Surveillance for Vaccine Preventable Disease in Children

构成部分A：项目总结 德克萨斯州儿童医院(TCH)计划继续对住院和急诊科进行监测，作为 更大的国家新疫苗监测网络(NVSN)，以评估儿科医生的负担 住院儿童和儿童的呼吸道和胃肠道疾病以及急性迟缓性脊髓炎 在急诊科寻求治疗。具体来说，我们会进行全年监察，以评估 多种病毒和细菌呼吸道病原体的负担，包括但不限于SARS-CoV-2， 流感、呼吸道合胞病毒、人类偏肺病毒、副流感病毒、冠状病毒、鼻病毒和 新出现的呼吸道病原体，如肠道病毒D68。一群健康的、无症状的儿童 向德克萨斯州儿童儿科实践介绍良好的儿童护理将被登记为对照组。鼻子 和/或喉咙拭子将从有症状和健康的对照儿童中收集，并进行广泛的测试 在佩德罗·皮德拉博士的实验室里使用分子方法对呼吸道病原体进行研究 儿科呼吸道疾病。此外，我们将评估胃肠道病原体的负担，如 轮状病毒和诺如病毒。来自有症状患者和健康对照儿童的粪便样本将接受 贝勒医学院的Robert Atmar博士和Sasirekha Ramani博士的实验室进行了分子测试。 将根据我们完善的程序为所有儿童获得完整的疫苗接种历史 正在收集疫苗接种历史。我们将计算呼吸道和肠道的基线和基于人口的比率 住院患者和ED患者的病原菌调查。使用测试阴性研究设计，我们将计算疫苗 对流感、轮状病毒和SARS-CoV-2等疫苗可预防疾病的有效性，比较 对有症状和无症状的患者感兴趣的病原体检测呈阳性的有症状患者， 对特定病原体检测为阴性的健康对照。重要的是，TCH是一个模范的监视 由于休斯敦每年的招生人数(36,000人)、种族和民族多样性 以及Tch种群与群落种群的相似性。考虑到大量的 每年的招生人数和当地神经学专业知识的深度，TCH是举办年度- 儿童急性弛缓性脊髓炎(AFM)查房监测及与AFM发生率的比较 循环的呼吸道和胃肠道病原体。

Component A: Project Summary Texas Children’s Hospital (TCH) aims to continue inpatient and emergency department surveillance as part of the larger national New Vaccine Surveillance Network (NVSN) to assess the burden of pediatric respiratory and gastrointestinal illnesses and acute flaccid myelitis in hospitalized children and children seeking care in the emergency department. Specifically, we will operate year-round surveillance to assess the burden of multiple viral and bacterial respiratory pathogens, including but not limited to SARS-CoV-2, influenza, respiratory syncytial virus, human metapneumovirus, parainfluenza virus, coronavirus, rhinovirus, and emerging respiratory pathogens, such as enterovirus D68. A concurrent group of healthy, asymptomatic children presenting to Texas Children’s Pediatric practices for well child care will be enrolled as a control group. Nose and/or throat swabs will be collected from symptomatic and healthy control children and tested for a wide array of respiratory pathogens using molecular methods in the laboratory of Dr. Pedro Piedra, a national expert in pediatric respiratory disease. In addition, we will assess the burden of gastrointestinal pathogens such as rotavirus and norovirus. Stool specimens from symptomatic patients and healthy control children will undergo molecular testing in the labs of Dr. Robert Atmar and Dr. Sasirekha Ramani at Baylor College of Medicine. Complete vaccination histories will be obtained for all children based on our well-established process for gathering vaccination histories. We will calculate baseline and population-based rates of respiratory and enteric pathogens among hospitalized and ED patients. Using a test negative study design, we will calculate vaccine effectiveness for vaccine-preventable diseases such as influenza, rotavirus and SARS-CoV-2, comparing symptomatic patients who test positive for a pathogen of interest to symptomatic patients and asymptomatic, healthy controls who test negative for the specific pathogen. Importantly, TCH is an exemplary surveillance site due the large number of admissions each year (>36,000), racial and ethnic diversity of the Houston area, and the similarity of the TCH population to that of the community. Given the large number of admissions per year and depth of local neurologic expertise, TCH represents the ideal site for conducting year- round surveillance for children with acute flaccid myelitis (AFM) and comparing rates of AFM with rates of circulating respiratory and gastrointestinal pathogens.