PUERTO RICO ENHANCED SURVEILLANCE AND CONTROL OF ARBOVIRUSES (PRESCA) PROGRAM

项目总结 由蚊子传播的感染的影响是全球性的。虫媒病毒疾病，如登革热， 基孔肯雅热和寨卡病毒是一个重大的健康问题，因为许多 蚊子种类。强调疾病监测系统是评估初级保健计划有效性的核心。 和二级登革热预防方法和战略，包括采用登革热疫苗和 新的矢量控制方法。在当前的应用中，研究小组将解决具体和基本的问题 登革热和其他急性发热性疾病(AFI)的诊断和临床管理方面的差距；最终， 通过评估媒介控制策略在降低虫媒病毒感染发生率方面的效果 诊所和社区监测系统的结合。研究小组的长期目标是 通过改进诊断、临床管理和预防来减轻虫媒病毒和其他AFI疾病的负担 战略。这项研究的中心假设是虫媒病毒感染和AFI疾病监测，通过 继续实施SEDSS和COPA，将促进以证据为导向的公共卫生政策决策，并减少 疾病的负担。目前这项研究的基本原理是，了解病原学、流行病学和 虫媒病毒疾病的严重性将使美国能够更好地准备和应对关键媒介- 传播的疾病暴发。研究小组将通过追求两个具体目标来检验中心假设：1) 探讨登革热和虫媒病毒感染的自然病史以及其他急性发热性疾病的区别 诊断以了解他们的流行病学、疾病谱和结果，并提供建议 用于诊断和临床管理，以及；2)确定虫媒病毒风险和保护的相关性 在设定传播矢量缩减策略的情况下。在具体目标1下，团队将加强医院 监测急性发热性疾病(AFI)，并维持AFI平台进行临床研究。为 具体目标2，该小组将维持一个以社区为基础的队列，以评估艾滋病的发病率和流行率 虫媒病毒感染，以及评估选择的其他AFI的发生率、流行率和病因学 社区。这两个目标的核心是建立一个数据管理系统，并继续 加强与当地政府、社区领袖和其他利益攸关方的合作，以确保 已建立的计划的连续性。这项拟议的研究具有重要意义，因为它有望提供 在此背景下，对常见虫媒病毒疾病的流行病学模式有充分和广泛的了解 目前的其他AFI和可能在地理环境中出现的那些AFI。这样的结果提供了证据-- 基于对登革热(和其他虫媒病毒)诊断、免疫反应、 和临床管理。此外，以社区为基础的系统将是评估媒介有效性的核心 减少人类虫媒病毒病发病率和评估其潜在用途的控制策略 在其他种群中。

PROJECT SUMMARY The impact of infections transmitted by mosquitoes is global. Arboviral diseases such as dengue, chikungunya, and Zika are a significant health concern due to the expanding geographical range of many mosquito species. Emphasis on disease surveillance systems is central to evaluate the effectiveness of primary and secondary dengue prevention methods and strategies, including the introduction of dengue vaccines and new vector control methods. In the current application, the study team will address specific and fundamental gaps in the diagnosis and clinical management of dengue and other acute febrile illnesses (AFI); ultimately, evaluating the efficacy of vector control strategies in reducing the incidence of arbovirus infection through a combination of both clinic- and community-based surveillance systems. The study team’s long-term goal is to mitigate arboviral and other AFI disease burdens by improving diagnosis, clinical management, and prevention strategies. The study’s central hypothesis is that arbovirus infections and AFI disease surveillance, through the continuation of SEDSS and COPA, will promote evidence-driven public health policy decisions and reduce the burden of disease. The rationale for the current study is that understanding the etiology, epidemiology, and severity of arboviral diseases will allow the United States to be better prepared and respond to critical vector- borne disease outbreaks. The study team will test the central hypothesis by pursuing two specific aims: 1) Explore the natural history of dengue and arboviral infections and other acute febrile illnesses in their differential diagnosis to understand their epidemiology, spectrum of disease, and outcomes to provide recommendations for diagnosis and clinical management, and; 2) Define the correlates of risk and protection of arbovirus transmission in the setting of vector-reduction strategies. Under Specific Aim 1, the team will strengthen hospital surveillance of acute febrile illness (AFI) and maintain an AFI platform for conducting clinical research. For Specific Aim 2, the team will maintain a community-based cohort to assess the incidence and prevalence of arboviral infection, as well as, evaluate the incidence, prevalence, and etiology of other AFIs in selected communities. Central to both aims is the establishment of a data management system and the continuation of strengthening collaborations with the local government, community leaders, and other stakeholders to ensure continuity of the established program. The proposed research is significant because it is expected to deliver robust and broad knowledge regarding the epidemiologic patterns of common arboviral diseases in the context of other AFI of the present and those that may emerge in the geographical setting. Such results provide evidence- based responses to critical questions regarding dengue (and other arboviruses) diagnosis, immune response, and clinical management. Also, the community-based system will be central to evaluate the efficacy of vector control strategies in reducing the incidence of arboviral diseases in humans and assessing its potential use among other populations.