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Linking syndromic surveillance with virological self-sampling

  • D. L. COOPER (a1), G. E. SMITH (a1), F. CHINEMANA (a2), C. JOSEPH (a3), P. LOVERIDGE (a1), P. SEBASTIONPILLAI (a4), E. GERARD (a5) and M. ZAMBON (a4)...

Calls to a UK national telephone health helpline (NHS Direct) have been used for syndromic surveillance, aiming to provide early warning of rises in community morbidity. We investigated whether self-sampling by NHS Direct callers could provide viable samples for influenza culture. We recruited 294 NHS Direct callers and sent them self-sampling kits. Callers were asked to take a swab from each nostril and post them to the laboratory. Forty-two per cent of the samples were returned, 16·2% were positive on PCR for influenza (16 influenza A(H3N2), three influenza A (H1N1), four influenza B) and eight for RSV (5·6%). The mean time between the NHS Direct call and laboratory analysis was 7·4 days. These samples provided amongst the earliest influenza reports of the season, detected multiple influenza strains, and augmented a national syndromic surveillance system. Self-sampling is a feasible method of enhancing community-based surveillance programmes for detection of influenza.

Corresponding author
*Author for correspondence: Mr D. L. Cooper, Senior Scientist, Regional Surveillance Unit, Health Protection Agency West Midlands, 9th Floor, Lincoln House, 45/46 Stephenson Street, Birmingham B2 4DY, UK. (Email:
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1.  DM Fleming , FG Schellevis , WJ Paget . Health monitoring in sentinel practices networks; the contribution of primary care. European Journal of Public Health 2003; 13 (3 Suppl.): 8084.

3.  M Baker , Early warning and NHS Direct a role in community surveillance? Journal of Public Health Medicine 2003; 25: 362368.

7.  HC Wiesenfeld , Self-collection of vaginal swabs for the detection of Chlamydia, gonorrhea, and trichomoniasis: opportunity to encourage sexually transmitted disease testing among adolescents. Sexually Transmitted Diseases 2001; 28: 321325.

8.  GW Wheeler , Study of infectious intestinal disease in England: rates in the community, presenting to general practice, and reported to national surveillance. British Medical Journal 2000; 318: 10461050.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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