Surveillance for Respiratory Syncytial Virus (RSV) and Other Viral Respiratory Infections Among American Indians/Alaska Natives

项目摘要 呼吸道合胞病毒(RSV)是引起急性下呼吸道感染(ALRI)的主要病毒原因， 包括毛细支气管炎和肺炎。婴儿时期的呼吸道合胞病毒病与相当大的发病率有关。 和死亡率，经历严重呼吸道合胞病毒的婴儿复发喘息和哮喘的风险增加 在以后的生活中。美国印第安人和阿拉斯加原住民(AI/AN)经历了许多健康差距，他们在 与普通美国人相比，RSV的风险大大增加。面向客户的众多产品 预防婴幼儿呼吸道合胞病毒目前正处于后期发展阶段，包括产妇疫苗。 和单抗。人工智能/人工智能社区迫切需要这种干预措施。 目前的疾控中心监测系统不衡量AI/AN人群中的RSV疾病。此外，负担 RSV在孕妇中的传播及其可能对妊娠和分娩结果的影响很差 明白了。量化AI/AN中RSV疾病的当前负担和流行病学特征 儿童和孕妇是告知最佳使用RSV预防产品的关键步骤，以减少 防治疾病，促进健康公平。 这项拟议的研究将建立在部落伙伴约翰·霍普金斯家族之间长期合作的基础上 美洲印第安人健康中心(JHCAIH)和阿拉斯加土著部落健康联盟(ANTHC) 创建美洲原住民呼吸道合胞病毒监测(RSV-SUNA)系统。RSV-SUNA将量化并描述 西南部三个社区5岁以下儿童和孕妇中的呼吸道合胞病毒病 美国和阿拉斯加的两个社区在五个RSV季节。该平台将由活跃的人口组成- 跨多个环境和季节对ALRI进行基于住院和门诊的监测，以便提供 对土著人群中的呼吸道合胞病毒病有深入的了解。鼻拭子将在同意的情况下收集 参与者并使用VALIDATED测试RSV和其他与ALRI相关的病原体 实验室方法。这一点，以及在文书中使用标准化病例定义和数据收集，将 促进跨站点和与其他主动监控网络(例如CDC的现有新功能)进行比较 疫苗监测网络)。这项研究将确定与RSV相关的年龄相关性发病率 这些AI/AN社区的住院和门诊就诊情况以及RSV和非RSV的特征 相关的ALRI，包括危险因素、临床病程和后遗症。 这种协作、多地点的方法将填补我们对RSV流行病学和 产生有意义的数据，为政策提供信息，并监测人工智能/AN人群中的RSV疾病。RSV-SUNA 该系统可在其他AI/AN人群中复制，并可在引入RSV后使用 预防产品，以量化其对呼吸道合胞病毒和非呼吸道合胞病毒急性呼吸道感染负担的影响。

Project Summary Respiratory Syncytial virus (RSV) is the leading viral cause of acute lower respiratory tract infection (ALRI), including bronchiolitis and pneumonia, globally. RSV disease in infancy is associated with substantial morbidity and mortality, and infants who experience severe RSV are at increased risk of recurrent wheeze and asthma later in life. American Indians and Alaska Natives (AI/AN), who experience many health disparities, are at substantially increased risk of RSV compared to the general US population. Numerous products for the prevention of RSV in infants and children are currently in late stage development, including maternal vaccines and monoclonal antibodies. Such interventions are urgently needed in AI/AN communities. Current CDC surveillance systems do not measure RSV illness in AI/AN populations. Furthermore, the burden of RSV in pregnant women and the effect it may have on pregnancy and delivery outcomes are poorly understood. Quantifying the current burden and characterizing the epidemiology of RSV disease in AI/AN children and pregnant women is a critical step to inform optimal use of RSV-prevention products to reduce disease and promote health equity. The proposed research will build upon long-standing collaborations between tribal partners, the Johns Hopkins Center for American Indian Health (JHCAIH) and the Alaska Native Tribal Health Consortium (ANTHC) to create the RSV Surveillance in Native Americans (RSV-SuNA) system. RSV-SuNA will quantify and describe RSV disease in AI/AN children under five years and pregnant women in three communities in the southwestern US and two communities in Alaska over five RSV seasons. The platform will consist of active, population- based, in-patient and outpatient surveillance for ALRI across multiple settings and seasons in order to provide a robust understanding of RSV disease in Native populations. Nasal swabs will be collected from consenting participants and tested for the presence of RSV and other pathogens associated with ALRI using validated laboratory methods. This, and the use of standardized case definitions and data collection in instruments, will facilitate comparison across sites and with other active surveillance networks (e.g. CDC’s existing New Vaccine Surveillance Network). This study will determine the age-specific incidence of RSV-associated hospitalizations and outpatient visits in these AI/AN communities and characterize RSV- and non-RSV associated ALRI, including risk factors, clinical course, and sequalae. The collaborative, multi-site approach will fill key gaps in our understanding of the epidemiology of RSV and produce meaningful data to inform policy and monitor RSV disease in AI/AN populations. The RSV-SuNA system could be replicated in other AI/AN populations and could be used after the introduction of RSV prevention products to quantify their impact on the burden of both RSV and non-RSV ALRI.