Oregon Child Absenteeism due to Respiratory Disease Study

果园 俄勒冈州儿童因呼吸系统疾病缺勤研究 总结 背景：流感常见于学龄儿童，发病率高，是一种 学校旷课的主要原因。它与大量的发病率、死亡率和 经济成本。最近，我们发现学校的校历 学龄儿童因各种原因的呼吸道感染就诊的比例和患病率 0-4岁的儿童。尽管流感疫苗在这些地区具有合理的功效， 然而，在20多岁的儿童中，只有三分之一的学龄儿童接种了疫苗。因为流感是 在学校环境中有效传播，旷课率已被用于 流感监测计划，并建议作为早期预警系统的组成部分。的 然而，缺乏具体性带来了很大的限制。自从现代分子生物学出现以来， 检测方法，目前还没有研究耦合缺勤与直接识别 病原体，以评估病因特异性缺勤对早期发现流感的价值。 计划目标：果园的目标是迅速确定学校的原因， 一个学区的缺勤率在三年内，并评估可比性 在基于流感特异性缺勤的监测和多层次的 以这个学区为中心的免费流感监测。方法：我们将 积极招募多达500名因呼吸道感染而缺课的儿童， 感染来自俄勒冈州学区，戴恩县，威斯康星州，在每三年。我们 将使用杰克逊标准确认ARI，并在 学生之家进行病毒学检测详细的人口统计学、流行病学和症状数据 将在此次访视中收集。鼻样本将在2小时内使用索菲亚RIDT进行检测 该平台可将结果即时无线传输到安全服务器。NP/OP 标本将被运送到威斯康星州卫生国家实验室进行近实时 在Qiagen Multiplex上使用rT-PCR对17种呼吸道病毒的存在进行分子检测 PCR平台。具体原因缺勤的时间模式将与 流感监测基于（1）对四个周围地区进行针对具体原因的医疗访问 诊所，（2）在两层周围的初级保健诊所进行ILI的EHR监测，（3）ILI网络 对于威斯康星州，（4）基于威斯康星州PCR和RIDT网络的病毒学监测 网站.意义：以学校为基础的流感监测提供了一个机会， 在社区中及早发现流感。具体原因引起的缺勤与高 灵敏度，无线RIDT与PCR确认允许廉价，快速识别 季节性和大流行性流感。

ORCHARDS ORegon CHild Absenteeism due to Respiratory Disease Study SUMMARY Background: Influenza is common in school-aged children, has high attack rates, and is a leading cause of school absenteeism. It is associated with substantial morbidity, mortality and economic costs. Recently, we have shown significant relationships between school calendars and prevalence of medically-attended visits for all-cause respiratory infections in school-aged children and children 0-4 years. Despite reasonable efficacy of influenza vaccines at these ages, however, only one third of school-aged children are immunized. Because influenza is efficiently spread within school settings, rates of school absenteeism have been used in influenza surveillance programs and proposed as a component of early warning systems. The lack of specificity, however, presents significant limits. Since the advent of modern molecular detection methods, there have been no studies coupling absenteeism with direct identification of pathogens to assess the value of cause-specific absenteeism for early detection of influenza. Program Goal: The goal of ORCHARDS is to determine rapidly the causes of school absenteeism across a school district over a three-year period and to assess the comparability between surveillance based on influenza-specific absenteeism and a multiple layers of complimentary influenza surveillance centered on this school district. Methods: We will actively recruit up to 500 children on the first day of their school absence due to respiratory infection from the Oregon School District, Dane County, Wisconsin, in each of three years. We will use the Jackson criteria to confirm ARI, and collect nasal and NP/OP specimens at the student's home for virological testing. Detailed demographic, epidemiologic and symptom data will be collected at that visit. Nasal specimens will be tested within 2 hours using a SOFIA RIDT platform with instantaneous wireless transmission of results to a secure server. NP/OP specimens will be transported to the Wisconsin State Laboratory of Hygiene for near real-time molecular testing for the presence of 17 respiratory viruses using rT-PCR on a Qiagen Multiplex PCR platform. The temporal patterns of cause-specific absenteeism will be compared to influenza surveillance based on (1) cause-specific medically attended visits to four surrounding clinics, (2) EHR surveillance for ILI in two layers of surrounding primary care clinics, (3) ILI-Net for Wisconsin, (4) virological surveillance based on a network of Wisconsin PCR and RIDT sites. Significance: School-based influenza surveillance provides an opportunity for extremely early detection of influenza in a community. Coupling cause-specific absenteeism with high sensitivity, wireless RIDT with PCR confirmation allows for inexpensive, rapid identification of seasonal and pandemic influenza.