Rapid on-site molecular Point of Care Testing during influenza outbreaks in aged care facilities improves antiviral use and reduces hospitalisation

Aust N Z J Public Health. 2022 Dec;46(6):884-888. doi: 10.1111/1753-6405.13307. Epub 2022 Oct 3.


Objective: Western Sydney Local Health District (WSLHD) measured the utility and validity of rapid molecular point-of-care testing (POCT) in aged care facilities (ACFs) experiencing influenza-like illness (ILI) outbreaks against routine laboratory testing.

Methods: A descriptive epidemiological study into 82 respiratory outbreaks reported across 63 ACFs within WSLHD supporting approximately 6,500 residents aged ≥65 years and staffed by ∼6,500 employees, from 1 August 2018 to 31 December 2019.

Results: WSLHD Public Health Unit performed on-site testing at 27 ACF outbreaks (34%), while 53(66%) ACFs conducted only routine laboratory testing. The Xpert®Xpress Flu/RSV molecular PCR provided a sensitivity and specificity of 100%. Those with on-site testing, antiviral prophylaxis was prescribed at 75% of facilities within 24 hours of testing, as opposed to 32% of those using laboratory testing (p<0.01). There were 24 of 181 ACF residents hospitalised in the POCT group compared to 76 of 357 in the laboratory-only group (OR=0.57; p=0.02).

Conclusions: On-site ACF testing is reliable and practical for early identification of influenza, enabling timely use of antiviral treatment and prophylaxis, and was associated with decreased hospitalisation.

Public health implications: Enhanced respiratory surveillance and on-site testing should be strongly considered as part of routine management of respiratory outbreaks in ACFs and may reduce outbreak severity.

Keywords: aged care; influenza; point of care testing; public health; respiratory viruses.

MeSH terms

  • Antiviral Agents / therapeutic use
  • Disease Outbreaks / prevention & control
  • Hospitalization
  • Humans
  • Influenza, Human* / diagnosis
  • Influenza, Human* / drug therapy
  • Influenza, Human* / epidemiology
  • Point-of-Care Testing


  • Antiviral Agents