IP21-002, Enhanced Surveillance Network for Enteric and Respiratory Viruses in Children: Assessing Disease Burden, Natural History, and Vaccine Effectiveness

项目摘要/摘要(构成部分A、B和C)： 病毒性急性呼吸道感染(ARI)和急性胃肠炎(AGE)仍然是发病的主要原因 在儿童中，使疫苗的开发和实施成为高度公共卫生优先事项。的总目标是 美国疾病控制与预防中心新疫苗监测网络(NVSN)将建立一个由美国机构组成的网络， 并实施标准研究方案，以回答有关疾病负担和 疫苗可预防疾病的自然病史，特别是那些引起ARI和年龄的疾病。第二个目标是 基于人群的NVSN监测是为了提供对#年疫苗有效性(VE)的准确估计 防止儿科住院或就医。第三个目标是快速转向学习的能力 新的药物，如肠道病毒D68(EV-D68)或SARS-CoV-2，以及急性弛缓症等症状 儿童脊髓炎(AFM)和多系统炎症综合征(MIS-C)。 拟议工作(包括强制性核心A和可选组成部分B和C)将加强 位于纽约州罗切斯特的NVSN站点-现在由7个站点组成的网络的2个原始成员之一。20年来，我们一直在 发表了关于轮状病毒引起的疾病负担和自然年龄史的重要研究 诺沃克病毒，以及因流感、呼吸道合胞病毒(RSV)和其他病毒引起的ARI。这些数据帮助AAP和ACIP了解 儿童流感和轮状病毒疫苗接种，以及使用帕利维珠单抗预防呼吸道合胞病毒。我们的具体目标是： 强制性核心组成部分A：对ARI和ARI执行前瞻性、基于人群的主动监测 0-18岁儿童的住院和急诊设置以及无症状对照的年龄。我们将使用 轮状病毒、诺如病毒、流感、RSV、PIV、EV-D68、SARS-CoV-2和其他病毒的分子诊断。 我们将评估VE对流感、轮状病毒和未来SARS-CoV-2疫苗的预防作用 住院和急诊科就诊。我们将使用我们独特的 几乎涵盖了我们地区所有的儿科住院和急诊科就诊。我们将评估以下方面的影响 未来的疫苗和其他免疫预防策略。我们将进行积极的监视和 儿童急性弛缓性脊髓炎(AFM)综合征流行病学研究最后，我们将表演并领导 以人群为基础的非传染性非传染性疾病监测的流行病学、实施和实验室研究。 可选组成部分B：实施积极的基于预期人群的急性呼吸窘迫综合征/年龄监测研究 儿童在门诊就医，因为ARI和年龄的负担可能很高。 可选组件C：调查与以下各项相关的发病率、疾病谱和风险因素 SARS-CoV-2 MIS-C。 我们提出的研究将为制定合理的预防政策提供重要信息。 儿童疫苗可预防的疾病，并改善美国儿童的健康。

PROJECT SUMMARY/ABSTRACT (COMPONENTS A, B and C): Viral acute respiratory infections (ARI) and acute gastroenteritis (AGE) remain major causes of morbidity in children, making vaccine development and implementation a high public health priority. The overall goal of the CDC New Vaccine Surveillance Network (NVSN) is to establish a network of US institutions that develop and implement standard research protocols to answer important questions about the burden of disease and natural history of vaccine preventable diseases, specifically, those causing ARI and AGE. A second goal of population-based NVSN surveillance is to provide accurate estimates of vaccine effectiveness (VE) in preventing pediatric hospitalization or medical care visits. A third goal is the ability to rapidly pivot to study novel agents such as enterovirus-D68 (EV-D68) or SARS-CoV-2, and syndromes such as acute flaccid myelitis (AFM) and multisystem inflammatory syndrome in children (MIS-C). The proposed work (comprising Mandatory Core A, and Optional Components B and C) will enhance the NVSN site in Rochester, NY—one of 2 original members of the now 7-site network. For 20 years we have published important studies on the burden of disease and natural history of AGE due to rotavirus and norovirus, and ARI due to influenza, (RSV), and other viruses. These data helped inform AAP and ACIP on pediatric influenza and rotavirus vaccination, and palivizumab use for RSV prevention. Our specific aims are:  Mandatory Core Component A: Perform prospective, population-based active surveillance for ARIs and AGEs in inpatient and ED settings as well as asymptomatic controls, for children 0-18 years. We will use molecular diagnostics for rotavirus, norovirus, influenza, RSV, PIV, EV-D68, SARS-CoV-2, and other viruses. We will assess VE for influenza, rotavirus, and future SARS-CoV-2 vaccines in preventing pediatric hospitalizations and ED visits. We will delineate the disease burden of ARI and AGE using our unique capture of virtually all pediatric hospitalizations and ED visits in our region. We will assess the impact of future vaccines and other immunoprophylaxis strategies. We will perform active surveillance and epidemiologic studies of acute flaccid myelitis (AFM) syndrome in children. Finally, we will perform and lead epidemiological, implementation and laboratory studies based on population-based NVSN surveillance.  Optional Component B: Implement active prospective population-based ARI/AGE surveillance studies in children seeking medical care in outpatient practices, as the burden of ARI and AGE are likely high.  Optional Component C: Investigate the incidence, spectrum of disease, and risk factors associated with SARS-CoV-2 MIS-C. Our proposed research will provide high impact information to develop sound policies for the prevention of pediatric vaccine-preventable diseases, and to improve the health of US children.