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Theranostics 2016; 6(2):231-242. doi:10.7150/thno.14023 This issue Cite

Research Paper

Smartphone-Based Fluorescent Diagnostic System for Highly Pathogenic H5N1 Viruses

Seon-Ju Yeo^1‡, Kyunghan Choi^2‡, Bui Thi Cuc¹, Nguyen Ngoc Hong¹, Duong Tuan Bao¹, Nguyen Minh Ngoc¹, Mai Quynh Le³, Nguyen Le Khanh Hang³, Nguyen Co Thach³, Shyam Kumar Mallik⁴, Hak Sung Kim⁴, Chom-Kyu Chong⁵, Hak Soo Choi⁶, Haan Woo Sung⁷, Kyoungsik Yu^2✉, Hyun Park^1✉

1. Zoonosis Research Center, Department of Infection Biology, School of Medicine, Wonkwang University, Iksan, 570-749, Republic of Korea
2. School of Electrical Engineering, Korea Advanced Institute of Science and Technology, Daejeon, 305-338, Republic of Korea
3. National Institute of Hygiene and Epidemiology, No 1- Yersin street, Hanoi, Vietnam
4. College of Pharmacy, Institute of Pharmaceutical Research and Development, Wonkwang University, Iksan, 570-749, Republic of Korea
5. GenBody Inc, No.206, Biotech Business IC, DanKook University, San-29, Anseo-dong, Dongnam-gu, Cheonan, Republic of Korea
6. Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston USA
7. College of Veterinary Medicine, Kangwon National University, Chunchon, 200-701, Republic of Korea
‡ Equal contributor: Seon-Ju Yeo and Kyunghan Choi contributed equally to this work.

✉ Corresponding authors: Hyun Park, MD, Ph.D: hyunpkac.kr. Kyoungsik Yu, Ph.D: ksyuedu

Abstract

Field diagnostic tools for avian influenza (AI) are indispensable for the prevention and controlled management of highly pathogenic AI-related diseases. More accurate, faster and networked on-site monitoring is demanded to detect such AI viruses with high sensitivity as well as to maintain up-to-date information about their geographical transmission. In this work, we assessed the clinical and field-level performance of a smartphone-based fluorescent diagnostic device with an efficient reflective light collection module using a coumarin-derived dendrimer-based fluorescent lateral flow immunoassay. By application of an optimized bioconjugate, a smartphone-based diagnostic device had a two-fold higher detectability as compared to that of the table-top fluorescence strip reader for three different AI subtypes (H5N3, H7N1, and H9N2). Additionally, in a clinical study of H5N1-confirmed patients, the smartphone-based diagnostic device showed a sensitivity of 96.55% (28/29) [95% confidence interval (CI): 82.24 to 99.91] and a specificity of 98.55% (68/69) (95% CI: 92.19 to 99.96). The measurement results from the distributed individual smartphones were wirelessly transmitted via short messaging service and collected by a centralized database system for further information processing and data mining. Smartphone-based diagnosis provided highly sensitive measurement results for H5N1 detection within 15 minutes. Because of its high sensitivity, portability and automatic reporting feature, the proposed device will enable agile identification of patients and efficient control of AI dissemination.

Keywords: highly pathogenic H5N1 influenza virus, smartphone-based fluorescent diagnostic device, fluorescence-based immunochromatographic strip test, coumarin-derived dendrimer, field application

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