2064.0 Supporting equitable public health solutions with saliva-based testing - an innovative, low-cost, and scalable testing methodology

Session: Epidemiology Methods

Program: Epidemiology

Time: 3 - 3:15 PM

Presenters:

Anne Wyllie, PhD

Abstract

Background: The “gold standard” sample for SARS-CoV-2 detection defaulted to nasopharyngeal swabs due to their use for other respiratory pathogens. However, supply chains buckled, healthcare workers were put at risk when obtaining samples, and discomfort from invasive swabbing created testing aversion. Saliva quickly emerged as a viable sample to overcome these challenges.

Objective(s): Saliva-based diagnostic tests enable a proactive response to potential disease outbreaks, saving valuable resources while increasing accessibility and equity. Saliva collection can also transform patient care in remote or low-resource settings as a flexible tool for diagnostic testing, surveillance programs, sequencing, and/or monitoring vaccine impact.

Methods: We designed ‘SalivaDirect’ to simplify testing through: 1) demonstrating the sensitivity of saliva for SARS-CoV-2 detection; 2) developing clear instructions for reliable self-collection; 3) negating the need for healthcare worker-assisted collection; 4) eliminating collection tubes with propriety buffers and/or preservatives; 5) replacing nucleic acid extraction with a simple heat and/or enzymatic step; 6) validating reagents and instruments from multiple suppliers; and 7) establishing a novel, open-source emergency use authorization (EUA) regulatory framework. SalivaDirect has since been validated for the detection of influenza, RSV, and mpox, with more targets on the horizon.

Results: Advances in testing during the pandemic created new possibilities for respiratory pathogen detection. Approaches like SalivaDirect demonstrate that saliva can be used as a sensitive, reliable option for not only SARS-CoV-2 detection, but other infectious diseases.

Conclusion: Saliva supports effective and sustainable testing approaches which merits further exploration as we look to overcome current and evolving public health challenges.