tetano
Editor, Senior Moderator
Influenza Other Respir Viruses
. 2021 May 3.
doi: 10.1111/irv.12859. Online ahead of print.
A remote household-based approach to influenza self-testing and antiviral treatment
Jessica Heimonen[SUP] 1 [/SUP], Denise J McCulloch[SUP] 1 [/SUP], Jessica O'Hanlon[SUP] 1 [/SUP], Ashley E Kim[SUP] 1 [/SUP], Anne Emanuels[SUP] 1 [/SUP], Naomi Wilcox[SUP] 1 [/SUP], Elisabeth Brandstetter[SUP] 1 [/SUP], Mark Stewart[SUP] 2 [/SUP], David McCune[SUP] 2 [/SUP], Scott Fry[SUP] 3 [/SUP], Sean Parsons[SUP] 3 [/SUP], James P Hughes[SUP] 4 [/SUP], Michael L Jackson[SUP] 5 [/SUP], Timothy M Uyeki[SUP] 6 [/SUP], Michael Boeckh[SUP] 7 [/SUP], Lea M Starita[SUP] 8 9 [/SUP], Trevor Bedford[SUP] 7 [/SUP], Janet A Englund[SUP] 10 [/SUP], Helen Y Chu[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Households represent important settings for transmission of influenza and other respiratory viruses. Current influenza diagnosis and treatment relies upon patient visits to healthcare facilities, which may lead to under-diagnosis and treatment delays. This study aimed to assess the feasibility of an at-home approach to influenza diagnosis and treatment via home testing, telehealth care, and rapid antiviral home delivery.
Methods: We conducted a pilot interventional study of remote influenza diagnosis and treatment in Seattle-area households with children during the 2019-2020 influenza season using pre-positioned nasal swabs and home influenza tests. Home monitoring for respiratory symptoms occurred weekly; if symptoms were reported within 48 hours of onset, participants collected mid-nasal swabs and used a rapid home-based influenza immunoassay. An additional home-collected swab was returned to a laboratory for confirmatory influenza RT-PCR testing. Baloxavir antiviral treatment was prescribed and delivered to symptomatic and age-eligible participants, following a telehealth encounter.
Results: 124 households comprising 481 individuals self-monitored for respiratory symptoms, with 58 home tests administered. 12 home tests were positive for influenza, of which eight were true positives confirmed by RT-PCR. The sensitivity and specificity of the home influenza test were 72.7% and 96.2%, respectively. There were eight home deliveries of baloxavir, with 7 (87.5%) occurring within 3 hours of prescription and all within 48 hours of symptom onset.
Conclusions: We demonstrate the feasibility of self-testing combined with rapid home delivery of influenza antiviral treatment. This approach may be an important control strategy for influenza epidemics and pandemics.
Keywords: Ellume; baloxavir; households; influenza; testing; treatment.
. 2021 May 3.
doi: 10.1111/irv.12859. Online ahead of print.
A remote household-based approach to influenza self-testing and antiviral treatment
Jessica Heimonen[SUP] 1 [/SUP], Denise J McCulloch[SUP] 1 [/SUP], Jessica O'Hanlon[SUP] 1 [/SUP], Ashley E Kim[SUP] 1 [/SUP], Anne Emanuels[SUP] 1 [/SUP], Naomi Wilcox[SUP] 1 [/SUP], Elisabeth Brandstetter[SUP] 1 [/SUP], Mark Stewart[SUP] 2 [/SUP], David McCune[SUP] 2 [/SUP], Scott Fry[SUP] 3 [/SUP], Sean Parsons[SUP] 3 [/SUP], James P Hughes[SUP] 4 [/SUP], Michael L Jackson[SUP] 5 [/SUP], Timothy M Uyeki[SUP] 6 [/SUP], Michael Boeckh[SUP] 7 [/SUP], Lea M Starita[SUP] 8 9 [/SUP], Trevor Bedford[SUP] 7 [/SUP], Janet A Englund[SUP] 10 [/SUP], Helen Y Chu[SUP] 1 [/SUP]
Affiliations
- PMID: 33939275
- DOI: 10.1111/irv.12859
Abstract
Background: Households represent important settings for transmission of influenza and other respiratory viruses. Current influenza diagnosis and treatment relies upon patient visits to healthcare facilities, which may lead to under-diagnosis and treatment delays. This study aimed to assess the feasibility of an at-home approach to influenza diagnosis and treatment via home testing, telehealth care, and rapid antiviral home delivery.
Methods: We conducted a pilot interventional study of remote influenza diagnosis and treatment in Seattle-area households with children during the 2019-2020 influenza season using pre-positioned nasal swabs and home influenza tests. Home monitoring for respiratory symptoms occurred weekly; if symptoms were reported within 48 hours of onset, participants collected mid-nasal swabs and used a rapid home-based influenza immunoassay. An additional home-collected swab was returned to a laboratory for confirmatory influenza RT-PCR testing. Baloxavir antiviral treatment was prescribed and delivered to symptomatic and age-eligible participants, following a telehealth encounter.
Results: 124 households comprising 481 individuals self-monitored for respiratory symptoms, with 58 home tests administered. 12 home tests were positive for influenza, of which eight were true positives confirmed by RT-PCR. The sensitivity and specificity of the home influenza test were 72.7% and 96.2%, respectively. There were eight home deliveries of baloxavir, with 7 (87.5%) occurring within 3 hours of prescription and all within 48 hours of symptom onset.
Conclusions: We demonstrate the feasibility of self-testing combined with rapid home delivery of influenza antiviral treatment. This approach may be an important control strategy for influenza epidemics and pandemics.
Keywords: Ellume; baloxavir; households; influenza; testing; treatment.