title: Successful application of a simple specimen transport method for the conduct of respiratory virus surveillance in remote Indigenous communities in Australia.
abstract: OBJECTIVE
  Surveillance programs and research for acute respiratory infections in remote Aboriginal communities are complicated by difficulties in the storage and transport of frozen samples to urban laboratories for testing. This study assessed the sensitivity of a simple method for transporting respiratory samples from a remote setting for viral PCR compared with frozen specimens.
  
  
  METHODS
  We sampled every individual who presented to a remote Aboriginal community clinic in a non-epidemic respiratory season. Two anterior nasal swabs were collected from each participant. The left nare specimen was mailed to the laboratory via routine postal services. The right nare specimen was transported frozen. Testing for 16 viruses was undertaken using real-time multiplex PCR.
  
  
  RESULTS
  A total of 140 participants were enrolled who contributed 150 study visits. Respiratory illnesses accounted for 10% of the reasons for presentation. Sixty-one viruses were identified in 50 (33.3%) presentations for 40 (28.6%) individuals; bocavirus and rhinovirus were the most common viruses identified (14.0% and 12.6% of episodes respectively). The sensitivity for any virus detected in mailed specimens was 67.2% (95%CI 55.4, 78.9) compared to 65.6% (95%CI 53.7, 77.5) for frozen specimens.
  
  
  CONCLUSIONS
  The mailing of unfrozen nasal specimens from remote communities does not compromise the viability of the specimen for viral studies.
authors.affiliation: Queensland Children's Medical Research Institute, Herston, Qld, Australia.
authors.forename: Kerry-Ann F
authors.initials: KA
authors.lastname: O'Grady
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Torzillo
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Rockett
authors.forename: David M
authors.initials: DM
authors.lastname: Whiley
authors.forename: Michael D
authors.initials: MD
authors.lastname: Nissen
authors.forename: Theo P
authors.initials: TP
authors.lastname: Sloots
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Lambert
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015925:Cryopreservation; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008507:Medically Underserved Area; D009296:Nasal Cavity / Q000821:virology; D016133:Polymerase Chain Reaction / Q000379:methods; D011159:Population Surveillance; D011177:Postal Service; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000208:ethnology / Q000821:virology*; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*; D014186:Transportation / Q000379:methods*; D014777:Virus Diseases / Q000175:diagnosis / Q000208:ethnology / Q000821:virology*; D014780:Viruses / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D055815:Young Adult