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. From October 2019 to March 2020, we conducted a home-based cross-sectional study in the greater Seattle, WA, 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 1 week later. 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 relative cycle threshold (C_rt) 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 8.0 days (interquartile range [IQR], 7.0 to 14.0). A single adverse event occurred and did not cause long-term effects or require medical attention. 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.

中文翻译：

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从社区范围的、基于家庭的呼吸监测研究中评估样本质量和结果

虽然流感和其他呼吸道病原体会导致显着的发病率和死亡率，但这些感染的社区负担仍未完全了解。开发检测呼吸道感染的新方法对于减轻流行病和发展大流行防范基础设施至关重要。从 2019 年 10 月到 2020 年 3 月，我们利用电子同意书和数据收集工具在华盛顿州大西雅图地区进行了一项以家庭为基础的横断面研究。参与者在自我报告呼吸道症状的 24 小时内通过快速交付获得了鼻拭子采集套件。样本被送回实验室并筛选了 26 种呼吸道病原体和一个看家基因。在样本收集时和 1 周后通过在线调查记录参与者数据。在这 4 个中，572 名同意的参与者，4,359 (95.3%) 人收到了家庭拭子套件，3,648 (83.7%) 人返回了鼻标本进行呼吸道病原体筛查。3,638 个可测试样本具有平均 RNase P 相对循环阈值（C _rt ) 值为 19.0 (SD, 3.4)，1,232 (33.9%) 个样本对一种或多种病原体具有阳性结果，包括 645 (17.7%) 个流感阳性样本。在可检测的样本中，家用拭子套件发货与实验室检测完成之间的中位时间为 8.0 天（四分位距 [IQR]，7.0 至 14.0）。发生了单一不良事件，但不会造成长期影响或需要医疗护理。使用在线参与者登记和样本自收集进行的家庭监测是一种安全可行的方法，可在社区层面监测流感和其他呼吸道病原体，可以很容易地适应在大流行期间使用。