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APHA Scientific Session and Event Listing

Sara A. Lowther, MPH¹, William J. Moss, MD, MPH¹, and Michaela Riddell, PhD². (1) Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Room 7133, Baltimore, MD 21205, 404-414-1542, slowther@jhsph.edu, (2) Victorian Infectious Diseases Reference Laboratory, 10 Wreckyn St, Melbourne, 3051, Australia

Background: Although serum is the gold standard for detecting infection or immune response, phlebotomy is not feasible in some situations and subjects often decline participation. A non-invasive sample such as oral fluid (OF) may be more favorable to participants. Methods: We reviewed published literature from the 1988-2005 to examine OF usage in epidemiology and surveillance for agents other than HIV(subject to previous review). Results: Ninety-four publications described OF usage for agents other than HIV. OF has been used increasingly in surveillance, program evaluation, and surveys, studies, and outbreak investigations (2.1 publications/year in 1988-1997 versus 8.5 /year in 1998-2006). Although used worldwide in both developing and developed country settings, most studies have been in the Europe (41). Common agents detected with OF are antibodies to vaccine-preventable diseases (Measles, Mumps, Rubella ) or other viral infections (Hepatitis A, B, C), with more recent studies successfully using PCR to detect genetic material in OF. Most publications have been either comparisons to serum samples (48) or surveys (25), with many studies using OF among more vulnerable populations (e.g., children, prison populations, injecting drug users). Several devices for OF collection are available, each with strengths and weaknesses. Novel agents have also been detected (SARS-CoV). Conclusions: OF may be particularly beneficial for specific populations for whom drawing blood may influence response and participation and settings where phlebotomy is not feasible or inconvenient such as children or the elderly. Given these previous applications, more widespread use OF may be considered in the US.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• List the purposes in public health infectious disease epidemiology and surveillance in which oral fluid (salivary) has been used as an alternative to serum.
• Articulate the strengths and weaknesses of using oral fluid as a sample for infectious disease epidemiology and surveillance
• Evaluate and identify areas in the participants practice or research for which they may consider the use of oral samples.

Keywords: Infectious Diseases, Public Health Research

Presenting author's disclosure statement:

Not Answered