie Respiratoire – VIM Suresnes, UMR 0892, Université Paris-Saclay, Suresnes, France
| | - Stanislas Grassin-Delyle
- Exhalomics, Hôpital Foch, Suresnes, France
- Université Paris-Saclay, UVSQ, INSERM, Infection et inflammation (2I), U1173, Département de Biotechnologie de la Santé, Montigny le Bretonneux, France
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Soggiu F, Sabbatinelli J, Giuliani A, Benedetti R, Marchegiani A, Sgarangella F, Tibaldi A, Corsi D, Procopio AD, Calgaro S, Olivieri F, Spaterna A, Zampieri R, Rippo MR. Sensitivity and specificity of in vivo COVID-19 screening by detection dogs: Results of the C19-Screendog multicenter study. Heliyon 2023; 9:e15640. [PMID: 37251897 PMCID: PMC10209336 DOI: 10.1016/j.heliyon.2023.e15640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/24/2023] [Accepted: 04/17/2023] [Indexed: 05/31/2023] Open
Abstract
Trained dogs can recognize the volatile organic compounds contained in biological samples of patients with COVID-19 infection. We assessed the sensitivity and specificity of in vivo SARS-CoV-2 screening by trained dogs. We recruited five dog-handler dyads. In the operant conditioning phase, the dogs were taught to distinguish between positive and negative sweat samples collected from volunteers' underarms in polymeric tubes. The conditioning was validated by tests involving 16 positive and 48 negative samples held or worn in such a way that the samples were invisible to the dog and handler. In the screening phase the dogs were led by their handlers to a drive-through facility for in vivo screening of volunteers who had just received a nasopharyngeal swab from nursing staff. Each volunteer who had already swabbed was subsequently tested by two dogs, whose responses were recorded as positive, negative, or inconclusive. The dogs' behavior was constantly monitored for attentiveness and wellbeing. All the dogs passed the conditioning phase, their responses showing a sensitivity of 83-100% and a specificity of 94-100%. The in vivo screening phase involved 1251 subjects, of whom 205 had a COVID-19 positive swab and two dogs per each subject to be screened. Screening sensitivity and specificity were respectively 91.6-97.6% and 96.3-100% when only one dog was involved, whereas combined screening by two dogs provided a higher sensitivity. Dog wellbeing was also analyzed: monitoring of stress and fatigue suggested that the screening activity did not adversely impact the dogs' wellbeing. This work, by screening a large number of subjects, strengthen recent findings that trained dogs can discriminate between COVID-19 infected and healthy human subjects and introduce two novel research aspects: i) assessement of signs of fatigue and stress in dogs during training and testing, and ii) combining screening by two dogs to improve detection sensitivity and specificity. Using some precautions to reduce the risk of infection and spillover, in vivo COVID-19 screening by a dog-handler dyad can be suitable to quickly screen large numbers of people: it is rapid, non-invasive and economical, since it does not involve actual sampling, lab resources or waste management, and is suitable to screen large numbers of people.
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Affiliation(s)
- Francesca Soggiu
- Dipartimento di Prevenzione, ATS Sardegna, Italy
- Progetto Serena APS, Cinto Caomaggiore, Italy
| | - Jacopo Sabbatinelli
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, Ancona, Italy
| | - Angelica Giuliani
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, Ancona, Italy
| | | | - Andrea Marchegiani
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | | | | | | | - Antonio Domenico Procopio
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, Ancona, Italy
- Clinical Laboratory and Molecular Diagnostic, IRCCS INRCA, Ancona, Italy
| | | | - Fabiola Olivieri
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, Ancona, Italy
- Clinical Laboratory and Molecular Diagnostic, IRCCS INRCA, Ancona, Italy
| | - Andrea Spaterna
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | | | - Maria Rita Rippo
- Department of Clinical and Molecular Sciences, DISCLIMO, Università Politecnica delle Marche, Ancona, Italy
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Pirrone F, Piotti P, Galli M, Gasparri R, La Spina A, Spaggiari L, Albertini M. Sniffer dogs performance is stable over time in detecting COVID-19 positive samples and agrees with the rapid antigen test in the field. Sci Rep 2023; 13:3679. [PMID: 36872400 PMCID: PMC9985821 DOI: 10.1038/s41598-023-30897-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/02/2023] [Indexed: 03/07/2023] Open
Abstract
Rapid antigen diagnostic (RAD) tests have been developed for the identification of the SARS-CoV-2 infection. However, they require nasopharyngeal or nasal swab, which is invasive, uncomfortable, and aerosolising. The use of saliva test was also proposed but has not yet been validated. Trained dogs may efficiently smell the presence of SARS-CoV-2 in biological samples of infected people, but further validation is needed both in laboratory and in field. The present study aimed to (1) assess and validate the stability over a specific time period of COVID-19 detection in humans' armpit sweat by trained dogs thanks to a double-blind laboratory test-retest design, and (2) assess this ability when sniffing people directly. Dogs were not trained to discriminate against other infections. For all dogs (n. 3), the laboratory test on 360 samples yielded 93% sensitivity and 99% specificity, an 88% agreement with the Rt-PCR, and a moderate to strong test-retest correlation. When sniffing people directly (n. 97), dogs' (n. 5) overall sensitivity (89%) and specificity (95%) were significantly above chance level. An almost perfect agreement with RAD results was found (kappa 0.83, SE 0.05, p = 0.001). Therefore, sniffer dogs met appropriate criteria (e.g., repeatability) and WHO's target product profiles for COVID-19 diagnostics and produced very promising results in laboratory and field settings, respectively. These findings support the idea that biodetection dogs could help reduce the spread of the virus in high-risk environments, including airports, schools, and public transport.
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Affiliation(s)
- Federica Pirrone
- Department of Veterinary Medicine and Animal Sciences, University of Milan (UNIMI), 26900, Lodi, Italy
| | - Patrizia Piotti
- Department of Veterinary Medicine and Animal Sciences, University of Milan (UNIMI), 26900, Lodi, Italy.
| | - Massimo Galli
- III Infectious Diseases Unit, L. Sacco Hospital, ASST Fatebenefratelli-Sacco, 20157, Milan, Italy
- Department of Biomedical and Clinical Sciences DIBIC, Luigi Sacco, University of Milan, Milan, Italy
| | - Roberto Gasparri
- Division of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Aldo La Spina
- Medical Detection Dogs Italy, Novate milanese, Italy
| | - Lorenzo Spaggiari
- Division of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology-DIPO, University of Milan, Milan, Italy
| | - Mariangela Albertini
- Department of Veterinary Medicine and Animal Sciences, University of Milan (UNIMI), 26900, Lodi, Italy
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Christopher DM, Curtis-Robles R, Hamer GL, Bejcek J, Saunders AB, Roachell WD, Cropper TL, Hamer SA. Collection of triatomines from sylvatic habitats by a Trypanosoma cruzi-infected scent detection dog in Texas, USA. PLoS Negl Trop Dis 2023; 17:e0010813. [PMID: 36940217 PMCID: PMC10063167 DOI: 10.1371/journal.pntd.0010813] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 03/30/2023] [Accepted: 02/14/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND Triatomine insects, vectors of the etiologic agent of Chagas disease (Trypanosoma cruzi), are challenging to locate in sylvatic habitats. Collection techniques used in the United States often rely on methods to intercept seasonally dispersing adults or on community scientists' encounters. Neither method is suited for detecting nest habitats likely to harbor triatomines, which is important for vector surveillance and control. Furthermore, manual inspection of suspected harborages is difficult and unlikely to reveal novel locations and host associations. Similar to a team that used a trained dog to detect sylvatic triatomines in Paraguay, we worked with a trained scent detection dog to detect triatomines in sylvatic locations across Texas. PRINCIPLE METHODOLOGY/FINDINGS Ziza, a 3-year-old German Shorthaired Pointer previously naturally infected with T. cruzi, was trained to detect triatomines. Over the course of 6 weeks in the fall of 2017, the dog and her handler searched at 17 sites across Texas. The dog detected 60 triatomines at 6 sites; an additional 50 triatomines were contemporaneously collected at 1 of these sites and 2 additional sites without the assistance of the dog. Approximately 0.98 triatomines per hour were found when only humans were conducting searches; when working with the dog, approximately 1.71 triatomines per hour were found. In total, 3 adults and 107 nymphs of four species (Triatoma gerstaeckeri, Triatoma protracta, Triatoma sanguisuga, and Triatoma indictiva) were collected. PCR testing of a subset revealed T. cruzi infection, including DTUs TcI and TcIV, in 27% of nymphs (n = 103) and 66% of adults (n = 3). Bloodmeal analysis of a subset of triatomines (n = 5) revealed feeding on Virginia opossum (Didelphis virginiana), Southern plains woodrat (Neotoma micropus), and eastern cottontail (Sylvilagus floridanus). CONCLUSION/SIGNIFICANCE A trained scent detection dog enhanced triatomine detections in sylvatic habitats. This approach is effective at detecting nidicolous triatomines. Control of sylvatic sources of triatomines is challenging, but this new knowledge of specific sylvatic habitats and key hosts may reveal opportunities for novel vector control methods to block the transmission of T. cruzi to humans and domestic animals.
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Affiliation(s)
| | - Rachel Curtis-Robles
- Department of Veterinary Integrative Biosciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Gabriel L. Hamer
- Department of Entomology, Texas A&M University, College Station, Texas, United States of America
| | - Justin Bejcek
- Department of Veterinary Integrative Biosciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
- Department of Entomology, Texas A&M University, College Station, Texas, United States of America
| | - Ashley B. Saunders
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Walter D. Roachell
- Public Health Command Central, JBSA-Fort Sam Houston, San Antonio, Texas, United States of America
| | - Thomas Leo Cropper
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio, San Antonio Texas
| | - Sarah A. Hamer
- Department of Veterinary Integrative Biosciences, School of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, United States of America
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Interactions between Humans and Dogs during the COVID-19 Pandemic: Recent Updates and Future Perspectives. Animals (Basel) 2023; 13:ani13030524. [PMID: 36766413 PMCID: PMC9913536 DOI: 10.3390/ani13030524] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
COVID-19 is one of the deadliest epidemics. This pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the role of dogs in spreading the disease in human society is poorly understood. This review sheds light on the limited susceptibility of dogs to COVID-19 infections which is likely attributed to the relatively low levels of angiotensin-converting enzyme 2 (ACE2) in the respiratory tract and the phylogenetic distance of ACE2 in dogs from the human ACE2 receptor. The low levels of ACE2 affect the binding affinity between spike and ACE2 proteins resulting in it being uncommon for dogs to spread the disease. To demonstrate the role of dogs in spreading COVID-19, we reviewed the epidemiological studies and prevalence of SARS-CoV-2 in dogs. Additionally, we discussed the use of detection dogs as a rapid and reliable method for effectively discriminating between SARS-CoV-2 infected and non-infected individuals using different types of samples (secretions, saliva, and sweat). We considered the available information on COVID-19 in the human-dog interfaces involving the possibility of transmission of COVID-19 to dogs by infected individuals and vice versa, the human-dog behavior changes, and the importance of preventive measures because the risk of transmission by domestic dogs remains a concern.
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Bauër P, Leemans M, Audureau E, Gilbert C, Armal C, Fromantin I. Remote Medical Scent Detection of Cancer and Infectious Diseases With Dogs and Rats: A Systematic Review. Integr Cancer Ther 2022; 21:15347354221140516. [PMID: 36541180 PMCID: PMC9791295 DOI: 10.1177/15347354221140516] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Remote medical scent detection of cancer and infectious diseases with dogs and rats has been an increasing field of research these last 20 years. If validated, the possibility of implementing such a technique in the clinic raises many hopes. This systematic review was performed to determine the evidence and performance of such methods and assess their potential relevance in the clinic. METHODS Pubmed and Web of Science databases were independently searched based on PRISMA standards between 01/01/2000 and 01/05/2021. We included studies aiming at detecting cancers and infectious diseases affecting humans with dogs or rats. We excluded studies using other animals, studies aiming to detect agricultural diseases, diseases affecting animals, and others such as diabetes and neurodegenerative diseases. Only original articles were included. Data about patients' selection, samples, animal characteristics, animal training, testing configurations, and performances were recorded. RESULTS A total of 62 studies were included. Sensitivity and specificity varied a lot among studies: While some publications report low sensitivities of 0.17 and specificities around 0.29, others achieve rates of 1 sensitivity and specificity. Only 6 studies were evaluated in a double-blind screening-like situation. In general, the risk of performance bias was high in most evaluated studies, and the quality of the evidence found was low. CONCLUSIONS Medical detection using animals' sense of smell lacks evidence and performances so far to be applied in the clinic. What odors the animals detect is not well understood. Further research should be conducted, focusing on patient selection, samples (choice of materials, standardization), and testing conditions. Interpolations of such results to free running detection (direct contact with humans) should be taken with extreme caution. Considering this synthesis, we discuss the challenges and highlight the excellent odor detection threshold exhibited by animals which represents a potential opportunity to develop an accessible and non-invasive method for disease detection.
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Affiliation(s)
- Pierre Bauër
- Institut Curie, Paris, France,Univ Paris Est Creteil, INSERM, IMRB, Team CEpiA
| | - Michelle Leemans
- Univ Paris Est Creteil, INSERM, IMRB, Team CEpiA,Michelle Leemans, Univ Paris Est Creteil, INSERM, IMRB, Team CEpiA, 61 Av. du Général de Gaulle, 94000 Créteil, F-94010 Créteil, France.
| | | | - Caroline Gilbert
- Muséum National d’Histoire Naturelle, Brunoy, France,Ecole nationale vétérinaire d’Alfort, Maisons-Alfort cedex, France
| | | | - Isabelle Fromantin
- Institut Curie, Paris, France,Univ Paris Est Creteil, INSERM, IMRB, Team CEpiA
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12
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Meller S, Al Khatri MSA, Alhammadi HK, Álvarez G, Alvergnat G, Alves LC, Callewaert C, Caraguel CGB, Carancci P, Chaber AL, Charalambous M, Desquilbet L, Ebbers H, Ebbers J, Grandjean D, Guest C, Guyot H, Hielm-Björkman A, Hopkins A, Kreienbrock L, Logan JG, Lorenzo H, Maia RDCC, Mancilla-Tapia JM, Mardones FO, Mutesa L, Nsanzimana S, Otto CM, Salgado-Caxito M, de los Santos F, da Silva JES, Schalke E, Schoneberg C, Soares AF, Twele F, Vidal-Martínez VM, Zapata A, Zimin-Veselkoff N, Volk HA. Expert considerations and consensus for using dogs to detect human SARS-CoV-2-infections. Front Med (Lausanne) 2022; 9:1015620. [PMID: 36569156 PMCID: PMC9773891 DOI: 10.3389/fmed.2022.1015620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022] Open
Affiliation(s)
- Sebastian Meller
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hanover, Germany
| | | | - Hamad Khatir Alhammadi
- International Operations Department, Ministry of Interior of the United Arab Emirates, Abu Dhabi, United Arab Emirates
| | - Guadalupe Álvarez
- Faculty of Veterinary Science, University of Buenos Aires, Buenos Aires, Argentina
| | - Guillaume Alvergnat
- International Operations Department, Ministry of Interior of the United Arab Emirates, Abu Dhabi, United Arab Emirates
| | - Lêucio Câmara Alves
- Department of Veterinary Medicine, Federal Rural University of Pernambuco, Recife, Brazil
| | - Chris Callewaert
- Center for Microbial Ecology and Technology, Department of Biotechnology, Ghent University, Ghent, Belgium
| | - Charles G. B. Caraguel
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
| | - Paula Carancci
- Faculty of Veterinary Science, University of Buenos Aires, Buenos Aires, Argentina
| | - Anne-Lise Chaber
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, SA, Australia
| | - Marios Charalambous
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Loïc Desquilbet
- École Nationale Vétérinaire d’Alfort, IMRB, Université Paris Est, Maisons-Alfort, France
| | | | | | - Dominique Grandjean
- École Nationale Vétérinaire d’Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Claire Guest
- Medical Detection Dogs, Milton Keynes, United Kingdom
| | - Hugues Guyot
- Clinical Department of Production Animals, Fundamental and Applied Research for Animals & Health Research Unit, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Anna Hielm-Björkman
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - Amy Hopkins
- Medical Detection Dogs, Milton Keynes, United Kingdom
| | - Lothar Kreienbrock
- Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Hanover, Germany
| | - James G. Logan
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Arctech Innovation, The Cube, Dagenham, United Kingdom
| | - Hector Lorenzo
- Faculty of Veterinary Science, University of Buenos Aires, Buenos Aires, Argentina
| | | | | | - Fernando O. Mardones
- Escuela de Medicina Veterinaria, Facultad de Agronomía e Ingeniería Forestal and Facultad de Ciencias Biológicas y Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Leon Mutesa
- Center for Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Rwanda National Joint Task Force COVID-19, Kigali, Rwanda
| | | | - Cynthia M. Otto
- Penn Vet Working Dog Center, Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Marília Salgado-Caxito
- Escuela de Medicina Veterinaria, Facultad de Agronomía e Ingeniería Forestal and Facultad de Ciencias Biológicas y Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | - Esther Schalke
- Bundeswehr Medical Service Headquarters, Koblenz, Germany
| | - Clara Schoneberg
- Department of Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Anísio Francisco Soares
- Department of Animal Morphology and Physiology, Federal Rural University of Pernambuco, Recife, Brazil
| | - Friederike Twele
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Victor Manuel Vidal-Martínez
- Laboratorio de Parasitología y Patología Acuática, Departamento de Recursos del Mar, Centro de Investigación y de Estudios Avanzados del IPN Unidad Mérida, Mérida, Yucatán, Mexico
| | - Ariel Zapata
- Faculty of Veterinary Science, University of Buenos Aires, Buenos Aires, Argentina
| | - Natalia Zimin-Veselkoff
- Escuela de Medicina Veterinaria, Facultad de Agronomía e Ingeniería Forestal and Facultad de Ciencias Biológicas y Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Holger A. Volk
- Department of Small Animal Medicine & Surgery, University of Veterinary Medicine Hannover, Hanover, Germany
- Center for Systems Neuroscience Hannover, Hanover, Germany
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13
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Sun X, Wandelt S, Zhang A. COVID-19 pandemic and air transportation: Summary of Recent Research, Policy Consideration and Future Research Directions. TRANSPORTATION RESEARCH INTERDISCIPLINARY PERSPECTIVES 2022; 16:100718. [PMID: 36407295 PMCID: PMC9640395 DOI: 10.1016/j.trip.2022.100718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/02/2022] [Accepted: 11/06/2022] [Indexed: 05/19/2023]
Abstract
The COVID-19 pandemic can be considered an unparalleled disruption to the aviation industry in the last century. Starting with an at-that-time inconceivable reduction in the number of flights from March 2020 to May 2020, the aviation industry has been trying to navigate through and out of the crisis. This process is accompanied with a significant number of scientific studies, reporting on the direct and indirect impact of the COVID-19 pandemic on aviation and vice versa. This paper reviews the impacts in context of the recent literature. We have collected nearly 200 well-published papers on the subject in the years 2021/2022 and dissected them into a framework of eight categories, built around: airlines, airports, passengers, workforce, markets, contagion, sustainability, and economics. We highlight the essence of findings in the literature and derive a set of future research directions and policy considerations which we deem important on the way towards pandemic-resilient aviation.
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Affiliation(s)
- Xiaoqian Sun
- National Key Laboratory of CNS/ATM, School of Electronic and Information Engineering, Beihang University, 100191 Beijing, China
| | - Sebastian Wandelt
- National Key Laboratory of CNS/ATM, School of Electronic and Information Engineering, Beihang University, 100191 Beijing, China
| | - Anming Zhang
- Sauder School of Business, University of British Columbia, Vancouver, BC, Canada
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14
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Gokool VA, Crespo-Cajigas J, Mallikarjun A, Collins A, Kane SA, Plymouth V, Nguyen E, Abella BS, Holness HK, Furton KG, Johnson ATC, Otto CM. The Use of Biological Sensors and Instrumental Analysis to Discriminate COVID-19 Odor Signatures. BIOSENSORS 2022; 12:1003. [PMID: 36421122 PMCID: PMC9688190 DOI: 10.3390/bios12111003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 05/27/2023]
Abstract
The spread of SARS-CoV-2, which causes the disease COVID-19, is difficult to control as some positive individuals, capable of transmitting the disease, can be asymptomatic. Thus, it remains critical to generate noninvasive, inexpensive COVID-19 screening systems. Two such methods include detection canines and analytical instrumentation, both of which detect volatile organic compounds associated with SARS-CoV-2. In this study, the performance of trained detection dogs is compared to a noninvasive headspace-solid phase microextraction-gas chromatography-mass spectrometry (HS-SPME-GC-MS) approach to identifying COVID-19 positive individuals. Five dogs were trained to detect the odor signature associated with COVID-19. They varied in performance, with the two highest-performing dogs averaging 88% sensitivity and 95% specificity over five double-blind tests. The three lowest-performing dogs averaged 46% sensitivity and 87% specificity. The optimized linear discriminant analysis (LDA) model, developed using HS-SPME-GC-MS, displayed a 100% true positive rate and a 100% true negative rate using leave-one-out cross-validation. However, the non-optimized LDA model displayed difficulty in categorizing animal hair-contaminated samples, while animal hair did not impact the dogs' performance. In conclusion, the HS-SPME-GC-MS approach for noninvasive COVID-19 detection more accurately discriminated between COVID-19 positive and COVID-19 negative samples; however, dogs performed better than the computational model when non-ideal samples were presented.
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Affiliation(s)
- Vidia A. Gokool
- Global Forensic and Justice Center, Department of Chemistry and Biochemistry, Florida International University, Miami, FL 33199, USA
| | - Janet Crespo-Cajigas
- Global Forensic and Justice Center, Department of Chemistry and Biochemistry, Florida International University, Miami, FL 33199, USA
| | - Amritha Mallikarjun
- Penn Vet Working Dog Center, Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Amanda Collins
- Penn Vet Working Dog Center, Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sarah A. Kane
- Penn Vet Working Dog Center, Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Victoria Plymouth
- Penn Vet Working Dog Center, Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Elizabeth Nguyen
- Penn Vet Working Dog Center, Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Benjamin S. Abella
- Department of Emergency Medicine and Penn Acute Research Collaboration, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Howard K. Holness
- Global Forensic and Justice Center, Department of Chemistry and Biochemistry, Florida International University, Miami, FL 33199, USA
| | - Kenneth G. Furton
- Global Forensic and Justice Center, Department of Chemistry and Biochemistry, Florida International University, Miami, FL 33199, USA
| | - Alan T. Charlie Johnson
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Cynthia M. Otto
- Penn Vet Working Dog Center, Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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15
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ten Hagen NA, Twele F, Meller S, Wijnen L, Schulz C, Schoneberg C, Kreienbrock L, von Köckritz-Blickwede M, Osterhaus A, Boeck AL, Boeck K, Bonda V, Pilchová V, Kaiser FK, Gonzalez Hernandez M, Ebbers H, Hinsenkamp J, Pink I, Drick N, Welte T, Manns MP, Illig T, Puyskens A, Nitsche A, Ernst C, Engels M, Schalke E, Volk HA. Canine real-time detection of SARS-CoV-2 infections in the context of a mass screening event. BMJ Glob Health 2022; 7:bmjgh-2022-010276. [DOI: 10.1136/bmjgh-2022-010276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/15/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionPrevious research demonstrated that medical scent detection dogs have the ability to distinguish SARS-CoV-2 positive from negative samples with high diagnostic accuracy. To deploy these dogs as a reliable screening method, it is mandatory to examine if canines maintain their high diagnostic accuracy in real-life screening settings. We conducted a study to evaluate the performance of medical scent detection dogs under real-life circumstances.MethodsEight dogs were trained to detect SARS-CoV-2 RT-qPCR-positive samples. Four concerts with a total of 2802 participants were held to evaluate canines’ performance in screening individuals for SARS-CoV-2 infection. Sweat samples were taken from all participants and presented in a line-up setting. In addition, every participant had been tested with a SARS-CoV-2 specific rapid antigen test and a RT-qPCR and they provided information regarding age, sex, vaccination status and medical disease history. The participants’ infection status was unknown at the time of canine testing. Safety measures such as mask wearing and distance keeping were ensured.ResultsThe SARS-CoV-2 detection dogs achieved a diagnostic specificity of 99.93% (95% CI 99.74% to 99.99%) and a sensitivity of 81.58% (95% CI 66.58% to 90.78%), respectively. The overall rate of concordant results was 99.68%. The majority of the study population was vaccinated with varying vaccines and vaccination schemes, while several participants had chronic diseases and were under chronic medication. This did not influence dogs’ decisions.ConclusionOur results demonstrate that SARS-CoV-2 scent detection dogs achieved high diagnostic accuracy in a real-life scenario. The vaccination status, previous SARS-CoV-2 infection, chronic disease and medication of the participants did not influence the performance of the dogs in detecting the acute infection. This indicates that dogs provide a fast and reliable screening option for public events in which high-throughput screening is required.
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16
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Dogs can discriminate between human baseline and psychological stress condition odours. PLoS One 2022; 17:e0274143. [PMID: 36170254 PMCID: PMC9518869 DOI: 10.1371/journal.pone.0274143] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
Abstract
Previous research suggests that dogs can detect when humans are experiencing stress. This study tested whether baseline and stress odours were distinguishable to dogs, using a double-blind, two-phase, three-alternative forced-choice procedure. Combined breath and sweat samples were obtained from participants at baseline, and after a stress-inducing (mental arithmetic) task. Participants’ stress was validated with self-report and physiological measures recorded via a Biopac MP150 system. Thirty-six participants’ samples were presented to four dogs across 36 sessions (16, 11, 7 and 2 sessions, respectively). Each session consisted of 10 Phase One training trials and 20 Phase Two discrimination trials. In Phase One, the dog was presented with a participant’s stress sample (taken immediately post-task) alongside two blanks (the sample materials without breath or sweat), and was required to identify the stress sample with an alert behaviour. In Phase Two, the dog was presented with the stress sample, the same participant’s baseline sample (taken pre-task), and a blank. Which sample (blank, baseline, or stress) the dog performed their alert behaviour on was measured. If dogs can correctly alert on the stress sample in Phase Two (when the baseline sample was present), it suggests that baseline and stress odours are distinguishable. Performance ranged from 90.00% to 96.88% accuracy with a combined accuracy of 93.75% (N trials = 720). A binomial test (where probability of success on a single trial was 0.33, and alpha was 0.05) showed that the proportion of correct trials was greater than that expected by chance (p < 0.001). Results indicate that the physiological processes associated with an acute psychological stress response produce changes in the volatile organic compounds emanating from breath and/or sweat that are detectable to dogs. These results add to our understanding of human-dog relationships and could have applications to Emotional Support and Post Traumatic Stress Disorder (PTSD) service dogs.
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17
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Travel in the Time of COVID: A Review of International Travel Health in a Global Pandemic. Curr Infect Dis Rep 2022; 24:129-145. [PMID: 35965881 PMCID: PMC9361911 DOI: 10.1007/s11908-022-00784-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/03/2022]
Abstract
Abstract
Purpose of Review
This review critically considers the impact of the COVID-19 pandemic on global travel and the practice of travel medicine, highlights key innovations that have facilitated the resumption of travel, and anticipates how travel medicine providers should prepare for the future of international travel.
Recent Findings
Since asymptomatic transmission of the virus was first recognized in March 2020, extensive efforts have been made to characterize the pattern and dynamics of SARS-CoV-2 transmission aboard commercial aircraft, cruise ships, rail and bus transport, and in mass gatherings and quarantine facilities. Despite the negative impact of further waves of COVID-19 driven by the more transmissible Omicron variant, rapid increases of international tourist arrivals are occurring and modeling anticipates further growth. Mitigation of spread requires an integrated approach that combines masking, physical distancing, improving ventilation, testing, and quarantine. Vaccines and therapeutics have played a significant role in reopening society and accelerating the resumption of travel and further therapeutic innovation is likely.
Summary
COVID-19 is likely to persist as an endemic infection, and surveillance will assume an even more important role. The pandemic has provided an impetus to advance technology for telemedicine, to adopt mobile devices and GPS in contact tracing, and to apply digital applications in research. The future of travel medicine should continue to harness these novel platforms in the clinical, research, and educational arenas.
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18
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Photopoulos J. The dogs learning to sniff out disease. Nature 2022; 606:S10-S11. [PMID: 35732774 DOI: 10.1038/d41586-022-01629-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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