Contributed Commentary by Neil Polwart
August 14, 2018 | Following one of the cruise industry’s biggest outbreaks of norovirus last year, it’s clear that new approaches to tackling the highly contagious virus need to be explored.
The outbreaks, on board two cruise ships, saw more than 500 crew and passengers fall ill with Norovirus in one month—one of the largest outbreaks on record.
Although it’s recognized as the “winter vomiting bug,” norovirus isn’t just a seasonal illness. It is not only confined to cruise ships. Iit’s one of the leading causes of acute gastroenteritis in the US, with an average of 19 to 21 million cases reported each year.
Norovirus is highly contagious and can be contracted through contaminated food, surfaces, and people. Coupled with the stubborn nature of the disease—norovirus can still be detected in a patient’s stool two weeks after recovery—there is a necessity to develop rapid detection methods which bring cases quickly under control.
In the era of digital healthcare, how can the connected technologies support rapid detection? Evidence suggests that the mobile phone has already played a significant role in the track and trace of infectious diseases, like Ebola in West Africa. Within chronic conditions, patients displaying symptoms consistent with Crohn's or Colitis disease, have used smartphone readers with home test kits.
Whilst schools and tour operators increasingly have their own apps, which enable messages to be pushed to users and help share critical information, the potential to harness the meta data from such apps is currently underutilized. However, as the BBC Pandemic App demonstrated, it’s possible to use such data for epidemiological prediction.
From swabbing surface areas, testing stool samples for those displaying norovirus symptoms (sickness, diarrhea, and vomiting), to tracking the spread of infection using geo-tracking, smartphone technology has the potential to enhance point-of-care testing and support decentralized healthcare—particularly when the cautionary measure is to avoid further human contact and self-quarantine.
Access to smartphone diagnostic readers on-board a cruise ship, for example, could enable at-risk groups to perform an accurate diagnosis, from an isolated environment, using a rapid test kit and their own mobile phone, with all the workflow support and traceable attributes normally only achieved in a sophisticated clinical laboratory.
By exploiting the intuitive user-experience on mobile devices, minimal end-user training is required. Mandatory instructions and timers can be built into the mobile app to ensure self-testing is performed correctly. The mobile phone is used to scan the test and the result is shared with healthcare professionals online, in exchange for medical advice and a treatment plan.
As global travel and events bring us ever closer together, we believe no other technology has the widespread distribution and accessibility to revolutionize how we tackle infectious disease.
Neil Polwart is the founder of Novarum DX and Group Head of Mobile at BBI Group. He has a PhD in Chemistry and over a decade of experience in mHealth development within the diagnostic industry, delivering connected health and enabling true point of care technology. He can be reached at npolwart@novarumdx.com.
Editor’s Note: Neil Polwart will presenting on this topic in his co-presentation, “Improving the Performance and Connectivity of Lateral Flow Assays for Diagnostic Applications,” during the Next Generation Dx Summit in Washington, DC.