Hospital Admissions & Emergency Room Visits in Adults Associated with Influenza C

 描述（由申请人提供）：尽管诊断技术取得了进步，但在精心设计的研究中，只有39-75%的呼吸道疾病发作确定了病因。聚合酶链反应（PCR）的引入有助于识别病毒病原体，这些病原体以前由于快速抗原和培养诊断在老年人中的表现不佳而无法识别，流感和呼吸道合胞病毒是两种最常见的病毒病因。不幸的是，由于没有已知的病因，治疗和预防策略缺失。因此，需要更多的研究来确定与流感样疾病和肺炎相关的病原体。一种潜在的病原体是C型流感。C型流感最初称为“1233变异株”，于1947年3月在流感常规监测中发现。一项在年轻健康成年人中进行的丙型流感挑战研究描述了由此产生的疾病与普通感冒相似，但老年人和患病者的数据不可用。由于缺乏对丙型流感的全面研究，因此没有很好地描述成人中丙型流感的临床表现，也没有计算任何基于人群的发病率。如果丙型流感导致大量的医疗护理疾病，包括住院，将丙型流感纳入成人疫苗接种计划可能会预防发病和死亡。前瞻性地收集了过去六个流感季节中有呼吸道症状的成年人的信息，以确定住院率，并进行年度病例阳性、对照阴性流感疫苗有效性研究。监测于2006年11月开始，2012年5月完成。每年11月开始招募，4月结束，但大流行除外，2008年11月至2010年5月持续监测。如果患者出现呼吸道疾病，则与患者接触，并且对于每名参与受试者，获得鼻拭子和咽拭子样本用于RT-PCR。患者问卷调查和图表审查捕获CDC定义的高风险状况，症状和疫苗接种。利用这些数据，我们将能够实现以下目标。具体目标：1。丙型流感病毒检测标本来自前瞻性入组6年以上的≥ 50岁、因急性呼吸道疾病接受医疗保健访视的成人人群样本。 2. 定义与甲型和B型流感以及其他呼吸道病毒相比，丙型流感相关疾病的临床和人口统计学特征3。估计50岁以下成人中与丙型流感相关的住院率。

 DESCRIPTION (provided by applicant): Despite advances in diagnostic techniques, only 39-75% of episodes of respiratory illness in well-designed studies have an etiology identified. The introduction of polymerase chain reaction (PCR) has helped identified viral pathogens that were previously unidentified due to the poor performance of rapid antigen and culture diagnostics in older adults with influenza and respiratory syncytial virus being two of the most common viral etiologies. Unfortunately, without known etiologies, treatment and prevention strategies are missing. Hence more research is needed to identify pathogens associated with influenza-like illness and pneumonia. One potential pathogen is Influenza C. Influenza C originally called, the "1233 aberrant strain" was discovered in March 1947 during routine surveillance for influenza. One influenza C challenge study done in young healthy adults, described the resulting illness to be similar to the common cold, but data is unavailable who are older and sick. Due to lack of comprehensive studies in influenza C, there is not a good description of the clinical picture of influenza C in adults, nor have any population based rates been calculated. If influenza C causes a significant number of medically attended illness including hospitalizations inclusion of influenza C in the adult vaccination program may prevent morbidity and mortality. Information on adults with respiratory symptoms during the past six influenza seasons has been prospectively collected to determine rates of hospital admissions and to perform yearly case-positive, control-negative influenza vaccine effectiveness studies. The surveillance began in November of 2006 and was completed May 2012. Recruitment began yearly in November in ended in April with the exception of the pandemic where surveillance was continuous from November 2008 through May 2010. Patients were approached if they presented with a respiratory illness and for each participating subject, both a nasal and a throat swab sample were obtained for RT- PCR. Patient questionnaires and chart review captured CDC-defined high risk conditions, symptoms, and vaccinations. Using this data we will be able to accomplish the following aims. Specific Aims: 1. Test specimens for influenza C from a population-based sample of adults =50 years of age with health care visits for acute respiratory illness prospectively enrolled over 6 years. 2. Define the clinical and demographic features of illness associated with influenza C compared with influenza A and B and other respiratory viruses 3. Estimate rates of hospitalizations associated with influenza C among adults =50 years of age.