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At home self-swabbing study to help understand influenza outbreaks in the UK

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A recent study published in the Journal of Medical Internet Research shows that self-swabbing for influenza at home could help surveillance of emerging stages of pandemic and understand ongoing transmission.



Monitor flu trends across the UK more accurately than ever before

Influenza and influenza-like-illness cause a considerable burden on health in the UK. Each winter hundreds of thousands of people visit their doctors, tens of thousands are hospitalised and there are on average 8,000 deaths attributable to influenza. Moreover, pandemic influenza ranks at the top of the Cabinet Office risk register of civil threats. 

The i-sense self-swabbing pilot study was conducted by London School of Hygiene and Tropical Medicine in collaboration with researchers from University College London and Public Health England, with funding from the i-sense EPSRC IRC in Early Warning Sensing Systems for Infectious Diseases.

Research Fellow in Public Health Engagement at the London School of Hygiene and Tropical Medicine, Clare Wenham, says “Influenza surveillance based on lab tests cannot accurately estimate the burden of infection on the population as many people with influenza like illness may never present to a doctor.”

“By combining self-swabbing with data captured through Flusurvey, this process could compliment traditional surveillance methods and help monitor flu trends across the UK more accurately than ever before.”

Complimenting existing surveillance methods

Flusurvey is UK’s largest crowd-sourced platform for online influenza surveillance, collecting data in real-time from its 6,000 voluntary participants.

Although the platform can estimate the circulation of influenza like illness by the way people report their symptoms online, not all of those who report symptoms are suffering from the influenza virus.

Confirming diagnosis is important in understanding when a pandemic may arise and therefore we need to confirm viral load. The self-swabbing pilot was carried out to understand whether it was feasible to ask individuals to perform a self-swab at home to confirm whether they had influenza or an influenza-like-illness.

Professor of Biomedical Nanotechnology at UCL and Director of i-sense, Professor Rachel McKendry, says, “This important study, puts the public at the heart of public health efforts to study and prevent the spread of influenza. It demonstrates the feasibility and acceptability of people self-swabbing at home and lays the foundations for larger studies and future work on self-testing for influenza using a diagnostic test.”

How was the study recieved by participants? 

During the pilot study, swabbing kits were sent to 700 participants of which 66 were asked to complete the test because they met the symptoms and timings of onset criteria, and 51 swab samples were returned.

Although the study was only for a small sample size, participants generally found the self-swabbing kits easy to use and indicated that they would be interested in using a similar kit for testing of illness in the future.

Almost all (95%) participants who responded to the feedback survey said undertaking the swab test was easy, and more than half (62%) said they would prefer to undertake a self-swab at home to diagnose symptoms.

The pilot provided positive support that if results for self-swabbing could be provided to people with reported symptoms in real time, then it could affect their behaviour. People with a confirmed diagnosis could be encouraged to visit a doctor, take appropriate medication to reduce the misuse of antibiotics and ensure quick recovery, or change their routine to prevent the spread of infection.

For more information on the Flusurvey, visit flusurvey.org.uk, or to understand how you can help, visit i-sense.org.uk

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