Pilot study of participant-collected nasal swabs for acute respiratory infections in a low-income, urban population

Vargas, Celibell Y; Wang, Liqun; Castellanos de Belliard, Yaritza; Morban, Maria; Diaz, Hilbania; Larson, Elaine L; LaRussa, Philip; Saiman, Lisa; Stockwell, Melissa S

This study also confirmed that standard US Postal Service mailings can be used to provide viable self-swab specimens. The feasibility of using the postal service is important, since other commercial shipping services may be less accessible to low-income populations due to the limited availability of drop-off locations, the need for someone to be available for home pickup and, furthermore, are more costly. 3 Although this study was completed during the winter, which may have reduced sample degradation, a previous study demonstrated the integrity and quality of self-swabs sent via regular mail across seasons. 11 Table 1 Characteristics of study population and relationship between demographic characteristics and positivity or negativity of a selfswab with a corresponding positive research swab While the collection of self-swab samples is useful for the surveillance of ill individuals and collection of samples of nonmedically attended infections, another potential use of self-swabbing in a household is to collect samples from asymptomatic individuals in affected households. Characterizing the level of asymptomatic infection is useful, as these individuals may also be contagious. In studies conducted during the 2009 influenza A H1N1 pandemic, up to 28% of those who were infected were asymptomatic. [12] [13] [14] However, there are few data available on asymptomatic infection for seasonal influenza and other respiratory pathogens. [12] [13] [14] Since serial swabbing would likely be needed to monitor the duration of asymptomatic shedding, it may be cost-and time-prohibitive for participants to be swabbed daily at a research site or by a health care worker in the household.