Spotlight influenza: Influenza surveillance before and after the introduction of point-of-care testing in Denmark, season 2014/15 to 2018/19

Background: In Denmark, influenza surveillance is ensured by data capturing from existing population based registers. Since 2017, point-of-care (POC) testing has been implemented outside the regional clinical microbiology departments (CMD). Aim: We aimed to assess influenza laboratory results in view of the introduction of POC testing. Methods: We retrospectively observed routine surveillance data on national influenza tests before and after the introduction of POC testing as available in the Danish Microbiological Database. Also, we conducted a questionnaire study among Danish CMD about influenza diagnostics. Results: Between the seasons 2014/15 and 2018/19, 199,744 influenza tests were performed in Denmark of which 44,161 were positive (22%). After the introduction of POC testing, the overall percentage of positive influenza tests per season did not decrease. The seasonal influenza test incidence was higher in all observed age groups. The number of operating testing platforms placed outside a CMD and with an instrument analytical time <= 3 h increased after 2017. Regionally, the number of tests registered as POC in the Danish Microbiological Database and the number of tests performed with an instrument analytical time <= 3 h or outside a CMD partially differed. Where comparable (71% of tests), the relative proportion of POC tests out of all tests increased from season 2017/18 to 2018/19. In both seasons, the percentage of positive POC tests resulted slightly lower than for non-POC tests. Conclusion: POC testing integrated seamlessly into national influenza surveillance. We propose the use of POC results in the routine surveillance of seasonal influenza.

Automated summary

This study aimed to assess influenza laboratory results in view of the introduction of point-of-care testing in Denmark. The results showed that the percentage of positive influenza tests did not decrease after the introduction of POC testing, and the test incidence was higher in all age groups. The use of POC testing seamlessly integrated into national influenza surveillance, and it is proposed to use POC results in routine surveillance of seasonal influenza.