Mentoring in transmission of influenza and strategies for prevention

项目总结/摘要 这项K24提案将为Grijalva博士提供受保护的时间，以便为博士后提供高质量的指导。 和初级教员调查员，以及扩大他的研究，流感传播和疾病 预防Grijalva博士提出了一个全面和专门的指导计划，将促进 有效地将他的学员过渡到独立的学术生涯。该应用程序包括详细的 描述通过获得指导方面的高级技能来加强Grijalva博士自身培训的计划， 传染病传播模型和因果推断。他目前的研究项目是 通过重点关注急性呼吸道感染，特别是流感感染， 大力强调查明可改变的风险因素，以便为随后的干预措施提供信息。流感 仍然是世界范围内发病率和死亡率的一个重要原因。减轻影响的主要策略是 流感流行的最大威胁是接种疫苗，但疫苗的有效性并不理想。预防的替代方法 流感的传播是必要的。关于流感在美国家庭中的传播知之甚少， 在我们的现代生活方式中。我们对流感传播的理解主要基于 在20世纪60年代和70年代进行的家庭研究。诊断测试已经改变，目前 分子和测序技术可以准确鉴定流感传播。同样，接触 在过去的几十年里，家庭和社区的模式可能发生了变化， 电子设备的发展可能会进一步改变这些动态。理解当代的驱动力 流感在美国家庭和社区内的传播是预防性干预的基础。 NIAID预防流感感染和设计通用流感疫苗的战略计划已经确定， 现代流感传播的研究是一个重要的研究重点。虽然很大一部分 流感感染是在家中获得的，家庭环境的作用，接触模式和疾病 对流感传播严重程度尚未进行充分研究。当代家庭案件认定 研究是有效的设计，以量化传输参数，并研究这些和其他新的 可变因素研究目的是：1）检验假设，可修改的因素，包括家庭， 温度、相对湿度和家庭内部的社会互动独立地与 流感在家庭传播的风险; 2）提供一个全面的评估， 抗病毒药物在预防家庭中流感传播方面的有效性; 3）检验以下假设： 指示病例的疾病严重程度（家庭中首例感染患者）和家庭暴露情况 强度和持续时间改变了流感在家庭中传播的风险。这些研究将为 设计和评价新的预防战略，并将提供广泛的辅导机会 初级研究人员在以病人为导向的研究，在流感感染，传播和预防。

PROJECT SUMMARY / ABSTRACT This K24 proposal will provide protected time for Dr. Grijalva to deliver high-quality mentoring to post-doctoral and junior faculty investigators as well as to expand his studies of influenza transmission and disease prevention. Dr. Grijalva proposes a comprehensive and dedicated mentoring plan that will facilitate the effective transition of his mentees into independent academic careers. The application includes a detailed description of plans to augment Dr. Grijalva’s own training through acquisition of advanced skills in mentoring, and modelling of transmission of infectious diseases and causal inference. His current research projects are thematically linked through their focus on acute respiratory infections, especially influenza infections, with a strong emphasis on identification of modifiable risk factors to inform subsequent interventions. Influenza remains an important cause of morbidity and mortality worldwide. The primary strategy to attenuate the impact of influenza epidemics is vaccination, but vaccine effectiveness is suboptimal. Alternative methods to prevent the spread of influenza are needed. Little is known about the transmission of influenza in US households and communities in our modern lifestyle. Our understanding of influenza transmission is largely based on household studies that were done in the 1960’s and 1970’s. Diagnostic tests have changed, and current molecular and sequencing techniques allow accurate identification of influenza transmission. Similarly, contact patterns within households and communities have likely changed during the last decades, and widespread use of electronic devices may have further modified those dynamics. Understanding the contemporary drivers of influenza transmission within US households and communities is the foundation for preventative interventions. The NIAID strategic plan to prevent influenza infections and design a Universal influenza vaccine has identified modern studies of influenza transmission as an important research priority. Although a large proportion of influenza infections are acquired at home, the role of household environment, contact patterns, and disease severity on influenza transmission have not been well studied. Contemporary household case-ascertained studies are efficient designs to quantify transmission parameters and to study the role of these and other novel modifiable factors. The research aims are: 1) Test the hypothesis that modifiable factors, including household temperature, relative humidity, and within-household social interactions are independently associated with the risk of influenza transmission in households; 2) To provide a comprehensive assessment of the use and effectiveness of antivirals in the prevention of influenza transmission in households; 3) Test the hypothesis that the disease severity in the index case (first patient infected in the household), and the household exposure intensity and duration modify the risk of influenza transmission in households. These studies will inform the design and evaluation of new prevention strategies, and will provide extensive opportunities for mentoring junior investigators in patient-oriented research in influenza infections, transmission and prevention.