Covid in Italy, molecular salivary tests can be used “as part of screening activities in children involved in the Sars-CoV-2 circulation monitoring plan in the school setting, for the screening of case contacts in children even if the school is not part of the monitoring plan, in health and social health workers in the context of scheduled screening in the workplace or in fragile individuals (symptomatic or asymptomatic) with poor collaboration skills (for example elderly people in RSA, disabled people, people with autism spectrum disorders). This is what clarified by the circular signed by the Director General of Prevention of the Ministry of Health, Giovanni Rezza.
The ministry experts confirm instead that “rapid antigen tests on saliva, based on the available evidence, are not currently recommended as an alternative to oral-nasopharyngeal swabs, as they do not reach the minimum acceptable levels of sensitivity and specificity. Furthermore – they continue – antigenic tests on salivary matrix are currently excluded from the common European list of rapid antigenic tests valid for obtaining the green Covid-19 certification. Some scientific evidence is emerging regarding the possible use of salivary antigen tests based on measurement with laboratory instruments, which however are still being evaluated “for such applications.
The Ministry of Health – in the circular ‘Update of the indications on the use of salivary tests for the detection of Sars-CoV-2 infection, with particular reference to the monitoring of viral circulation in schools’ – reiterates however that “the molecular test on a nasopharyngeal and oropharyngeal respiratory sample, it still remains the international ‘gold standard’ for the diagnosis of Covid-19 in terms of sensitivity and specificity “.
The circular also specifies that in the event of a positive molecular salivary test “it will not be necessary to perform a confirmation test on a nasopharyngeal-oropharyngeal sample”, the experts recall.
On the use of the molecular salivary test in the context of school screening, the circular points out that “taking into account the ease of sample collection and the advantages deriving from the minimization of the intervention of health personnel, the collection of the salivary sample, in the context of school monitoring plan of the Saes-CoV-2 circulation, it can also be carried out with self-collection methods at home by the parents-guardians (if provided for self-collection by the manufacturer and in accordance with the legislation on medical devices and regional provisions), following a preventive training process to achieve the necessary confidence with the collection devices “.