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New Coronary Pneumonia | Deep Throat Saliva, Nasopharyngeal, and Throat Swabs to see the similarities and differences of the three major detection methods

2020-08-13T10:37:23.968Z


With the outbreak of the epidemic in Hong Kong, the Hong Kong government announced earlier that it would launch voluntary testing for all people. The services will be undertaken by three mainland testing institutions including BGI, Golden Mile Testing and Kaipu Medical. The authorities have not finalized the relevant sampling methods. In addition to the deep throat saliva test that is more familiar to Hong Kong people, nasopharyngeal swabs and throat swabs are also considered. The comprehensive data and expert opinions of "Hong Kong 01" show that professional medical care assists in collecting pharynx The test criterion of swabs is higher than that of deep throat saliva. However, if the citizens "suck the throat" or "sniff" by themselves, there may be deviations, reducing the sensitivity of the sample, and may not be suitable for children or the elderly.


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Written by: Chen Shuxia

2020-08-13 18:25

Last update date: 2020-08-13 18:25

With the outbreak of the epidemic in Hong Kong, the Hong Kong government announced earlier that it would launch voluntary testing for all people. The services will be undertaken by three mainland testing institutions including BGI, Golden Mile Testing and Kaipu Medical.

The authorities have not finalized the relevant sampling methods. In addition to the deep throat saliva test that is more familiar to Hong Kong people, nasopharyngeal swabs and throat swabs are also considered. The comprehensive data and expert opinions of "Hong Kong 01" show that professional medical care assists in collecting pharynx The test criterion of swabs is higher than that of deep throat saliva. However, if the citizens "suck the throat" or "sniff" by themselves, there may be deviations, reducing the sensitivity of the sample, and may not be suitable for children or the elderly.

The Hong Kong government will implement voluntary testing for all citizens, but the distribution and testing methods have not yet been finalized. The picture shows the situation of the throat swab sampling kit distributed by Ci Ai Yuan a few days ago. (Photo by Liang Pengwei/Picture of Profile)

Collection method and required testing and laboratory time

Deep Throat Saliva:

Samples can be collected by citizens themselves. It takes 1 to several minutes, but they must be collected after waking up, brushing teeth, gargle, and before eating. It takes 1 to 7 working days for the test results to be released, depending on the amount and ability of medical institutions.

Nasopharyngeal swabs:
medical personnel wearing full protective equipment assisted in sampling. The test report is available as soon as possible, depending on the time of sample submission.

Throat swabs:
mainly medical staff wearing full protective equipment to assist in sampling. According to the People’s Daily report, Lu Dan, the head nurse of the Department of Respiratory and Critical Care Medicine of Wuhan First Hospital, who is responsible for sampling in Wuhan, mentioned that sampling takes an average of 3 minutes, but those with poor tolerance will need to rinse repeatedly in the middle. Mouth or rest, the longest time it took more than 10 minutes to sample. One of them was commissioned by the government to carry out universal community testing. Huang Libao, director of the Hong Kong Molecular Pathology Testing Center opened in Hong Kong, once pointed out that if swab sampling is used and mixed samples are used for testing, the daily test volume can reach 50 Ten thousand samples.

Acquisition steps

Deep Throat Saliva:

According to the demonstration footage of the HA, the tester must collect samples after getting up, brushing their teeth and gargle and before eating. First, clean your hands and check the personal information of the sample bottle, then open the bottle cap and make a "Kruuua" sound in your throat to clear out the saliva from the throat, and spit about 4ml of saliva into the sample bottle. Saliva gets on the outside of the sample bottle. Then you can close and tighten the cap of the sample bottle, wipe the surface of the sample bottle with a paper towel, put it in the sample bag, and clean your hands.

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The method of testing for deep throat saliva is more familiar to Hong Kong people, that is, the commonly heard test of "Bottle Boy". (Photo by Ou Jiale/Data Picture)

Nasopharyngeal swabs:

generally need to be performed outdoors or in a large open room. Medical staff must wear protective equipment and use a long cotton swab to wipe the samples deep in the nasal cavity, and put them back into the sample bottle immediately after sampling. According to the introduction of the Victoria Hospital, the medical staff will collect the patient’s nasopharyngeal swab samples in a separate room, and gently insert a sterile cotton swab from the nostril level into the back of the nose, and then gently rotate it to collect the secretions. If necessary, it may be repeated in the other nostril. You may feel pressure or discomfort during the process, but you should not feel pain.

Throat swabs:

generally need to be performed outdoors or in a large open room. Medical staff must wear protective equipment. According to the self-sampling instructional video of BGI, the tester must first clean his hands, then face the mirror, tilt his head slightly, open his mouth, and make an "ah" sound; then put the tip of a throat swab similar to a cotton swab. Extend to the "postpharyngeal wall" position and wipe up and down 5 times. The tester must then put the throat swab head into the sampling tube, break off the long handle of the throat swab tail, and finally tighten the lid of the sampling tube, and seal it with two disposable sealed bags.

Accuracy

Deep Throat Saliva: According

to a study by the Faculty of Medicine of CUHK, 31% of deep throat saliva test results are false-negative, or “leak” infected patients. Studies by Queen Elizabeth Hospital and Prince of Wales Hospital show that the test results of deep throat saliva and nasopharynx samples are 70% similar, and deep throat saliva is a satisfactory testing method. The Hong Kong Adventist Hospital stated that the sensitivity and accuracy of collecting deep throat saliva samples for nucleic acid testing exceeded 90%.

Nasopharyngeal swabs: According

to research conducted by the School of Medicine of CUHK, 80% of nasopharyngeal swabs test positive, that is, 20% are false negatives, which are more accurate than deep throat saliva tests. The Hong Kong Adventist Hospital stated that the sensitivity and accuracy of direct collection of nasopharyngeal secretions for nucleic acid testing are close to 100%.

However, Xu Shuchang, a government expert consultant and chair professor of the Department of Respiratory System at CUHK, said in an interview that the process of throat swab sampling would be uncomfortable because the cotton swab had to be inserted into the nasal septum and the swab had to be rotated several times. You may sneeze or even feel nauseated during the test. Medical staff is recommended to assist, otherwise the sample quality may be poor, which will affect the test results.


Throat swabs: According

to research conducted by the School of Medicine of CUHK, the positive rate of throat swabs is also 80%, which is more accurate than deep throat saliva tests.

However, if the samples are taken by the citizens themselves or there are deviations, Liang Zichao, a specialist in respiratory medicine, said that the accuracy of self-collecting throat swab samples is questionable because of the high degree of uncertainty. The positive rate of the collection can be the same as that of the medical care sampling. "It is difficult to control the throat and a few wide straps, and some people will have neurological reflexes. If you are sick, you can’t take samples." He also said, children or the elderly sampling It is even more difficult. He worried that the sampling process would irritate the elderly’s trachea and cause coughing.

The Hong Kong government has earlier expanded the scope of free testing. Different from previous practices, throat swab sampling kits have been distributed to Tsz Wan Shan and other areas affected by the disease. Some citizens have reported that the process of self-collecting samples is difficult. ".

The Hong Kong government expanded the scope of free testing earlier. Residents of Ciyunshan Epidemic Building were distributed with throat swab sampling kits, which are different from the deep throat saliva sample bottles in the past. (Photo by Liang Pengwei/Picture of Profile)

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Detection risk

Deep Throat Saliva: In

terms of personal risk, the Public Medical Doctors Association believes that the collection of deep throat saliva samples is not traumatic, the techniques are easier to master, and the sampling process will not cause atomization. Also, because they can be collected by themselves, the risk of infection for medical staff is low. Relatively speaking, laboratory personnel are more risky. The chairman of the Hong Kong Medical Laboratory Association, Li Weizhen, once interviewed that deep throat saliva is thicker, and enzymes must be used to dissolve the samples during the test. Each sample takes about 5 minutes. It has not completely melted and needs to be re-tested, and it is easier for the public to contaminate the sample bottle when collecting deep throat saliva by themselves.

Nasopharyngeal swabs: In

terms of the risks of self-collection, Professor Yuan Guoyong of the Department of Microbiology at the University of Hong Kong once said that nasopharyngeal swabs should be placed close to the ear. Incorrect sampling can cause nosebleeds. If the sample is taken by a dedicated person, you must wear full protective equipment and adopt anti-infection facilities. Because the sampled person may cough or sneeze, there is a risk of transmission. There was a nurse in the North District Hospital who did not wear a nasopharyngeal swab for the patient. After the patient was diagnosed with a face mask, the nurse was required to undergo medical supervision on the 28th.

Throat swabs:

If citizens need to collect them by themselves, Yuan Guoyong, the Chair Professor of the Department of Microbiology at the University of Hong Kong, once said that the throat swabs must be taken close to the tonsils, otherwise it will be very inaccurate. , I don’t want to help, I don’t want to vomit until I vomit.” The Hong Kong Association of Public Medical Doctors recently issued a statement stating that self-sampling has certain risks, including uncomfortable reactions such as coughing or sneezing. Droplets produced during the period can transmit diseases. People with inexperienced people may also break the throat swab during the collection period. Swallow a foreign body accidentally.

According to the records, when a 9-month-old baby girl was tested with a throat swab in Macau, she was suspected of swallowing a broken sampling rod of about 3 cm and needed to be sent to hospital. The Macau authorities subsequently stipulated that people under the age of 18 should use nasopharyngeal swabs for sampling, and adult citizens can choose either nasopharyngeal swabs or throat swabs.

▼In the third wave, the government has extended the restrictions on gatherings and banned food in the evening market.▼

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Coronavirus disease

Source: hk1

All news articles on 2020-08-13

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