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Self-swabbing for virological confirmation of influenza like illness (ILI) amongst an internet based cohort in the UK, 2014-5

Wenham, Clare ORCID: 0000-0001-5378-3203, Gray, Eleanor R., Keane, Candice E., Donati, Matthew, Paolotti, Daniela, Pebody, Richard, Fragaszy, Ellen, McKendry, Rachel A and Edmunds, W. John (2018) Self-swabbing for virological confirmation of influenza like illness (ILI) amongst an internet based cohort in the UK, 2014-5. Journal of Medical Internet Research, 20 (3). ISSN 1438-8871

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Identification Number: 10.2196/preprints.9084


Background: Routine influenza surveillance, based on laboratory confirmation of viral infection often fails to estimate a true burden of influenza like illness (ILI) in the community due to the fact that those suffering from ILI often manage their own symptoms, without visiting a health professional. Internet based surveillance can complement this traditional health-service-based surveillance by measuring symptoms and health behaviour of a population with minimal time delay. Flusurvey, the UK’s largest crowd-sourced platform for surveillance of influenza, collects routine data on over 6,000 voluntary participants and offers real-time estimates of ILI circulation. However, one criticism of this method of surveillance is that it is only able to assess ILI, rather than virologically confirmed influenza. Objective: We designed a pilot to see if it was feasible to ask individuals from the Flusurvey platform to perform a self-swabbing task, and to assess whether they were able to collect samples with a suitable viral content to be able to identify an influenza virus in the laboratory. Methods: Virological swabbing kits were sent to pilot participants, who then monitored their ILI symptoms over the influenza season (2014-5) through the Flusurvey platform. If they reported ILI, they were asked to undertake the self-swabbing exercise, and return the swabs to Public Health England (PHE) laboratory for multiplex PCR testing. Results: The results showed that samples from 18/51 people who reported ILI tested positive for a virological confirmed infection through multiplex PCR testing. Conclusions: This demonstrated proof of concept that it is possible to apply self-swabbing for virological laboratory testing to an online cohort study. This pilot does not have significant numbers to validate whether Flusurvey surveillance does reflect influenza infection in the community, but it highlights that the methodology is feasible and self-swabbing could be expanded to larger online surveillance activities, such as during the initial stages of a pandemic to understand community transmission or to better assess inter-seasonal activity.

Item Type: Article
Official URL:
Additional Information: © 2018 The Authors
Divisions: Health Policy
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 15 Jan 2018 12:06
Last Modified: 15 Sep 2023 11:46

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