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Epidemiology

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

Ashley E. Kim [BS], Elisabeth Brandstetter [MPH], Naomi Wilcox [MPH], Jessica Heimonen [MPH], Chelsey Graham [MEng], Peter D. Han [MS], Lea M. Starita [PhD], Denise J. McCulloch [MD MPH], Amanda M. Casto [MD PhD], Deborah A. Nickerson [PhD], Margaret M. Van de Loo [BA], Jennifer Mooney [BFA], Misja Ilcisin [BSc], Kairsten A. Fay [BSc], Jover Lee [BSc], Thomas R. Sibley [BA], Victoria Lyon [MPH], Rachel E. Geyer [MPH], Matthew Thompson [MBChB, MPH, DPhil], Barry R. Lutz [PhD], Mark J. Rieder [PhD], Trevor Bedford [PhD], Michael Boeckh [MD, PhD], Janet A. Englund [MD], Helen Y. Chu [MD, MPH]; on behalf of the Seattle Flu Study Investigators
Ashley E. Kim
1Department of Medicine, University of Washington, Seattle WA
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  • For correspondence: ashleyek@uw.edu helenchu@uw.edu
Elisabeth Brandstetter
1Department of Medicine, University of Washington, Seattle WA
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Naomi Wilcox
1Department of Medicine, University of Washington, Seattle WA
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Jessica Heimonen
1Department of Medicine, University of Washington, Seattle WA
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Chelsey Graham
2Brotman Baty Institute for Precision Medicine, Seattle WA
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Peter D. Han
2Brotman Baty Institute for Precision Medicine, Seattle WA
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Lea M. Starita
2Brotman Baty Institute for Precision Medicine, Seattle WA
3Department of Genome Sciences, University of Washington, Seattle WA
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  • ORCID record for Lea M. Starita
Denise J. McCulloch
1Department of Medicine, University of Washington, Seattle WA
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Amanda M. Casto
1Department of Medicine, University of Washington, Seattle WA
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Deborah A. Nickerson
2Brotman Baty Institute for Precision Medicine, Seattle WA
3Department of Genome Sciences, University of Washington, Seattle WA
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Margaret M. Van de Loo
4Formative, Seattle WA
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Jennifer Mooney
4Formative, Seattle WA
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Misja Ilcisin
5Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA
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Kairsten A. Fay
5Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA
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Jover Lee
5Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA
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Thomas R. Sibley
5Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA
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Victoria Lyon
7Department of Family Medicine, University of Washington, Seattle WA
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Rachel E. Geyer
7Department of Family Medicine, University of Washington, Seattle WA
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Matthew Thompson
7Department of Family Medicine, University of Washington, Seattle WA
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Barry R. Lutz
7Department of Family Medicine, University of Washington, Seattle WA
8Department of Bioengineering, University of Washington, Seattle WA
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Mark J. Rieder
2Brotman Baty Institute for Precision Medicine, Seattle WA
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Trevor Bedford
2Brotman Baty Institute for Precision Medicine, Seattle WA
3Department of Genome Sciences, University of Washington, Seattle WA
5Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA
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Michael Boeckh
5Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle WA
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Janet A. Englund
6Seattle Children’s Research Institute, Seattle WA
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Helen Y. Chu
1Department of Medicine, University of Washington, Seattle WA
2Brotman Baty Institute for Precision Medicine, Seattle WA
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  • For correspondence: ashleyek@uw.edu helenchu@uw.edu
DOI: 10.1128/JCM.02934-20
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ABSTRACT

Introduction. 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.

Methods. From 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 housekeeping gene. Participant data were recorded via online survey at the time of sample collection and one week later.

Results. 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 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]. A single adverse event occurred and did not cause long-term effects or require medical attention.

Discussion. 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.

  • Copyright © 2021 Kim et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

This article is made available via the PMC Open Access Subset for unrestricted noncommercial re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

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Evaluating Specimen Quality and Results from a Community-Wide, Home-Based Respiratory Surveillance Study
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 A. Fay, Jover Lee, Thomas R. Sibley, Victoria Lyon, Rachel E. Geyer, Matthew Thompson, Barry R. Lutz, Mark J. Rieder, Trevor Bedford, Michael Boeckh, Janet A. Englund, Helen Y. Chu on behalf of the Seattle Flu Study Investigators
Journal of Clinical Microbiology Feb 2021, JCM.02934-20; DOI: 10.1128/JCM.02934-20

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Evaluating Specimen Quality and Results from a Community-Wide, Home-Based Respiratory Surveillance Study
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 A. Fay, Jover Lee, Thomas R. Sibley, Victoria Lyon, Rachel E. Geyer, Matthew Thompson, Barry R. Lutz, Mark J. Rieder, Trevor Bedford, Michael Boeckh, Janet A. Englund, Helen Y. Chu on behalf of the Seattle Flu Study Investigators
Journal of Clinical Microbiology Feb 2021, JCM.02934-20; DOI: 10.1128/JCM.02934-20
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