Evaluating Specimen Quality and Results from a Community-Wide, Home-Based Respiratory Surveillance Study

Kim, A. E.; Brandstetter, E.; Wilcox, N.; Heimonen, J.; Graham, C.; Han, P. D.; Starita, L. M.; McCulloch, D. J.; Casto, A. M.; Nickerson, D. A.; Van de Loo, M. M.; Mooney, J.; Ilcisin, M.; Fay, K. A.; Lee, J.; Sibley, T. R.; Lyon, V.; Geyer, R. E.; Thompson, M.; Lutz, B. R.; Rieder, M. J.; Bedford, T.; Boeckh, M.; Englund, J. A.; Chu, H.

doi:10.1101/2020.12.07.415653

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bioRxiv · 10.1101/2020.12.07.415653

Evaluating Specimen Quality and Results from a Community-Wide, Home-Based Respiratory Surveillance Study

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Abstract

IntroductionWhile 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. MethodsFrom October 2019 to March 2020, we conducted a home-based cross-sectional study in the greater Seattle 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 human marker. Participant data were recorded via online survey at the time of sample collection and one week later. ResultsOf 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 CRT 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 days [IQR: 7.0-14.0]. DiscussionHome-based surveillance using online participant enrollment and specimen self-collection is a feasible method for community-level monitoring of influenza and other respiratory pathogens, which can readily be adapted for use during pandemics.

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Kim, A. E., Brandstetter, E., Wilcox, N., Heimonen, J., Graham, C., Han, P. D., Starita, L. M., McCulloch, D. J., Casto, A. M., Nickerson, D. A., Van de Loo, M. M., Mooney, J., Ilcisin, M., Fay, K. A., Lee, J., Sibley, T. R., Lyon, V., Geyer, R. E., Thompson, M., Lutz, B. R., Rieder, M. J., Bedford, T., Boeckh, M., Englund, J. A., Chu, H.. 2020-12-08. Evaluating Specimen Quality and Results from a Community-Wide, Home-Based Respiratory Surveillance Study. https://doi.org/10.1101/2020.12.07.415653

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