Canine olfactory detection and its relevance to medical detection

Recapitulating COVID-19 detection methods: RT-PCR, sniffer dogs and electronic nose

In December 2019, a number of subjects presenting with an unexplained pneumonia-like illness were suspected to have a link to a seafood market in Wuhan, China. Subsequently, this illness was identified as the 2019-novel coronavirus (2019-nCoV) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the World Committee on Virus Classification. Since its initial identification, the virus has rapidly sperad across the globe, posing an extraordinary challenge for the medical community. Currently, the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) is considered the most reliable method for diagnosing SARS-CoV-2. This procedure involves collecting oro-pharyngeal or nasopharyngeal swabs from individuals. Nevertheless, for the early detection of low viral loads, a more sensitive technique, such as droplet digital PCR (ddPCR), has been suggested. Despite the high effectiveness of RT-PCR, there is increasing interest in utilizing highly trained dogs and electronic noses (eNoses) as alternative methods for screening asymptomatic individuals for SARS-CoV-2. These dogs and eNoses have demonstrated high sensitivity and can detect volatile organic compounds (VOCs), enabling them to distinguish between COVID-19 positive and negative individuals. This manuscript recapitulates the potential, advantages, and limitations of employing trained dogs and eNoses for the screening and control of SARS-CoV-2.

Catch me if you can-emission patterns of human bodies in relation to postmortem changes

The present study examines for the first time the emission patterns and olfactory signatures of 9 complete human corpses of different stages of decomposition. Air sampling was performed inside the body bags with solid sorbents and analysed by coupled gas chromatography-mass spectrometry after thermal desorption (TD-GC-MS). Furthermore, odour-related substances were detected by gas chromatography-olfactometry (GC-O). Sulfurous compounds (mainly dimethyl di- and trisulfide) were identified as most important to the odour perception. Around 350 individual organic substances were detected by TD-GC-MS, notably sulfurous and nitrogenous substances as well as branched alkanes, aldehydes, ketones, alcohols, carboxylic acids, carboxylic acid esters and ethers. A range of terpenes was detected for the first time in a characteristic emission pattern over all decomposition stages. Concentrations of the substances varied greatly, and no correlation between the emission patterns, the stage of decomposition and the cause of death could be found. While previous studies often analysed pig cadavers or only parts of human tissue, the present study shows the importance of analysing complete human corpses over a range of decomposition stages. Moreover, it is shown that using body bags as a kind of "emission test chamber" is a very promising approach, also because it is a realistic application considering the usual transport and store of a body before autopsy.

Detection dogs fighting transnational narcotraffic: performance and challenges under real customs scenario in Brazil

Narcotic Detection Dogs (NDDs) are essential tools in the fight against drug trafficking, acting with high precision and improving efficiency at border posts. When trained efficiently, these dogs can detect a great variety of compounds, such as cocaine, marijuana and its derivatives, and synthetic drugs, among others. Most of the knowledge on canine detection processes and efficiency has been determined in experimentally controlled conditions, but narcotic seizures detected by dogs in realistic anti-drug operations have not yet been critically determined in a Country with continental dimensions such as Brazil. This study aimed to evaluate the data set concerning the performance, operations, efficiency, and success rate of NDDs used by the Brazilian Customs Authority (Aduana) in the fight against drug trafficking. Narcotic seizure rates increased in luggage and packages detected by NDDs working at border crossings from 2010 to 2020, with an estimated value of over US$ 2 billion in losses to the cocaine drug trafficking business. NDD units also increased most narcotic groups seized in the same period. The number of NDDs and anti-drug operations, and Customs Border Post (CBP) influenced the rates of drugs seized. NDDs provided an increase of 3,157 kg/animal of drugs seized for every new dog introduced into the inspection systems.

Intranasal drug delivery: The interaction between nanoparticles and the nose-to-brain pathway

Intranasal delivery provides a direct and non-invasive method for drugs to reach the central nervous system. Nanoparticles play a crucial role as carriers in augmenting the efficacy of brain delivery. However, the interaction between nanoparticles and the nose-to-brain pathway and how the various biopharmaceutical factors affect brain delivery efficacy remains unclear. In this review, we comprehensively summarized the anatomical and physiological characteristics of the nose-to-brain pathway and the obstacles that hinder brain delivery. We then outlined the interaction between nanoparticles and this pathway and reviewed the biomedical applications of various nanoparticulate drug delivery systems for nose-to-brain drug delivery. This review aims at inspiring innovative approaches for enhancing the effectiveness of nose-to-brain drug delivery in the treatment of different brain disorders.

Can scent-detection dogs detect the stress associated with trauma cue exposure in people with trauma histories? A proof-of-concept study

Introduction

Post-traumatic stress disorder (PTSD) is an impairing mental health condition with high prevalence among military and general populations alike. PTSD service dogs are a complementary and alternative intervention needing scientific validation. We investigated whether dogs can detect putative stress-related volatile organic compounds (VOCs) in the breath of people with trauma histories (54% with PTSD) exposed to personalized trauma cues.

Methods

Breath samples were collected from 26 humans over 40 experimental sessions during a calm (control breath sample) and stressed state induced by trauma cue exposure (target breath sample). Two scent detection canines were presented with the samples in a two alternative forced choice (2AFC) discrimination and yes/no detection task. The 2AFC task assessed the dogs' ability to discriminate between the two states within the breath samples of one individual. The detection task determined their ability to generalize the target odour across different individuals and different stressful events of one individual. Signal Detection Theory was applied to assess dogs' sensitivity, specificity, precision, and response bias.

Results

The dogs performed at ∼90% accuracy across all sample sets in the discrimination experiment, and at 74% and 81% accuracy, respectively, in the detection experiment. Further analysis of dog olfactory performance in relation to human donor self-reported emotional responses to trauma cue exposure suggested the dogs may have been detecting distinct endocrine stress markers. One dog's performance correlated with the human donors' self-reported fear responses and the other dog's performance correlated with the human donors' self-reported shame responses. Based on these correlations between dog performance and donor self-report measures, we speculate that the VOCs each dog was detecting likely originated from the sympathetico-adreno-medullary axis (SAM; adrenaline, noradrenaline) in the case of the first dog and the hypothalamo-pituitary-adrenal axis (HPA; glucocorticoids) in the case of the second dog.

Conclusion

Our proof-of-concept study is the first to demonstrate that some dogs can detect putative VOCs emitted by people with trauma histories when experiencing distress theoretically associated with the intrusion and arousal/reactivity symptoms of PTSD. Results have potential to improve the effectiveness and training protocol of PTSD service dogs with a focus on enhancing their alert function.

Dogs can detect an odor profile associated with Staphylococcus aureus biofilms in cultures and biological samples

Introduction

The study investigated the utilization of odor detection dogs to identify the odor profile of Staphylococcus aureus (S. aureus) biofilms in pure in vitro samples and in in vivo biosamples from animals and humans with S. aureus periprosthetic joint infection (PJI). Biofilms form when bacterial communities aggregate on orthopedic implants leading to recalcitrant infections that are difficult to treat. Identifying PJI biofilm infections is challenging, and traditional microbiological cultures may yield negative results even in the presence of clinical signs.

Methods

Dogs were trained on pure in vitro S. aureus biofilms and tested on lacrimal fluid samples from an in vivo animal model (rabbits) and human patients with confirmed S. aureus PJI.

Results

The results demonstrated that dogs achieved a high degree of sensitivity and specificity in detecting the odor profile associated with S. aureus biofilms in rabbit samples. Preliminary results suggest that dogs can recognize S. aureus volatile organic compounds (VOCs) in human lacrimal fluid samples.

Discussion

Training odor detection dogs on in vitro S. aureus, may provide an alternative to obtaining clinical samples for training and mitigates biosecurity hazards. The findings hold promise for culture-independent diagnostics, enabling early disease detection, and improved antimicrobial stewardship. In conclusion, this research demonstrates that dogs trained on in vitro S. aureus samples can identify the consistent VOC profile of PJI S. aureus biofilm infections. The study opens avenues for further investigations into a retained VOC profile of S. aureus biofilm infection. These advancements could revolutionize infectious disease diagnosis and treatment, leading to better patient outcomes and addressing the global challenge of antimicrobial resistance.

Olfaction in the canine cognitive and emotional processes: From behavioral and neural viewpoints to measurement possibilities

Domestic dogs (Canis familiaris) have excellent olfactory processing capabilities that are utilized widely in human society e.g., working with customs, police, and army; their scent detection is also used in guarding, hunting, mold-sniffing, searching for missing people or animals, and facilitating the life of the disabled. Sniffing and searching for odors is a natural, species-typical behavior and essential for the dog's welfare. While taking advantage of this canine ability widely, we understand its foundations and implications quite poorly. We can improve animal welfare by better understanding their olfactory world. In this review, we outline the olfactory processing of dogs in the nervous system, summarize the current knowledge of scent detection and differentiation; the effect of odors on the dogs' cognitive and emotional processes and the dog-human bond; and consider the methodological advancements that could be developed further to aid in our understanding of the canine world of odors.

The role of trained and untrained dogs in the detection and warning of seizures

Seizure unpredictability plays a major role in disability and decreased quality of life in people with epilepsy. Dogs have been used to assist people with disabilities and have shown promise in detecting seizures. There have been reports of trained seizure-alerting dogs (SADs) successfully detecting when a seizure is occurring or indicating imminent seizures, allowing patients to take preventative measures. Untrained pet dogs have also shown the ability to detect seizures and provide comfort and protection during and after seizures. Dogs' exceptional olfactory abilities and sensitivity to human cues could contribute to their seizure-detection capabilities. This has been supported by studies in which dogs have distinguished between epileptic seizure and non-seizure sweat samples, probably though the detection of volatile organic compounds (VOCs). However, the existing literature has limitations, with a lack of well-controlled, prospective studies and inconsistencies in reported timings of alerting behaviours. More research is needed to standardize reporting and validate the results. Advances in VOC profiling could aid in distinguishing seizure types and developing rapid and unbiased seizure detection methods. In conclusion, using dogs in epilepsy management shows considerable promise, but further research is needed to fully validate their effectiveness and potential as valuable companions for people with epilepsy.

Analytical Tools and Methods for Explosive Analysis in Forensics: A Critical Review

This review summarizes (i) compositions and types of improvised explosive devices; (ii) the process of collection, extraction and analysis of explosive evidence encountered in explosive and related cases; (iii) inter-comparison of analytical techniques; (iv) the challenges and prospects of explosive detection technology. The highlights of this study include extensive information regarding the National & International standards specified by USEPA, ASTM, and so on, for explosives detection. The holistic development of analytical tools for explosive analysis ranging from conventional methods to advanced analytical tools is also covered in this article. The most important aspect of this review is to make forensic scientists familiar with the challenges during explosive analysis and the steps to avoid them. The problems during analysis can be analyte-based, that is, interferences due to matrix or added molding/stabilizing agents, trace amount of parent explosives in post-blast samples and many more. Others are techniques-based challenges viz. specificity, selectivity, and sensitivity of the technique. Thus, it has become a primary concern to adopt rapid, field deployable, and highly sensitive techniques.

Unraveling the potential of breath and sweat VOC capture devices for human disease detection: a systematic-like review of canine olfaction and GC-MS analysis

The development of disease screening methods using biomedical detection dogs relies on the collection and analysis of body odors, particularly volatile organic compounds (VOCs) present in body fluids. To capture and analyze odors produced by the human body, numerous protocols and materials are used in forensics or medical studies. This paper provides an overview of sampling devices used to collect VOCs from sweat and exhaled air, for medical diagnostic purposes using canine olfaction and/or Gas Chromatography-Mass spectrometry (GC-MS). Canine olfaction and GC-MS are regarded as complementary tools, holding immense promise for detecting cancers and infectious diseases. However, existing literature lacks guidelines for selecting materials suitable for both canine olfaction and GC-MS. Hence, this review aims to address this gap and pave the way for efficient body odor sampling materials. The first section of the paper describes the materials utilized in training sniffing dogs, while the second section delves into the details of sampling devices and extraction techniques employed for exhaled air and sweat analysis using GC-MS. Finally, the paper proposes the development of an ideal sampling device tailored for detection purposes in the field of odorology. By bridging the knowledge gap, this study seeks to advance disease detection methodologies, harnessing the unique abilities of both dogs and GC-MS analysis in biomedical research.

The use of mantrailing dogs in police and judicial context, future directions, limits and possibilities - A law review

The extraordinary capabilities of the canine nose are increasingly being used by law enforcement agencies in many countries to solve and reconstruct crimes. As a result, this type of forensic evidence can be and is still being challenged in the courts. So far, only a few publications have addressed the jurisprudence concerning mantrailing. We provide an overview of the jurisprudence in Germany and the USA, as well as insights from France. Relevant databases were searched, and 201 verdicts from Germany and 801 verdicts from the USA were analyzed. As a result, 16 published verdicts on the topic of mantrailing were found for Germany, and 44 verdicts since 2010 were found for the USA. The use of mantrailers and human scent discrimination dogs is employed in the investigative process in all three countries. The results derived from these methods are admissible as evidence in court, albeit not as sole evidence.

The Olfaction Ability of Medical Detection Canine to Detect Prostate Cancer From Urine Samples: Progress Captured in Systematic Review and Meta-Analysis

Background

To date, early cancer detection is considered vital to reduce the global cancer burden through low-cost, but accurate screening modalities. The anatomical positioning of prostate cancer (PCa) created a potentially distinctive diagnostic method through the identification of volatile organic compounds (VOCs) in urine, which might be detectable not by humans but by canine species. This review aimed to capture the potential of the medical detection canine (MDC) to detect PCa by providing its diagnostic accuracy estimation on urine odor testing.

Methods

Databases, e.g., MEDLINE, Cochrane, ScienceDirect, and ProQuest, were searched to identify the studies. We focused on accessible original research, comparing the diagnostic utility of trained female MDC and histopathology examination as the gold standard for PCa diagnosis. The statistical analysis was performed in Meta-DiSc 1.4 and presented in diagnostic values, i.e., sensitivity (Sn), specificity (Sp), positive or negative likelihood ratio (LR+ or LR-), diagnostic odd ratio (DOR), and area under the curve (AUC) value, to conclude the Sn-Sp in a single outcome.

Results

Female German Shepherds were the most commonly utilized MDC from the five studies included in the final analysis. We estimate the pooled diagnostic value of eight different MDCs, with the findings as follows: Sn (0.95 (0.94 - 0.97)), Sp (0.92 (0.90 - 0.93)), LR+ (4.48 (1.90 - 10.58)), LR- (0.12 (0.01 - 1.42)), DOR (35.39 (2.90 - 432.53)), and an AUC value of 0.9232.

Conclusions

MDC's olfaction ability holds considerable potential on its diagnostic accuracies to distinguish the urine of PCa individuals by identifying its volatilome property.

Canine olfactory detection of SARS-CoV-2-infected humans-a systematic review

PURPOSE

To complement conventional testing methods for severe acute respiratory syndrome coronavirus type 2 infections, dogs' olfactory capability for true real-time detection has been investigated worldwide. Diseases produce specific scents in affected individuals via volatile organic compounds. This systematic review evaluates the current evidence for canine olfaction as a reliable coronavirus disease 2019 screening tool.

METHODS

Two independent study quality assessment tools were used: the QUADAS-2 tool for the evaluation of laboratory tests' diagnostic accuracy, designed for systematic reviews, and a general evaluation tool for canine detection studies, adapted to medical detection. Various study design, sample, dog, and olfactory training features were considered as potential confounding factors.

RESULTS

Twenty-seven studies from 15 countries were evaluated. Respectively, four and six studies had a low risk of bias and high quality: the four QUADAS-2 nonbiased studies resulted in ranges of 81%-97% sensitivity and 91%-100% specificity. The six high-quality studies, according to the general evaluation system, revealed ranges of 82%-97% sensitivity and 83%-100% specificity. The other studies contained high bias risks and applicability and/or quality concerns.

CONCLUSIONS

Standardization and certification procedures as used for canine explosives detection are needed for medical detection dogs for the optimal and structured usage of their undoubtful potential.

Canine Scent Detection in Lung Cancer Screening

Canines historically have been proven to have great benefits in human medicine. They have a unique ability to detect volatile organic compounds, or VOCs, in several different diseases, which allows them to work efficiently as a medical alert dog or detect the presence of certain diseases in human samples. Early studies have shown efficiency in the ability of canines to detect malignant cells from primary lung tumors in the fluid and breath samples of patients. Lung cancer is the third most common cancer and is the number one cause of cancer-related deaths in the United States. Because of its commonality, The U.S. Preventive Services Task Force developed guidelines for screening high-risk individuals, which includes low-dose CT with proven efficacy. Although effective, it comes with limitations, including increased cost, concern for radiation exposure, and low compliance amongst those who are eligible for screening. Other screening methods have been studied to overcome these deficiencies, including the use of canines trained in medical scent detection. Medical scent canines may prove to be an efficient alternative form of screening to the traditional use of low-dose CT and may be a viable non-imaging screening alternative.

β-Propiolactone (BPL)-inactivation of SARS-Co-V-2: in vitro validation with focus on saliva from COVID-19 patients for scent dog training

β-Propiolactone (BPL) is an organic compound widely used as an inactivating agent in vaccine development and production, for example for SARS-CoV, SARS-CoV-2 and Influenza viruses. Inactivation of pathogens by BPL is based on an irreversible alkylation of nucleic acids but also on acetylation and cross-linking between proteins, DNA or RNA. However, the protocols for BPL inactivation of viruses vary widely. Handling of infectious, enriched SARS-CoV-2 specimens and diagnostic samples from COVID-19 patients is recommended in biosafety level (BSL)-3 or BSL-2 laboratories, respectively. We validated BPL inactivation of SARS-CoV-2 in saliva samples with the objective to use saliva from COVID-19 patients for training of scent dogs for the detection of SARS-CoV-2 positive individuals. Therefore, saliva samples and cell culture medium buffered with NaHCO₃ (pH 8.3) were comparatively spiked with SARS-CoV-2 and inactivated with 0.1% BPL for 1hour (h) or 71h (± 1h) at 2-8°C, followed by hydrolysis of BPL at 37°C for 1 or 2h, converting BPL into non-toxic beta-hydroxy-propionic acid. SARS-CoV-2 inactivation was demonstrated by a titre reduction of up to 10^4 TCID₅₀/ml in the spiked samples for both inactivation periods using virus titration and virus isolation, respectively. The validated method was confirmed by successful inactivation of pathogens in saliva samples from COVID-19 patients. Furthermore, we reviewed the currently available literature on SARS-CoV-2 inactivation by BPL. Accordingly, BPL-inactivated, hydrolysed samples can be handled in a non-laboratory setting. Furthermore, our BPL inactivation protocols can be adapted to validation experiments with other pathogens.

Defining the Characteristics of Successful Biosecurity Scent Detection Dogs

To perform their role effectively, scent detection dogs require certain characteristics. Identifying these characteristics will inform the selection of prospective dogs and preferred approaches to their training. The current study drew upon the perspectives of industry stakeholders to identify the behavioural traits considered relevant for detection dogs in biosecurity screening roles. Dog handlers, trainers, and supervisors (n = 25) in Australian biosecurity operations participated in focus group interviews to determine the perceived characteristics that, in their experience, influence detection performance. Their descriptions were used to create a questionnaire which was then administered to handlers to assess the working behaviours of current biosecurity dogs. Responses were collected for 88% of the operational dogs (n = 36). An exploratory factor analysis revealed seven tentative dimensions: search motivation, emotional stability, search arousal, food motivation, play motivation, search independence, and search focus. Search motivation and search arousal were both positively associated with handler ratings of detection performance (p ≤ 0.006). In general, biosecurity dogs were scored consistently high in ratings of search motivation, emotional stability, and food motivation. Our approach has advanced our understanding of the working behaviours and characteristic profile of biosecurity detector dogs and will be used to inform candidate selection processes.

The neglected potential of invertebrates in detecting disease via olfaction

Agents that cause disease alter the cell metabolism of their hosts. Cells with an altered metabolism produce particular profiles of biomolecules, which are different from those of healthy cells. Such differences may be detected by olfaction. Historically, physicians used olfactory cues to diagnose sickness by smelling the breath or the urine of patients. However, other species have been shown to possess excellent olfactory abilities. Dogs, for instance, have been frequently used as biodetectors of human diseases, including cancer, viral and bacterial infections. Other mammalian species, such as rats, have been trained to perform similar tasks, but their disease detection abilities remain poorly explored. Here, we focus on the overlooked potential of invertebrate species and we review the current literature on olfactory detection of diseases by these animals. We discuss the possible advantages of exploring further the abilities of invertebrates as detection tools for human disease.

Remote Medical Scent Detection of Cancer and Infectious Diseases With Dogs and Rats: A Systematic Review

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.

Detection of Post-COVID-19 Patients Using Medical Scent Detection Dogs—A Pilot Study

There is a growing number of COVID-19 patients experiencing long-term symptoms months after their acute SARS-CoV-2 infection. Previous research proved dogs' ability to detect acute SARS-CoV-2 infections, but has not yet shown if dogs also indicate samples of patients with post-COVID-19 condition (Long COVID). Nine dogs, previously trained to detect samples of acute COVID-19 patients, were confronted with samples of Long COVID patients in two testing scenarios. In test scenario I (samples of acute COVID-19 vs. Long COVID) dogs achieved a mean sensitivity (for acute COVID-19) of 86.7% (95%CI: 75.4–98.0%) and a specificity of 95.8% (95%CI: 92.5–99.0%). When dogs were confronted with Long COVID and negative control samples in scenario IIa, dogs achieved a mean sensitivity (for Long COVID) of 94.4 (95%CI: 70.5–100.0%) and a specificity of 96.1% (95%CI: 87.6–100.0%). In comparison, when acute SARS-CoV-2 positive samples and negative control samples were comparatively presented (scenario IIb), a mean sensitivity of 86.9 (95%CI: 55.7–100.0%) and a specificity of 88.1% (95%CI: 82.7–93.6%) was attained. This pilot study supports the hypothesis of volatile organic compounds (VOCs) being long-term present after the initial infection in post-COVID-19 patients. Detection dogs, trained with samples of acute COVID-19 patients, also identified samples of Long COVID patients with a high sensitivity when presented next to samples of healthy individuals. This data may be used for further studies evaluating the pathophysiology underlying Long COVID and the composition of specific VOC-patterns released by SARS-CoV-2 infected patients throughout the course of this complex disease.

Detection of SARS-CoV-2 by Canine Olfaction: A Pilot Study

Background

As the number of coronavirus disease 2019 (COVID-19) cases continue to surge worldwide and new variants emerge, additional accurate, rapid, and noninvasive screening methods to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are needed. The number of COVID-19 cases reported globally is >455 million, and deaths have surpassed 6 million. Current diagnostic methods are expensive, invasive, and produce delayed results. While COVID-19 vaccinations are proven to help slow the spread of infection and prevent serious illness, they are not equitably available worldwide. Almost 40% of the world’s population remains unvaccinated. Evidence suggests that SARS-CoV-2 virus–associated volatile organic compounds found in the breath, urine, and sweat of infected individuals can be detected by canine olfaction. Medical detection dogs may be a feasible, accurate, and affordable SARS-CoV-2 screening method.

Methods

In this double-blinded, case–control, validation study, we obtained sweat samples from inpatients and outpatients tested for SARS-CoV-2 by a polymerase chain reaction test. Medical detection dogs were trained to distinguish SARS-CoV-2-positive samples from SARS-CoV-2-negative samples using reward-based reinforcement.

Results

Samples were obtained from 584 individuals (6–97 years of age; 24% positive SARS-CoV-2 samples and 76% negative SARS-CoV-2 samples). In the testing phase, all dogs performed with high accuracy in detecting SARS-CoV-2. The overall diagnostic sensitivity was 98%, and specificity was 92%. In a follow-up phase, 1 dog screened 153 patients for SARS-CoV-2 in a hospital setting with 96% diagnostic sensitivity and 100% specificity.

Conclusions

Canine olfaction is an accurate and feasible method for diagnosis of SARS-CoV-2, including asymptomatic and presymptomatic infected individuals.

The Use and Potential of Biomedical Detection Dogs During a Disease Outbreak

Biomedical detection dogs offer incredible advantages during disease outbreaks that are presently unmatched by current technologies, however, dogs still face hurdles of implementation due to lack of inter-governmental cooperation and acceptance by the public health community. Here, we refine the definition of a biomedical detection dog, discuss the potential applications, capabilities, and limitations of biomedical detection dogs in disease outbreak scenarios, and the safety measures that must be considered before and during deployment. Finally, we provide recommendations on how to address and overcome the barriers to acceptance of biomedical detection dogs through a dedicated research and development investment in olfactory sciences.

Biomedical detection dogs for the identification of SARS-CoV-2 Infections from axillary sweat and breath samples

A PCR test of a nasal swab is still the "gold standard" for detecting a SARS-CoV-2 infection. However, PCR testing could be usefully complemented by non-invasive, fast, reliable, cheap methods for detecting infected individuals in busy areas (e.g. airports and railway stations) or remote areas. Detection of the volatile, semivolatile and non-volatile compound signature of SARS-CoV-2 infection by trained sniffer dogs might meet these requirements. Previous studies have shown that well-trained dogs can detect SARS-CoV-2 in sweat, saliva and urine samples. The objective of the present study was to assess the performance of dogs trained to detect the presence of SARS-CoV-2 in axillary-sweat-stained gauzes and on expired breath trapped in surgical masks. The samples were provided by individuals suffering from mild-to-severe coronavirus disease 2019 (COVID-19), asymptomatic individuals, and individuals vaccinated against COVID-19. Results: Seven trained dogs tested on 886 presentations of sweat samples from 241 subjects and detected SARS-CoV-2 with a diagnostic sensitivity (relative to the PCR test result) of 89.6% (95% confidence interval (CI): 86.4-92.2%) and a specificity of 83.9% (95% CI: 80.3-87.0%) - even when people with a low viral load were included in the analysis. When considering the 207 presentations of sweat samples from vaccinated individuals, the sensitivity and specificity were respectively 85.7% (95% CI: 68.5-94.3) and 86.0% (95% CI: 80.2-90.3%). The likelihood of a false-positive result was greater in the two weeks immediately after COVID-19 vaccination. Four of the seven dogs also tested on 262 presentations of mask samples from 98 subjects; the diagnostic sensitivity was 83.1% (95% CI: 73.2-89.9) and the specificity was 88.6% (95% CI: 83.3-92.4%). There was no difference (McNemar's test P=0.999) in the dogs' abilities to detect the presence of SARS-CoV-2 in paired samples of sweat-stained gauzes vs. surgical masks worn for only 10 minutes. Conclusion: Our findings confirm the promise of SARS-CoV-2 screening by detection dogs and broaden the method's scope to vaccinated individuals and easy-to-obtain face masks, and suggest that a "dogs + confirmatory rapid antigen detection tests" screening strategy might be worth investigating.