Coronavirus: Canadian Authorized Mouthwash Test for Children

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A new detection method for Covid-19 has been introduced in British Columbia for school-age children. This more enjoyable alternative to a nasal swab is a simple mouth rinse and saliva analysis in the lab - a world first.

To get tested for suspected Covid-19, there are two main types of tests: the virological test (RT-PCR) and the serological test. The first allows to determine if a person is a carrier of the virus at the time of the test thanks to a nasal sample and the second allows to know if a person has developed an immune reaction after coming into contact with the virus through the presence of antibody to through a blood test.

Recently, the High Health Authority issued a favorable opinion on the use and reimbursement of saliva tests for the diagnosis of symptomatic patients for whom nasopharyngeal swabbing is difficult or even impossible.

Gargle with saline for 30 seconds.

In fact, saliva could be an alternative because this type of test makes sampling easier and is less unpleasant for patients. In Canada, as the population also struggles with excessively long wait times for tests, policymakers in the province of British Columbia have agreed to a new type of test that is one of a kind; for school children. Called the "gargle and spit test" according to the BC Center for Disease Control (BCCDC), it consists of rinsing the mouth and gargling with saline solution for 30 seconds, to sweep the tissues that may contain viral particles then spitting into a tube.

Reduce the demand for nasal exams

This new test for students ages 4 to 19 is, according to the BCCDC, as accurate and reliable as nasal swab tests and can be performed without the intervention of a healthcare professional, although it must be performed in a screening center. "The children are back in school and with the fall season looming, we expect more of them to be screened in the coming months," says Dr. David Goldfarb of BC Childrens Hospital. "We wanted to find a solution to make sample collection quick and easy, so that parents and students would feel comfortable attending an exam."

This was developed by the BCCDC Public Health Laboratory in collaboration with a team from BC Childrens Hospital. And to help kids prepare, the organization has posted a video on its site to provide instructions. "We initially envisioned this as an option to help relieve pressure on our supply chain for nasopharyngeal specimen collection," says Dr. Linda Hoang, one of the medical authorities behind this initiative. The researchers first conducted a clinical study at BC Childrens Hospital to ensure the performance and acceptability of this test in children.

Adults will have to wait

"In piloting the program, medical and laboratory personnel heard that people preferred this method and that children found it fun," adds Dr. David Goldfarb. Once this new test was tested, it was implemented in all collection centers in the province in just a few weeks. Children who cannot follow directions or who are too young still have the option of being tested with a nasopharyngeal swab. With the "mouthwash" method, however, children should avoid drinking, eating, chewing gum, or even brushing their teeth in the hours leading up to the sample.

While many adults would prefer this option as well, it is currently only available to school-age children, although the province is considering expanding the program in the future.

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