# P-531. Overlap of Respiratory Virus Detection from Concomitant Air and Human Specimens in Elementary School Classrooms in Kansas City, Missouri

## TL;DR

This study explores whether air sampling in schools can detect respiratory viruses similarly to human nasal swabs, aiming to simplify virus surveillance.

## Contribution

The study introduces concurrent air and human specimen sampling in schools to assess the feasibility of using air samples as a proxy for human testing.

## Key findings

- Respiratory viruses were detected in 89% of air samples collected in elementary school classrooms.
- RV/EV and SARS-CoV-2 were most frequently detected in air samples, while RV/EV and sCoV OC43 were most common in human specimens.
- 40% of air samples had at least one matching virus detected in concurrent human specimens.

## Abstract

Little data are available describing the circulation of respiratory viruses in pre-kindergarten (preK)-12th grade schools. Performing viral surveillance testing in students and staff can be resource intensive and requires large scale participation. Air sampling for respiratory viruses in schools could be a proxy to human sampling. Our objective was to describe the overlap of respiratory viral detection in human and air specimens collected concurrently.Respiratory viruses detected from air samples and nasal swab specimens in elementary schools in Kansas City, MO from September 2024- March 2025.Figure 2.Concordance of respiratory virus detections from matched air and human specimens in elementary schools in Kansas City, MO from September 2024-March 2025.

Respiratory viruses detected from air samples and nasal swab specimens in elementary schools in Kansas City, MO from September 2024- March 2025.

Concordance of respiratory virus detections from matched air and human specimens in elementary schools in Kansas City, MO from September 2024-March 2025.

School KIDS is a prospective respiratory virus surveillance program for students and staff in a preK-12th grade public school district in Kansas City, MO. In 15 classrooms across 5 elementary schools (3 classrooms/school), human (anterior nares) specimens were collected monthly; air samples were collected on the same day every 2-4 weeks using AerosolSense samplers (ThermoFisher Scientific) operating at 200 L/minute for 8 school hours. All specimens were tested by PCR for adenovirus, human metapneumovirus, influenza, parainfluenza viruses 1-4, respiratory syncytial virus, rhinovirus/ enterovirus (RV/EV), seasonal coronaviruses (sCoV) OC43, NL63, HKU1, 229E, and SARS-CoV-2. Concordance—defined as detection of the same virus in both air and human samples from the same room and day—was assessed.

From September 18, 2024-March 31, 2025, 160 air samples were collected concurrently with 561 human specimens, with a median of 3 [IQR 3,5] human specimens per air sample. Viruses were detected in 142/160 (89%) air samples, with a total of 348 viral detections. Of 160 air samples, 64 (40%) had the concurrent detection in at least one match human specimen. Of 561 human samples, 104 (18%) had the same virus as in matched air samples. Of the 561 human specimens, 144 (25%) had ≥1 virus detected with a total of 152 viral detections. RV/EV (128/160) and SARS-CoV-2 (61/160) were the most frequently detected viruses in air, while RV/EV (83/561) and sCoV OC43 (20/561) were the most frequently detected in human specimens (Fig 1). RV/EV (n=51) and sCoV OC43 (n=7) were the viruses most frequently identified from matched human and air samples (Fig 2).

Air sampling in schools may be useful to detect circulating viruses in schools. Further studies are needed to determine whether air sampling can be a proxy for human sampling.

Brian R. Lee, PhD, MPH, Merck: Grant/Research Support Rangaraj Selvarangan, PhD, Altona: Grant/Research Support|Biomerieux: Advisor/Consultant|Biomerieux: Grant/Research Support|Biomerieux: Honoraria|Cepheid: Grant/Research Support|Hologic: Grant/Research Support|Hologic: Honoraria|Meridian: Grant/Research Support|Qiagen: Grant/Research Support