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

总结/摘要 背景：流感（流感）在儿童中很常见，也是导致缺课的主要原因。 SARS-CoV-2（SARS）已成为一种重要的病原体，但在儿童发病高峰后的作用 以及大流行后的传播需要加以界定。这两种病毒都会导致大量的发病率， 死亡率和经济成本。由于流感在学校环境中有效传播， 有人提议将缺勤作为一种预警系统。因此，我们创造了， 测试了对现有电子学校信息系统（ESIS）的简单修改， 自动报告特定原因的缺勤。我们发现， 特定原因的K-12学校缺勤率和医疗参加流感的患病率在我们的六年 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- 使用我们建立的有效方法-是新出现的冠状病毒所需要的， 非典计划目标：果园-3的目标是扩大缺勤制度， 评价SARS监测的有效性，描述家庭内SARS监测水平 流感和SARS从学龄儿童的指示病例传播。方法：我们 将使用家长报告的症状到一个电话缺席报告系统， ESIS中用于每日缺勤评估的算法。我们将积极招募≥300人 因流感样疾病（ILI）或COVID样疾病（CLI）而缺席俄勒冈州学校的儿童 区，戴恩县，威斯康星州，在每三年。家访将用于收集详细信息 人口统计学、家庭、流行病学和症状数据，以及鼻和NP/OP标本 进行测试。将使用索菲亚-2 FIA快速检测法对鼻标本进行流感/SARS检测。 NP/OP标本将被运送至威斯康星州国家卫生实验室， 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PCR平台。我们将招募≥240个家庭/年的患病儿童进行传播 考核所有家庭成员将在第0、7和14天自行采集鼻标本， 流感/SARS rRT-PCR，并提供详细的疾病数据。因下列原因而缺勤的时间模式 ILI和CLI将与周围社区的病毒学监测进行比较。 将计算流感和SARS的家庭内传播率。重要性： 在学校内传播和扩大，然后从儿童向其他人传播 家庭成员可能会扩大疫情。流感的病因特异性缺勤监测 并且SARS可以在允许使用对策的社区中提供早期检测。

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.