University of Newcastle researchers from HMRI’s Infection Research program, Dr Camille Esneau, Professor Josh Davis and Professor Nathan Bartlett ran a surveillance study of 52 people in the Hunter region.  

The study, called PREVENT (Pandemic Respiratory Virus Epidemiological Virus Trial), asked members of the Flutracking trial whether they would be willing to swab themselves from June 2023 – June 2024 and post weekly swabs back to the lab for analysis. These people also needed to fill out a symptom survey indicating if they had any respiratory symptoms during that period. 

The good news is that the study was a resounding success. The participants diligently supplied their swabs and the labs were able to process them and retrieve good quality data even after the samples had been through the postal system. They were testing them for 11 known viruses as well as novel (unknown) viruses.  

Dr Esneau says, “We had good adherence, with 90 per cent of participants finishing the study,  and we received over 80 per cent return rate of the swabs. The swabs passed PCR quality control and we were even able to propagate the viruses in the lab. 

“We found 127 individual virus episodes (for a total of 247 detections, as some people shed viruses over multiple weeks).” 

These are the Top nine viral infections for June 2023 – June 2024 

1. The common cold – rhinovirus: 50% of episodes  

2. COVID-19 – SARS COV2: 21% episodes 

3. Seasonal coronavirus (not COVID-19): 7.1% of episodes  

4. Respiratory synctial virus – RSV: 6.3% of episodes 

5. Bocavirus: 4.7% of episodes 

6. Human parainfluenza virus – hPIV: 3.9% of episodes 

7. Enterovirus – EV: 3.1 % of episodes  

8. Human metapneumovirus – hMPV: 2.4% of episodes  

9. Influenza and adenovirus: less than 1 % of episodes 

Dr Esneau says, “Over 75% of viruses detected were symptomatic but this was not equal between the viruses we tested.”  

“For example, RSV and SARS COV 2 seemed highly associated with symptoms (over 80%), while rhinovirus and bocavirus had an increased likelihood to be asymptomatic (more than 30% of episodes were not associated with the participant reporting symptoms). 

How can virus surveillance be used in the future? 

The PREVENT study was designed to assess the feasibility of this approach in the hope that it could be scaled up nationally and globally to become an early warning system for the next pandemic. 

Dr Esneau says, “Viruses evolve really fast. For example, we count over 160 subtypes of rhinovirus and that number continues to grow. Depsite their tiny size and simple genome, they can create havoc.” 

The team is currently analysing selected samples where the participant reported symptoms, but no virus was detected from the swab.  

“It could indicate the presence of a virus that wasn’t part of the PCR panel. In terms of surveillance, if we keep finding a virus that isn’t commonly monitored, it would support the case for including this virus in surveillance efforts” says Dr Esneau. 

“We’re also looking at the symptoms associated with each virus.  We want to know whether some respiratory symptoms are more commonly associated with a specific virus? And did people miss out on work or normal duties and/or consult a healthcare professional? This would help give us an idea of how severe the symptoms were,” says Dr Esneau.  

The next steps are to implement PREVENT as a larger scale surveillance network to allow early detection of respiratory viral pathogens.  

“The team is currently looking at the best ways to implement this,” says Dr Esneau.