The Feasibility of Nasal Sampling Swabs for Respiratory Infection
Self-collected nasal sampling swabs were well accepted with over 99% of adults and 96% of children in a study in 2019 indicating willingness to participate in a longer nasal swabbing scheme. The procedure was mostly perceived as uncomplicated and non-injurious, with only brief discomfort reported by some children. The high rate of acceptance suggests that self-swabbing is a conceivable surveillance method for respiratory infections.
Timelines and completeness of sampling were satisfactory. 90% of nasal sampling swabs were taken within 3 days of symptom onset. A respiratory illness was reported online for 89% of symptom swabs, suggesting good adherence to the study protocol. When timing flexibility was allowed, 94% of swabs had a corresponding illness report. Swabbing rates were not influenced by illness severity. The timely and complete sampling demonstrates feasibility for self-swabbing surveillance.
The microbial results were valid with human genomic DNA detected in all swab samples, confirming that samples contained nasal cells. Influenza positivity rates for symptomatic participants with influenza-like illness (ILI) were comparable to those from the physician sentinel. For ILI patients, influenza positivity rates were 10 to 20% during peak activity. However, some non-ILI symptomatic patients also tested positive for influenza, indicating the potential for better case capture. Rhinovirus/enterovirus positivity rates trended higher than those from sentinel testing. Children had a higher pathogen yield than adults. The validity testing confirms that self-swabbing can generate useful microbiological data at the population level
This feasibility study demonstrates that self-collected nasal sampling swabs from a population cohort can support respiratory infection monitoring. The method was shown to be feasible, timely, valid and well-accepted by participants for implementation in surveillance. As self-swabbing allows sampling outside clinical settings, it may provide complementary population-level data to current sentinel physician systems. With further evaluation and refinement, self-swabbing appears to be a promising supplementary tool for respiratory infection tracking.
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Haussig JM, Targosz A, Engelhart S, Herzhoff M, Prahm K, Buda S, Nitsche A, Haas W, Buchholz U. Feasibility study for the use of self-collected nasal swabs to identify pathogens among participants of a population-based surveillance system for acute respiratory infections (GrippeWeb-Plus)-Germany, 2016. Influenza Other Respir Viruses. 2019 Jul;13(4):319-330. doi: 10.1111/irv.12644. Epub 2019 Mar 29. PMID: 30925029; PMCID: PMC6586186.
Nasal Sampling Swabs: Reliable Option For Screening COVID-19