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Background Households represent important settings for transmission of influenza and other respiratory viruses. Current influenza diagnosis and treatment relies upon patient visits to healthcare facilities, which may lead to under‐diagnosis and treatment delays. This study aimed to assess the feasibility of an at‐home approach to influenza diagnosis and treatment via home testing, telehealth care, and rapid antiviral home delivery. Methods We conducted a pilot interventional study of remote influenza diagnosis and treatment in Seattle‐area households with children during the 2019‐2020 influenza season using pre‐positioned nasal swabs and home influenza tests. Home monitoring for respiratory symptoms occurred weekly; if symptoms were reported within 48 hours of onset, participants collected mid‐nasal swabs and used a rapid home‐based influenza immunoassay. An additional home‐collected swab was returned to a laboratory for confirmatory influenza RT‐PCR testing. Baloxavir antiviral treatment was prescribed and delivered to symptomatic and age‐eligible participants, following a telehealth encounter. Results 124 households comprising 481 individuals self‐monitored for respiratory symptoms, with 58 home tests administered. 12 home tests were positive for influenza, of which eight were true positives confirmed by RT‐PCR. The sensitivity and specificity of the home influenza test were 72.7% and 96.2%, respectively. There were eight home deliveries of baloxavir, with 7 (87.5%) occurring within 3 hours of prescription and all within 48 hours of symptom onset. Conclusions We demonstrate the feasibility of self‐testing combined with rapid home delivery of influenza antiviral treatment. This approach may be an important control strategy for influenza epidemics and pandemics.

An experiment was conducted to test the hypothesis that Cu hydroxychloride (IntelliBond CII, Micronutrients, LLC, Indianapolis, IN) improves growth performance by upregulating the mRNA transcription of genes involved in lipid metabolism of pigs. Thirty-two pigs (15.05 ± 0.98 kg) were allotted to 2 dietary treatments with 2 pigs per pen for a total of 8 replicate pens per treatment. Pigs were fed a control diet based on corn, soybean meal, and distillers dried grains with solubles that included Cu to meet the requirement. A second diet was formulated by adding 150 mg Cu/kg from Cu hydroxychloride to the control diet. On the last day of the experiment, one pig per pen was sacrificed and samples from liver, skeletal muscle, and subcutaneous adipose tissue were collected to analyze relative mRNA abundance of genes involved in lipid metabolism. Data were analyzed using SAS with pen as the experimental unit. Diet was the fixed effect and replicate was the random effect. Results indicated that overall average daily gain and gain:feed were greater (P < 0.05) for pigs fed the diet containing Cu hydroxychloride compared with pigs fed the control diet (Table 1). Pigs fed the diet supplemented with Cu hydroxychloride had increased (P < 0.05) abundance of cluster of differentiation 36 in liver and increased (P < 0.05) abundance of fatty acid binding protein 4 and lipoprotein lipase in subcutaneous adipose tissue. Inclusion of Cu hydroxychloride also tended to increase (P < 0.10) abundance of fatty acid binding protein 1, peroxisome proliferator-activated receptor alpha, and carnitine palmitoyl transferase 1 B in liver, skeletal muscle, and subcutaneous adipose tissue, respectively. In conclusion, supplementation of Cu hydroxychloride to the control diet improved growth performance and may affect signaling pathways associated with lipid metabolism by upregulating abundance of some genes involved in post-absorptive metabolism of lipids.