In Reply.—

We thank Pilger and Cantarelli for their comments on our article. We agree that, as with all observational studies, ours had potential bias issues that may limit interpretability. The job for readers is to assess to what extent such biases invalidate the reported results.

The reference used to highlight potential issues with different specimen types was a study conducted on a variety of specimens from a relatively narrow population: children hospitalized with severe acute lower respiratory tract disease. In our opinion, there is a lack of data in the published literature on the broad range of community-managed acute respiratory illnesses (ARIs). For this reason, one of the aims of our study was to assess the utility of the relatively noninvasive, parent-collected nose-throat swabs. Bronchoalveolar lavage and tracheal secretions are too invasive and not suitable for a study that examines mostly upper respiratory tract disease. We feel...

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