Review of the efficacy of infrared thermography for screening infectious diseases with applications to COVID-19

Abstract

. Purpose: The recent coronavirus disease 2019 (COVID-19) pandemic, which spread across the globe in a very short period of time, revealed that the transmission control of disease is a crucial step to prevent an outbreak and effective screening for viral infectious diseases is necessary. Since the severe acute respiratory syndrome (SARS) outbreak in 2003, infrared thermography (IRT) has been considered a gold standard method for screening febrile individuals at the time of pandemics. The objective of this review is to evaluate the efficacy of IRT for screening infectious diseases with specific applications to COVID-19. Approach: A literature review was performed in Google Scholar, PubMed, and ScienceDirect to search for studies evaluating IRT screening from 2002 to present using relevant keywords. Additional literature searches were done to evaluate IRT in comparison to traditional core body temperature measurements and assess the benefits of measuring additional vital signs for infectious disease screening. Results: Studies have reported on the unreliability of IRT due to poor sensitivity and specificity in detecting true core body temperature and its inability to identify asymptomatic carriers. Airport mass screening using IRT was conducted during occurrences of SARS, Dengue, Swine Flu, and Ebola with reported sensitivities as low as zero. Other studies reported that screening other vital signs such as heart and respiratory rates can lead to more robust methods for early infection detection. Conclusions: Studies evaluating IRT showed varied results in its efficacy for screening infectious diseases. This suggests the need to assess additional physiological parameters to increase the sensitivity and specificity of non-invasive biosensors.

SARS-CoV-2 (Covid-19) workplace temperature screening: Seasonal concerns for thermal detection in northern regions

“…The implementation of temperature measurements to detect febrile individuals before entering a public space or private workplace has only been researched in a limited variety of workplaces in the field ( Aggarwal et al, 2020 ; Aragón-Vargas, 2020 ; Khaksari et al, 2021 ; Perpetuini et al, 2021 ). This research used two experiments to test four temperature measurement devices, where participants were exposed to both a simulated environmental exposure (temperature range: -20 to 20 º C) and actual outdoor environmental exposure (temperature range: -0.48 to 45.6 º C).…”

“…There is widespread literature simultaneously comparing different IR temperature measurement devices and measurement sites at ambient temperatures ( Bijur et al, 2016 ; Fletcher et al, 2018 ; Kiekkas et al, 2016 ; Weng Seng Fong et al, 2020 ). Environmental conditions, including combinations of air temperature, radiant temperature, humidity, and air velocity, can influence IRT and NCIT devices measurements ( Foster et al, 2021 ; Khaksari et al, 2021 ). For instance, in a study involving three environmental temperatures (15.5, 21.1 and 26.6 º C) and two humidity conditions (35 and 75%), the variance of each measurement site (rectal, esophageal, tympanic and oral) was found to decrease as the environmental temperature increased ( Pascoe & Fisher, 2009 ).…”

“…In an experiment where participants sat in a cold environment (10 º C, 50% relative humidity) for 20 minutes, then entered a warm chamber (30 º C, 50% relative humidity) and rested on a chair for 30 minutes, underestimations of core body temperature occurred for the first 10 minutes ( Kistemaker et al, 2006 ). To our knowledge, no assessment of the effectiveness of NCITs and IRTs has been reflective of environmental temperatures experienced at Canadian workplaces ( Khaksari et al, 2021 ; Perpetuini et al, 2021 ). Therefore, the purpose of this study was to establish the consistency of these devices for determining the surface temperature of the skin and ear in both a simulated environmental exposure (controlled temperature and humidity) and an actual environmental exposure (uncontrolled temperature and humidity).…”

Studying the Accuracy and Function of Different Thermometry Techniques for Measuring Body Temperature

“…Thermal cameras function by detecting the infrared radiation emitted from human skin and converting it into an electrical signal, which is used to display a body temperature profile [ 13 ]. Infrared thermography displays body temperature distribution over a large surface, including any hot or cold patterns [ 14 ]. This makes infrared thermography feasible as a method for detecting individuals with an elevated temperature and established fever.…”

The environment has effects on infrared temperature screening for COVID-19 infection

“…Infrared imaging systems (IRIs) and non-contact IR thermometers (NCITs) have been used for mass screenings during outbreaks of the SARS, Ebola, Dengue, and Influenza H1N1 viruses. 1 , 2 , 3 Across the United States, entry screening procedures for COVID-19 infection have been implemented according to the CDC guidelines, including a brief questionnaire and temperature measurement. There is evidence, however, that screening for fever is inadequate in the detection of infected individuals and preventing spread.…”