CK21-003, Oregon Child Absenteeism due to Respiratory Disease Study - 3

摘要/摘要 背景：流感在儿童中很常见，也是旷课的主要原因。 SARS-CoV-2(SARS)已经成为一种重要的病原体，但儿童在后高峰时期的作用 需要定义大流行后的传播。这两种病毒都会导致相当大的发病率， 死亡率和经济成本。随着流感在学校环境中的有效传播， 旷工已被提议作为一种早期预警系统。因此，我们创建了和 测试了对现有电子学校信息系统(ESIS)的简单修改，以 自动报告特定原因的缺勤情况。我们发现两者之间存在显著的联系 在我们的六年中，特定原因的K-12学校旷课和医疗流感的流行率 研究，允许流感监测和早期预警，以加速社区活动。 我们还记录了大量的家庭内流感传播。类似的研究-- 使用我们建立和有效的方法-是新出现的冠状病毒所需要的， 非典。计划目标：果园-3的目标是将旷工制度扩大到 评估SARS监测的有效性，并描述家庭内部的水平 流感和SARS的传播来自学龄儿童的指示病例。方法：我们 将使用父母对症状的报告进入电话缺勤报告系统和 ESIS中用于日常缺勤评估的算法。我们将积极招聘≥300 俄勒冈学校因流感样疾病(ILI)或冠状病毒样疾病(CLI)缺课的儿童 威斯康星州戴恩县学区，每三年一次。家访将用来收集详细的 人口、家庭、流行病学和症状数据以及鼻腔和NP/OP样本 以供测试。鼻腔样本将使用SOFIA-2 FIA快速检测进行流感/SARS检测。 NP/OP标本将被运送到威斯康星州立卫生实验室进行 使用Luminex进行流感/SARS RRT-PCR检测和其他呼吸道病毒的存在 多重聚合酶链式反应。我们将每年招募240个有患病儿童的≥家庭进行传播 评估。所有家庭成员将在第0、7和14天自行采集鼻部样本，用于 流感/SARS RRT-PCR，并提供详细的疾病数据。因以下原因而旷工的时间模式 ILI和CLI将被比作周围社区的病毒学监测。 将计算流感和SARS在家中的传播率。重要意义： 在学校内传播和放大，然后从儿童传播到其他 家庭成员可能会扩大疫情。流感的特定原因旷工监测 而SARS可能会在社区中提供早期发现，从而允许使用对策。

SUMMARY/ABSTRACT Background: Influenza (Flu) is common in children and a leading cause of school absenteeism. SARS-CoV-2 (SARS) has emerged as a significant pathogen, but the role of children in post-peak and post-pandemic transmission needs to be defined. Both viruses cause substantial morbidity, mortality and economic costs. As Flu is efficiently spread within school settings, rates of absenteeism have been proposed as an early warning system. Accordingly, we created and tested a simple modification of an existing electronic school information system (ESIS) to automatically report cause-specific absenteeism. We found a significant association between cause-specific K-12 school absenteeism and prevalence of medically-attended Flu in our six-year study, allowing for Flu monitoring and early warning for acceleration in community activity. We have also documented substantial within-household Flu transmission. Similar studies— using our established and effective methods—are needed for the newly emerged coronavirus, SARS. Program Goal: The goals of ORCHARDS-3 are to expand the absenteeism system to evaluate the effectiveness for SARS monitoring and to describe the level of within-household transmission of Flu and SARS from index cases who are school-aged children. Methods: We will use parental reporting of symptoms into a telephonic absence reporting system and an algorithm within the ESIS for daily absenteeism assessment. We will actively recruit ≥300 children absent due to Flu-like illness (ILI) or COVID-like illness (CLI) from the Oregon School District, Dane County, WI, in each of three years. Home visits will be used to collect detailed demographic, household, epidemiologic and symptom data, and nasal and NP/OP specimens for testing. Nasal specimens will be tested for Flu/SARS using SOFIA-2 FIA rapid testing. NP/OP specimens will be transported to the Wisconsin State Laboratory of Hygiene for Flu/SARS rRT-PCR testing and for the presence of other respiratory viruses using a Luminex Multiplex PCR platform. We will recruit ≥240 households/yr with ill children for transmission assessment. All household members will self-collect nasal specimens on day 0, 7 and 14 for Flu/SARS rRT-PCR and provide detailed illness data. Temporal patterns of absenteeism due to ILI and CLI will be compared to virological surveillance within the surrounding community. Rates of within-home transmission of Flu and SARS will be calculated. Significance: Transmission and amplification within schools, followed by transmission from children to other household members likely expands outbreaks. Cause-specific absenteeism monitoring of Flu and SARS may provide early detection in a community allowing for use of countermeasures.