There is theory… and practice. Things quickly got complicated when Matthieu received an email from the daycare in early January telling him a positive case had been detected in his son’s group. “The crèche will ask me if I have a negative antigen or PCR test result if I want to entrust my baby to them tomorrow,” he explains wearily. Only here the waiting times for a PCR are longer due to the strong demand since the advent of the Omicron variant. “No chance of having the result before the next morning,” the young father sighs. So Matthieu turns to pharmacies in Paris. “I’ve called a dozen in my neighborhood, all reject children under the age of two,” he complains.
Result of the races, Matthieu finally steeled himself with patience and allowed his barely 3-month-old baby to pass a nasopharyngeal PCR test in a laboratory. “It was arduous … and above all painful for him”. After that bad experience, a co-worker whispered in her ear the name of another pharmacy that would do “oral and painless” antigen testing. Surprising, since according to the Directorate-General for Health (DGS) contacted by Capital, alternative screening solutions to nasopharynx sampling involves saliva -RT-PCR testing, oropharyngeal PCR testing, or even nasal antigen testing with a swab orally.
In addition, the DGS points out that for children under the age of 3 years “it is strongly recommended to have the sample taken by a pediatrician”. It is still urgently necessary to find an available one to obtain proof of a negative result, which can be presented the next day at the reception of the crèche. Still, according to the DGS, “the saliva sample [est] preferred”. However, the parents were denied their child by Laboratories. Like this mother, who in a post Office posted on Twitter, says an analysis lab refused to test her baby via saliva sample on the pretext that babies can’t spit up.
The Baby Nasal Aspirator: Info or Tox?
So what is the procedure? Since the baby screening guidelines are not clear, parents have tried as best they can to find a solution to test their child as painlessly as possible. At that time, the technology of the baby bow tie or the used handkerchief began to circulate on social networks. A sample is taken with a swab from a self-test box in the baby bow tie or the children’s handkerchief. A method that is neither recognized nor reliable according to the DGS and is based on the recommendations of the High Authority for Health (HAS).
The virologist Stéphanie Haim-Boukobza has a more differentiated point of view: “They know this technique very well in the children’s wards, it’s called nasopharyngeal aspiration. Physiological serum is introduced into the baby’s nostrils and sucked in again with a pipette. But when you do it in the hospital, you completely master the gesture,” she explains. Performing this act by the parents themselves could be poorly performed, with the risk of missing “true positives” if the parents decide to test their baby themselves.
Is the saliva test really the best option?
Instead, the virologist recommends the saliva test, the effectiveness of which has been reassessed: “With Omicron, they would be more efficient, we find more viruses in the saliva,” she assures us. It remains to find a laboratory willing to do this test on a baby. “But babies can’t spit up,” recalls Lionel Barrand, president of the National Union of Medical Biologists. “You then have to put a swab of saliva in your mouth,” he continues. That’s good, according to Stéphanie Haim-Boukobza, spitting is not absolutely necessary. “You just have to drool into a bottle. Also, a saliva sample is not based on sputum, if so then it is of poor quality,” she believes.
For its part, the High Authority for Health does not rule out either method: in a press release published in February 2021, it indicated that “saliva collection can be assisted or self-collection in the medical biology laboratory, at home or at a screening site. If spitting is difficult for the patient (e.g. very young children), the saliva can be collected with a pipette under the tongue.”
However, the saliva sample is not uniform. For pediatrician Fabienne Cahn Sellem, “saliva tests on babies are almost impossible because they have too many enzymes in their mouth and the results are not always very reliable”. Instead, she recommends nasal antigen sampling or nasopharyngeal PCR, although “it hurts a little to avoid false negatives.” “It is true that making a baby salivate is difficult, it must be a conscious act,” acknowledges virologist Stéphanie Haim-Boukobza. The latter also believes that a nasal or nasopharyngeal swab might be sufficient in babies, “this technique remains simpler and more reliable in babies”.
Is the nasal swab in pharmacies really impossible?
Finally, why do some daycare centers give parents the choice of having a PCR or antigen test when the pharmacies end up refusing to take samples for which the results will be available quickly? “Pharmacists and laboratories have every right to perform nasopharyngeal antigen testing on babies,” said Lionel Barrand, President of the Association of Medical Biologists.
However, the head of the Federation of Pharmaceutical Unions of France (FSPF), Philippe Besset, tells Capital that these tests “are not suitable for babies and that it is better to give them a saliva test”. Unlike the Union of Community Pharmacists (Uspo), whose president Pierre-Olivier Variot assures that there is “a suitable nose test that is at least a month old and is similar to the self-tests used for primary school children”. In fact, a decree published in the Official Gazette of January 5 authorizes pharmacists, but also nurses, masseurs-physiotherapists and midwives, to perform nose tests on children under 12 years old, and not “nasopharynx”, including babies. So, on paper, a pharmacist can perform a nose test on babies of any age.
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