Open AccessEvaluating Specimen Quality and Results from a Community-Wide, Home-Based Respiratory Surveillance Study
Author(s) -
Ashley E. Kim,
Elisabeth Brandstetter,
Naomi Wilcox,
Jessica Heimonen,
Chelsey Graham,
Peter D. Han,
Lea M. Starita,
Denise J. McCulloch,
Amanda M. Casto,
Deborah A. Nickerson,
Margaret M. Van de Loo,
Jennifer Mooney,
Misja Ilcisin,
Kairsten Fay,
Jover Lee,
Thomas H. Sibley,
Victoria Lyon,
Rachel E. Geyer,
Matthew Thompson,
Barry R. Lutz,
Mark J. Rieder,
Trevor Bedford,
Michael Boeckh,
Janet A. Englund,
Helen Y. Chu
Publication year - 2021
Publication title -
journal of clinical microbiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.349
H-Index - 255
eISSN - 1070-633X
pISSN - 0095-1137
DOI - 10.1128/jcm.02934-20
Subject(s) - preparedness , pandemic , intensive care medicine , medicine , respiratory system , epidemiologic surveillance , environmental health , covid-19 , epidemiology , disease , infectious disease (medical specialty) , political science , law
While influenza and other respiratory pathogens cause significant morbidity and mortality, the community-based burden of these infections remains incompletely understood. The development of novel methods to detect respiratory infections is essential for mitigating epidemics and developing pandemic-preparedness infrastructure. From October 2019 to March 2020, we conducted a home-based cross-sectional study in the greater Seattle, WA, area, utilizing electronic consent and data collection instruments. Participants received nasal swab collection kits via rapid delivery within 24 hours of self-reporting respiratory symptoms. Samples were returned to the laboratory and were screened for 26 respiratory pathogens and a housekeeping gene. Participant data were recorded via online survey at the time of sample collection and 1 week later. Of the 4,572 consented participants, 4,359 (95.3%) received a home swab kit and 3,648 (83.7%) returned a nasal specimen for respiratory pathogen screening. The 3,638 testable samples had a mean RNase P relative cycle threshold ( C rt ) value of 19.0 (SD, 3.4), and 1,232 (33.9%) samples had positive results for one or more pathogens, including 645 (17.7%) influenza-positive specimens. Among the testable samples, the median time between shipment of the home swab kit and completion of laboratory testing was 8.0 days (interquartile range [IQR], 7.0 to 14.0). A single adverse event occurred and did not cause long-term effects or require medical attention. Home-based surveillance using online participant enrollment and specimen self-collection is a safe and feasible method for community-level monitoring of influenza and other respiratory pathogens, which can readily be adapted for use during pandemics.