Early Warning Diagnostics for Emerging Infectious Diseases in Developing into Late-Stage Pandemics

Abstract

Conspectus The spread of infectious diseases due to travel and trade can be seen throughout history, whether from early settlers or traveling businessmen. Increased globalization has allowed infectious diseases to quickly spread to different parts of the world and cause widespread infection. Posthoc analysis of more recent outbreaksSARS, MERS, swine flu, and COVID-19has demonstrated that the causative viruses were circulating through populations for days or weeks before they were first detected, allowing disease to spread before quarantines, contact tracing, and travel restrictions could be implemented. Earlier detection of future novel pathogens could decrease the time before countermeasures are enacted. In this Account, we examined a variety of novel technologies from the past 10 years that may allow for earlier detection of infectious diseases. We have arranged these technologies chronologically from prehuman predictive technologies to population-level screening tools. The earliest detection methods utilize artificial intelligence to analyze factors such as climate variation and zoonotic spillover as well as specific species and geographies to identify where the infection risk is high. Artificial intelligence can also be used to monitor health records, social media, and various publicly available data to identify disease outbreaks faster than traditional epidemiology. Secondary to predictive measures is monitoring infection in specific sentinel animal species, where domestic animals or wildlife are indicators of potential disease hotspots. These hotspots inform public health officials about geographic areas where infection risk in humans is high. Further along the timeline, once the disease has begun to infect humans, wastewater epidemiology can be used for unbiased sampling of large populations. This method has already been shown to precede spikes in COVID-19 diagnoses by 1 to 2 weeks. As total infections increase in humans, bioaerosol sampling in high-traffic areas can be used for disease monitoring, such as within an airport. Finally, as disease spreads more quickly between humans, rapid diagnostic technologies such as lateral flow assays and nucleic acid amplification become very important. Minimally invasive point-of-care methods can allow for quick adoption and use within a population. These individual diagnostic methods then transfer to higher-throughput methods for more intensive population screening as an infection spreads. There are many promising early warning technologies being developed. However, no single technology listed herein will prevent every future outbreak. A combination of technologies from across our infection timeline would offer the most benefit in preventing future widespread disease outbreaks and pandemics.

Diagnostic and therapeutic approach to occupational pneumonia

“…90% of cases are asymp-were already circulating in the population weeks before the first case was diagnosed. This shows our need for earlier detection of future emerging zoonoses [15,16].…”

Automated Microfluidic Nucleic Acid Detection Platform-Integrated RPA-T7-Cas13a for Pathogen Diagnosis

“…Infectious diseases pose a serious threat to human health. 1 There is an urgent need for more powerful diagnostic tools to improve testing capabilities. The outbreak of COVID-19 has greatly advanced the development of nucleic acid testing and extended its application to accurate and rapid molecular diagnosis of other pathogens.…”

“…Infectious diseases pose a serious threat to human health . There is an urgent need for more powerful diagnostic tools to improve testing capabilities.…”

High Sensitivity, Rapid Detection of Virus in High Traffic Environments

“…More than ever before, rapid diagnostic tests have become a fundamental component of outbreak mitigation, with crucial roles ranging from initial detection and quarantining procedures to population-level monitoring ( Oeschger et al, 2021 ). Although a number of diagnostic technologies exist, RT-qPCR is commonly considered the gold standard and is consequently the most widely adopted diagnostic method in test centers and hospitals.…”