Community Surveillance of Respiratory Viruses via Self-Collected Nasal Swabs

Overview

This study demonstrates the feasibility of integrating self-collected nasal swabs with the FluTracking symptom survey to monitor both symptomatic and asymptomatic respiratory virus infections in the community. Over a 50-week period, 2068 swabs were collected with an 84% return rate, detecting viruses in 11% of participant-weeks, including 24.2% asymptomatic cases.

Background

Traditional respiratory virus surveillance typically focuses on symptomatic individuals seeking healthcare, potentially missing asymptomatic infections that contribute to transmission. FluTracking is Australia's primary community-based symptom surveillance platform, collecting weekly respiratory symptom data from volunteers. Self-collected nasal swabs have shown comparable sensitivity to clinician-collected samples and can be mailed for testing, enabling scalable community surveillance. The PREVENT study nested within FluTracking aimed to assess the feasibility of combining weekly self-swabbing with symptom surveys to capture comprehensive respiratory virus circulation.

Data Highlights

Key Findings

• Self-collected nasal swabs returned by mail are a feasible method for respiratory virus surveillance in the community, achieving an 84% return rate over 50 weeks.
• Respiratory viruses were detected in 11% of participant-weeks, with nearly one quarter of positive detections occurring in asymptomatic individuals, highlighting the role of asymptomatic infection in virus circulation.
• Rhinovirus was the most commonly detected virus, followed by SARS-CoV-2, reflecting ongoing circulation of multiple respiratory viruses post-pandemic.
• Integration with the FluTracking platform allowed longitudinal monitoring of the same participants, capturing both symptomatic and asymptomatic infections.
• Sample stability and diagnostic sensitivity of self-collected swabs support their use in large-scale community surveillance programs.

Clinical Implications

Incorporating self-collected nasal swabs into existing community symptom surveillance platforms enables more comprehensive monitoring of respiratory virus transmission, including asymptomatic infections that traditional surveillance may miss. This approach can inform public health responses by providing timely data on circulating viruses and transmission dynamics outside healthcare settings.

Conclusion

The PREVENT study confirms that weekly self-collected nasal swabbing integrated with FluTracking is a practical and effective strategy for community-based respiratory virus surveillance, capturing valuable data on both symptomatic and asymptomatic infections.

References

1. FluTracking Platform -- www.flutracking.net
2. PREVENT Study Ethics Approval 2022/ETH02754