RSV ComNet II

Respiratory Syncytial Virus (RSV) is associated with a high rate of illness in children aged under 5 years. It is important to understand which children develop symptoms requiring further healthcare usage, including primary care, and to identify which groups are at risk of more severe RSV infection requiring hospitalisation or intensive care.

This study will involve a routine virology swab for All Year General Virology and Serology Surveillance from consented patients, under the age of 5 years, who have respiratory symptoms, and then extracting information from their medical records. The parents/guardians of children who test positive for RSV will be followed up by the practice for two short telephone surveys in the month following their child’s presentation in primary care.

Eligibility

Participating practices will provide virology swabs from patients whose parent/guardian have provided consent, and who are: 

• Aged under 5 years
• Consulting with symptoms of an acute respiratory infection (ARI), influenza-like illness (ILI), or fever

Approach and Informed Consent

Practices should approach parents/guardians of eligible patients about the RSV ComNet II study with reference to the RSV ComNet II Patient Information Sheet (Adults).

Practices will be advised on how to take verbal and written consent. 

Practices must keep a record of who has consented to be in the RSV ComNet II study so that recruitment figures can be provided to the study team when needed. A Data Linkage form will be provided to support practices.

Swabbing

In line with virology swabbing for All Year General Virology and Serology Surveillance, this can be done by either of the two pathways outlined below:

1. An in-practice virology kit can be administered by a healthcare professional at the practice, OR
2. A self-swabbing kit delivered directly to the patient to self-swab at home using TakeATestUK

Virology samples are sent to the Virus Reference Unit lab in London, tested for respiratory viruses, and then stored.

Coding

We encourage practices to code into the patient's computerised medical record (CMR) wherever possible, including during a consultation, when a swab has been taken, and when results have been received.

For the RSV ComNet II study, please be sure to code:

• 'Swab from nasopharynx taken for virology’ (SNOMED CT ID: 439578005), and
• For those who have given informed consent, please also code the RSV ComNet II CPMS ID into the patient's CMR. The RSV ComNetII CPMS ID is: 47281.

Results

Practice must inform parents/guardians of the patient's RSV result. Patients who have used the self-swabbing TakeATestUK kit will only receive an automatic notification of COVID-19 and flu test result.

Follow up telephone surveys

At Day 14 and Day 30 after the swab has been taken, practices will be expected to conduct two short follow up telephone surveys with the parent/guardians of child patient who test positive for RSV.

The electronic surveys include questions on the patient's medical history, healthcare usage, the impact of RSV on their quality of life, and the socio-economic impact of RSV on parents/guardians.

Targets

Across the network, we are aiming for 500 swabbed patients under the age of 5 years, regardless of whether the patient's RSV result is positive or negative.

Expressions of Interest

If you are interested in joining the study, please Elizabeth Button at elizabeth.button@phc.ox.ac.uk. You must be an Oxford-RCGP RSC network practice, and preferably already doing Virology Surveillance.

Practices who have expressed an interest will be sent the Local Information Pack (LIP), which contains the study documents required to implement this study. Practices will need return to the research team:

1. A completed Organisation Information Document (OID), and
2. Signed GP Site Agreement with the University of Oxford

Questionnaire 1

These are routine questions that should already be covered during the patient's initial consultation.  However, it is important that the GP codes this correctly into the patient's computerised medical record (CMR), and not only as free text.

Payments

In line with All Year General Virology and Serology Surveillance, practices will be paid £7.50 for each virology swab that is collected for Surveillance.

Additional payments will be made for approaching parents/guardians about the RSV ComNet II study, site set-up, and for conducting two follow up telephone surveys. For more information, please see the RISP.

Swabbing <5 year olds

For guidance on swabbing young children, please visit: How to test a child . For example, if you cannot swab their tonsils, you can swab both of their nostrils instead.

Material Requests

Virology swab kits for in-practice use can be ordered using the Material Requests portal. Please contact Elizabeth Button at elizabeth.button@phc.ox.ac.uk if you would like to register for TakeATestUK for patient self-swabbing at home.