Molecular salivary tests are valid for the purposes of greenpass and their use is also 'accepted' for monitoring the circulation of the SarsCoV2 virus in schools and other limited contexts.
However, not recommended – due to their insufficient level of precision – are the rapid saliva antigen tests, not valid for the green card. The new circular from the Ministry of Health 'Updating the indications on the use of salivary tests for the detection of SARS-CoV2 infection' clarifies the salivary tests, which specifies that, in any case, the molecular test on a nasopharyngeal and oropharyngeal respiratory sample “it remains, to this day, the international gold standard for the diagnosis of COVID-19 in terms of sensitivity and specificity”.
Recent scientific evidence on molecular saliva tests, explains the ministry, has identified sensitivity values between 77% and 93%. Furthermore, some studies conducted in schools have reported a high concordance between the results obtained with saliva molecular tests and with molecular tests on nasopharyngeal and oropharyngeal samples.
However, the use of molecular saliva tests requires a higher number of steps that involve longer times for sample processing. Therefore, the ministry states, in order to avoid overloading regional microbiology laboratories, and to ensure adequate resources to guarantee the sustainability of this public health activity, molecular tests on saliva samples, at least in the first phase, may be considered an alternative option to oro/nasopharyngeal swabs exclusively in these contexts: in frail individuals (symptomatic or asymptomatic) with poor collaboration capacity (for example elderly people in RSA, disabled people, people with autism spectrum disorders); as part of screening activities in children involved in SARS-CoV-2 Circulation Monitoring Plan in the school environment.
For screening of case contacts in children even if the school is not part of the Monitoring Plan; in healthcare and social healthcare workers in the context of scheduled screening in the workplace. In the event of a positive molecular saliva test, the circular specifies, it will not be necessary to perform a confirmatory test on a nasopharyngeal/oropharyngeal sample.
Furthermore, the collection of the saliva sample, as part of the school monitoring plan, can also be carried out by self-collection at home by parents, following a preventive training process. In any case, the Undersecretary of Health reminds Pierpaolo Sileri, the tests are from “use wisely, because they are not all the same, and the gold standard remains the swab”.
Article published on 25 September 2021 - 07:47
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