Mentoring in transmission of influenza and strategies for prevention

项目摘要/摘要 这份K24提案将为Grijalva博士提供高质量的博士后辅导时间 和初级教研室调查人员，以及扩大他对流感传播和疾病的研究 预防。Grijalva博士提出了一个全面和专注的指导计划，将促进 他的导师有效地过渡到独立的学术生涯。该应用程序包括详细的 介绍通过获取指导方面的高级技能来加强Grijalva博士自身培训的计划， 以及传染病传播的模型和因果推断。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，将主题联系在一起 高度重视确定可修改的风险因素，以便为后续干预提供信息。流感 仍然是全世界发病率和死亡率的重要原因。减轻影响的主要战略是 流感流行的主要原因是接种疫苗，但疫苗的效果并不理想。预防的替代方法 流感的传播是必要的。对流感在美国家庭和家庭中的传播知之甚少 我们现代生活方式中的社区。我们对流感传播的理解很大程度上是基于 上世纪60年代的S和70年代的S进行的家庭研究。诊断测试发生了变化，目前 分子和测序技术可以准确识别流感传播。同样，联系 在过去的几十年里，家庭和社区内的模式可能发生了变化，并广泛使用 电子设备的出现可能进一步修正了这些动态。了解当代的驱动因素 流感在美国家庭和社区中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 现代流感传播研究作为一个重要的研究重点。尽管有很大一部分 流感感染是在家里获得的，家庭环境的作用，接触方式，以及疾病 流感传播的严重性还没有得到很好的研究。当代家居病例--已查明 研究是量化传输参数并研究这些和其他新技术的作用的有效设计 可修改的因素。研究的目的是：1)检验包括家庭在内的可修改因素的假设 温度、相对湿度和家庭内部社交活动与 流感在家庭中传播的风险；2)全面评估使用和 抗病毒药物在防止流感在家庭中传播的有效性；3)检验假设 指示病例中的疾病严重程度(家庭中感染的首例患者)和家庭接触情况 强度和持续时间改变了流感在家庭中传播的风险。这些研究将告知 设计和评估新的预防战略，并将为指导提供广泛的机会 流感感染、传播和预防方面以病人为中心的初级研究人员。

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.