How can I use pooling for population surveillance?

Pooling and testing individual saliva specimens is a cost-effective way to increase throughput and decrease the cost per test. Multiple individual saliva specimens can be combined into a pooled specimen and run as a single test to provide results on a group level. Up to 5 individual saliva specimens can be pooled together for a single test. Any pool larger than 5 saliva specimens should be run with replicate tests to increase analytical sensitivity. 

The method for pooling will depend on the level at which health management action will be taken. Strategic pooling could include grouping together individuals who work in the same vicinity or come in frequent contact with one another. Here are some examples of pooling strategies:

  1. At an office, saliva specimens could be pooled by department: a pool of 3 samples from Human Resources, a pool of 5 samples from Sales, a pool of 4 samples from Manufacturing, and a pool of 2 samples from R&D.
  2. At a school, a class of 14 students and one teacher could be divided into 3 pools of 5 saliva specimens.  
  3. In an athletic department, saliva specimens could be pooled by sport. There might be 8 pools of 5 for football, 3 pools of 5 for basketball, 2 pools of 5 for volleyball, and 2 pools of 5 for field hockey. 

If any pooled samples return positive, you can optionally rerun the individual saliva specimens as individual samples to determine whose saliva is causing the presumptive positive, then refer that person for diagnostic testing.