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Canine Olfactory Detection and Its Jendrny et al. BMC Infect Dis (2021) 21:838 https://doi.org/10.1186/s12879-021-06523-8 REVIEW Open Access Canine olfactory detection and its relevance to medical detection Paula Jendrny1, Friederike Twele1, Sebastian Meller1, Albertus Dominicus Marcellinus Erasmus Osterhaus2, Esther Schalke3 and Holger Andreas Volk1* Abstract The extraordinary olfactory sense of canines combined with the possibility to learn by operant conditioning enables dogs for their use in medical detection in a wide range of applications. Research on the ability of medical detection dogs for the identifcation of individuals with infectious or non-infectious diseases has been promising, but compared to the well-established and–accepted use of snifer dogs by the police, army and customs for substances such as money, explosives or drugs, the deployment of medical detection dogs is still in its infancy. There are several factors to be considered for standardisation prior to deployment of canine scent detection dogs. Individual odours in disease consist of diferent volatile organic molecules that difer in magnitude, volatility and concentration. Olfaction can be infuenced by various parameters like genetics, environmental conditions, age, hydration, nutrition, microbiome, conditioning, training, management factors, diseases and pharmaceuticals. This review discusses current knowledge on the function and importance of canines’ olfaction and evaluates its limitations and the potential role of the dog as a biomedical detector for infectious and non-infectious diseases. Keywords: Biomedical detection dogs, Olfaction, Olfactory sense, Screening method, Snifer dogs Background information on odour origin and composition, neuro- Canines are macrosmatics with an extraordinary olfac- anatomy and physiology of the canine olfaction, difer- tory sense and memory [1, 2]. Olfaction is mandatory ent impacts on the olfactory sense and majorly current for the dog to perceive environmental information, research outcomes critically evaluating the possible role which has been used successfully by humans for track- of the dog as a biomedical detector. ing and detection of pest and prey animals and other food sources [3]. Routinely, dogs nowadays are pre- Methods dominantly deployed for the identifcation of explosives, Search strategies for this review included electronic drugs, currencies, people, endangered animal species and search engines for publication databases, searching ref- parasites [4]. In recent years, medical scenting dogs have erence lists of published papers and information from been trained to detect diferent medical conditions, but relevant scientifc conferences and discussion groups. this area of work is still relatively in its infancy [5]. Te For the section about biomedical detection dogs three use of odour detection as a diagnostic tool is of increas- databases (Google Scholar, Science Direct and PubMed) ing interest in recent [5, 6]. Tis review will summarise were searched for studies reporting the training, testing and deployment of biomedical detection dogs between 2004 and 2021. Te searches were performed by the *Correspondence: [email protected] authors using the following keywords: “biomedical detec- 1 Department of Small Animal Medicine and Surgery, University tion dogs” or “detection dogs” or “canines” in combina- of Veterinary Medicine Hannover, Bünteweg 9, 30559 Hannover, Germany Full list of author information is available at the end of the article tion with “infectious diseases”, “non-infectious diseases”, © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/. The Creative Commons Public Domain Dedication waiver (http:// creat iveco mmons. org/ publi cdoma in/ zero/1. 0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Jendrny et al. BMC Infect Dis (2021) 21:838 Page 2 of 15 “malaria”, “SARS-CoV-2”, “COVID-19”, “hypoglycaemia”, of detection dogs [39]. More published data about cancer “epileptic seizure”, “cancer”, “bacteria” or “viral”. Peer- detection by dogs is reviewed elsewhere [40, 41]. reviewed studies and pre-prints published in English and Medical scent detection dogs have also been deployed results presented at the WHO R&D Blueprint COVID-19 for patients with diabetic mellitus. Identifying hypogly- consultation [6] were evaluated. Literature that addressed caemic conditions is crucial for people with diabetes mel- detection rate and/or diagnostic accuracy (sensitivity and litus because of the potential severity of such a condition. specifcity) of biomedical detection dogs without restric- A drop of blood is required to measure blood glucose, tions to year of publication was included in this review which is an invasive method that must be performed article. Only double-blinded and randomised studies for consciously and regularly. Not every patient is able to SARS-CoV-2 detection were reported in this study. take blood themselves. Te deployment of a hypoglycae- mia snifer dog is a non-invasive method, but satisfactory Main text results have not been achieved. Te researchers found Research on biomedical detection dogs sensitivities between 36% [20] and 88% [42] and specif- Te use of biomedical detection dogs for various infec- cities of 49% [19]–98% [42] compared to the standard tious and non-infectious diseases like Helicobacter pylori method blood glucose measurement via blood glucose [7], diferent cancer types [8–17], hypoglycaemia in dia- meter. betes mellitus patients [18–20], epileptic seizures [21], Te prediction of an epileptic seizure could help the bacteriuria [22], bovine virus diarrhoea [23], COVID-19 afected person to fnd a safe environment before the [24–33], Malaria [34] and Clostridium difcile-infections seizure begins or to take emergency medication. It is [35] is still in its infancy (Table 1). Most of these studies assumed that canines have the ability to detect an altera- indicate a disease-specifc body odour or a specifc vola- tion of the body odour. Due to a high variability of the tile organic compound (VOC)-pattern associated with types and causes of epilepsy, it is still unknown which metabolic changes secondary to an infection [36]. In case specifc odour the dogs detect but chemical analyses of an infection with a virus, VOCs are generated purely could identify seizure-specifc odour molecules [21]. by the host cell, but for bacteria, VOCs are generated In another study using sweat of persons with epilepsy, by the host and the bacteria respectively [36]. For many canines distinguished between interictal and ictal sweat diseases the exact odour molecules that are recognised with a probability of 93% and warned the individual and indicated by dogs remain unknown. Disease-specifc before a clinical seizure occurred with a probability of VOC-patterns have been identifed in diseases such as 82% [43]. Some studies also report seizure alerting dogs asthma, several types of cancer, cystic fbrosis, diabe- that did not undergo any systematic training [44–46]. tes mellitus, dental diseases, gastrointestinal diseases, Tese dogs may detect specifc odour-alterations as well heart allograft rejection, heart diseases, liver diseases, as visual cues or behavioural changes of the person with pre-eclampsia, renal disease, cholera and tuberculosis epilepsy [44–46]. [36–38]. Studies including the detection of infectious diseases Canine medical scent detection appears more promis- by dogs appear to be more promising. Te training of ing for infectious diseases than non-infectious diseases detection dogs in the following studies was reward- such as cancer, diabetes mellitus and epileptic seizures. based (based on positive reinforcement). Guest et al., Despite some initially promising medical dog scent 2019, performed a study for the detection of protozoal detection studies, published data can vary signifcantly Malaria to develop a non-invasive screening method for for the identifcation of cancer. Studies with trained infected individuals [34]. Even in asymptomatic chil- snifer dogs achieved very diferent results in the identif- dren the dogs had a sensitivity and specifcity of 72% and cation of diferent cancer types, such as bladder, prostate 91%, respectively. Previously worn nylon socks were pre- or ovarian cancer, lung and breast cancer as well as colo- sented to the two trained dogs. Te results were higher rectal neoplasms. Diagnostic accuracies varied with sen- than the threshold for WHO malaria diagnostics [34]. sitivities ranging from 19 to 99% and specifcities from Te training of dogs to identify bacterial infections like 73 to 99% when compared to histopathology [8–17]. Dif- bacteriuria in urine [22] or Clostridium difcile in stool ferent sample materials
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