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Prepared Witness Testimony The House Committee on Energy and Commerce
SARS: Assessment, Outlook, and Lessons Learned
Subcommittee on Oversight and Investigations
Mr. John M. Brenna John M. Brenna
Good afternoon ladies and gentlemen. On behalf of Computerized Thermal Imaging I thank you for the opportunity today to testify before this sub-committee as to "How Infrared Imaging could be used for SARS Screening". My name is John Brenna and I am the president of the company. The material I will present is based on recent experiences learned from our technology being used in China for SARS Screening. Before I begin, Computerized Thermal Imaging is a small manufacturing and research and development company located in Portland, Oregon and Ogden, Utah. Our core competence is specializing in medical and industrial applications for Infrared Camera technology. These cameras are sensitive scientific instruments that measure heat and temperature changes. In industry, our technology is used for non-destructive testing, principally for turbine blade testing where conventional forms of testing fail to reveal minute imperfections that could result in a catastrophic failure. Our medical products are used primarily for the location and therapeutic treatment of pain and pain management. In 1999, we started the FDA Pre-Market Approval process for an infrared breast imaging system that provides physiological information, which studies have shown can be used as an diagnostic adjunct to mammography x-ray to reduce biopsies of benign masses. This product application is currently pending, and we are working with FDA to obtain approval. We are fortunate to have an authorized dealer in China who has been working with various provincial healthcare administrators over the past several weeks, and has installed six of our infrared cameras specifically for SARS screening. Four of the cameras are located at hospitals, one at a railway depot and one at an airport. The magnitude of the challenge facing China is shown by their having over 300 major airports, over a 1000 railway stations and over 12,000 hospitals. Their early learning experiences indicate that, using Infrared camera technology for SARS screening has been beneficial. We know that SARS is an atypical pneumonia transmitted by contact with body fluids and air particles coughed or sneezed by an infected person. Symptoms may include respiratory distress, coughing, shortness of breath and breathing difficulty and is accompanied by a fever greater than 100 degrees Fahrenheit. A chest x-ray finding of pneumonia or respiratory distress syndrome is the only known way now to confirm SARS: although other companies are working on serum blood tests. As I mentioned earlier, our infrared cameras are at four hospitals, one railway station and one airport; these are crowded, mission critical facilities that are, unfortunately, terrific amplifiers for any airborne disease. When a human image is taken with an infrared camera, we know that skin temperature is lower than the normal 98.6 degrees Fahrenheit body temperature, because of well-studied heat evaporation, conduction and convection principles. Medical specialists in China use a facial temperature baseline of 33 degrees centigrade or 91.4 degrees Fahrenheit as the upper limit for normal healthy temperature. Let's now turn to the practical application of the technology to SARS Screening and the logistical considerations that must be addressed. At the airport, a special health-screening gate was established to detect facial temperatures exceeding 33 degrees centigrade, before a passenger passes through security. At the railway station, passengers are screened at the ticket counter and at the hospitals all patients and visitors are screened. A temperature reading above 33 degrees centigrade signals a potential fever. When a fever like symptom is detected, the subject's body temperature is taken with a thermometer and then checked for respiratory distress symptoms. A chest x-ray at the screening location or nearby clinic may then be used to confirm the presence of pneumonia. These are example images of the screening process. You will note the "normal" image of a subject exhibiting facial skin temperature below 33 degrees centigrade and the abnormal image detecting skin temperature above 33 degrees centigrade. The abnormal condition can also be signaled by an audible alarm. (See attachment) This is what the Infrared camera system looks like. (See attachment) Early results provided by our dealer distributor, indicate that half of the subjects screened, who had temperatures exceeding 33 degrees centigrade required further examination and treatment. The other half of the subjects, for which examination was required, were false positives caused by some form of physical exertion or pharmaceuticals. The Computerized Thermal Imaging infrared camera is a scientific instrument designed to image the human body skin temperatures. Let me explain in more detail: First, the camera is "radiometric" meaning it measures actual skin temperature. Most other cameras measure "relative" heat, which differentiates humans from inanimate objects, as used in military or weather forecasting applications. Secondly, the Computerized Thermal Imaging camera was designed with "high sensitivity" using a Mercury Cadmium Telluride detector providing optimal measurements for human temperatures in the 20 to 40 degree centigrade range. This technology detects infrared transmission in the wavelengths range of 8 to 12 microns; those are wavelengths between 8 and 12 millionths of an inch. The human body's peak emission wavelength is about 10 microns. Thus, our technology is optimized for human applications. Most other infrared cameras are either not radiometric, meaning they do not measure actual temperature, or do not operate in the 8 to 12 micron spectral range for sufficient resolution and accuracy. Most operate in the 3 to 5 micron range and are designed for industrial applications. And last, the Computerized Thermal Imaging system captures images dynamically in near real time, providing the capability for high volume throughput as subjects pass through security check points. Just one of the systems can image up to 12 subjects per minute or over 700 per hour yielding a "positive" or "negative" test result. Subject images for storage and retention purposes are structured in common Microsoft ACCESS and compatible with standard WORD and Microsoft programs. In closing, we are constantly learning from the experiences in China. Infrared Camera technology offers much promise in SARS screening as it measures facial body temperature as a first defense early warning indicator. We know that Mercury Cadmium Telluride detectors optimally capture human infrared frequencies. And that "radiometric" technology works best for temperature measurement accuracy. The SARS death toll is rising. SARS clearly is a global microbial threat. I would strongly recommend to this sub-committee that additional government research and development support be considered for advancing infrared technology as a SARS screening device; including consideration for establishing a trial site or sites at high risk international entry locations. I thank the sub-committee for this opportunity to describe infrared camera technology as a potential means for first defense SARS Screening.
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