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. 2021 Mar;15(2):227-234.
doi: 10.1111/irv.12822. Epub 2020 Oct 26.

Home collection of nasal swabs for detection of influenza in the Household Influenza Vaccine Evaluation Study

Ryan E Malosh  1 , Joshua G Petrie  1 , Amy P Callear  1 , Arnold S Monto  1 , Emily T Martin  1
Affiliations

Home collection of nasal swabs for detection of influenza in the Household Influenza Vaccine Evaluation Study

Ryan E Malosh et al. Influenza Other Respir Viruses. 2021 Mar.

Abstract

Background: Community-based studies of influenza and other respiratory viruses (eg, SARS-CoV-2) require laboratory confirmation of infection. During the current COVID-19 pandemic, social distancing guidelines require alternative data collection in order to protect both research staff and participants. Home-collected respiratory specimens are less resource-intensive, can be collected earlier after symptom onset, and provide a low-contact means of data collection. A prospective, multi-year, community-based cohort study is an ideal setting to examine the utility of home-collected specimens for identification of influenza.

Methods: We describe the feasibility and reliability of home-collected specimens for the detection of influenza. We collected data and specimens between October 2014 and June 2017 from the Household Influenza Vaccine Evaluation (HIVE) Study. Cohort participants were asked to collect a nasal swab at home upon onset of acute respiratory illness. Research staff also collected nose and throat swab specimens in the study clinic within 7 days of onset. We estimated agreement using Cohen's kappa and calculated sensitivity and specificity of home-collected compared to staff-collected specimens.

Results: We tested 336 paired staff- and home-collected respiratory specimens for influenza by RT-PCR; 150 staff-collected specimens were positive for influenza A/H3N2, 23 for influenza A/H1N1, 14 for influenza B/Victoria, and 31 for influenza B/Yamagata. We found moderate agreement between collection methods for influenza A/H3N2 (0.70) and B/Yamagata (0.69) and high agreement for influenza A/H1N1 (0.87) and B/Victoria (0.86). Sensitivity ranged from 78% to 86% for all influenza types and subtypes. Specificity was high for influenza A/H1N1 and both influenza B lineages with a range from 96% to 100%, and slightly lower for A/H3N2 infections (88%).

Conclusions: Collection of nasal swab specimens at home is both feasible and reliable for identification of influenza virus infections.

Keywords: acute respiratory illness; community-based; influenza; self-collected nasal swabs.

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Conflict of interest statement

REM, JGP, and APC have no conflicts of interest to disclose. ASM reports personal fees from Sanofi Pasteur and Seqirus outside the current work. ETM reports grants from Pfizer and personal fees from Merck outside the current work.

Figures

Figure 1
Figure 1
Time (days) from symptom onset to specimen collection for paired home‐collected and staff‐collected respiratory specimens
Figure 2
Figure 2
Ct value for home‐collected and staff‐collected respiratory specimens by influenza type, stratified by time (days) between home and staff collection
See this image and copyright information in PMC

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