PDF(Pubmed)
Abstract：
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 (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 8.0 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.
摘要：
虽然流感和其他呼吸道病原体导致显著的发病率和死亡率，这些感染的社区负担仍未完全了解.检测呼吸道感染的新方法的开发对于减轻流行病和发展大流行准备基础设施至关重要。从2019年10月到2020年3月，我们在大西雅图进行了一项基于家庭的横断面研究，WA,area,利用电子同意和数据收集工具。参与者在自我报告呼吸道症状后24小时内通过快速递送接受鼻拭子收集试剂盒。将样品返回实验室，并筛选26种呼吸道病原体和一个管家基因。参与者数据在样本收集时和1周后通过在线调查记录。在4572名同意的与会者中，4,359（95.3％）接受了家用拭子试剂盒，3,648（83.7％）返回了鼻样本用于呼吸道病原体筛查。3,638个可测试样品的平均RNaseP相对循环阈值（Crt）值为19.0（SD，3.4),1,232份(33.9%)样本对一种或多种病原体有阳性结果，包括645份(17.7%)流感阳性标本。在可测试的样本中，家庭拭子套件的装运与实验室测试完成之间的中位时间为8.0天(四分位距[IQR]，7.0至14.0）。发生了单个不良事件，没有引起长期影响或需要医疗护理。使用在线参与者注册和标本自我收集的家庭监测是社区级监测流感和其他呼吸道病原体的安全可行方法，可以很容易地适应大流行期间的使用。
