Enhanced Surveillance for New Vaccine Preventable Disease

描述（由申请人提供）：德克萨斯儿童医院旨在建立并运营一个全年监测站点，作为更大的国家新疫苗监测网络（NVSN）的一部分，以更好地了解疫苗可预防疾病的负担、新疫苗的影响以及不断变化的疫苗政策的影响。为了了解轮状病毒或其他疫苗可预防疾病的疾病负担，德克萨斯儿童医院的监测小组建议在所有拨款年度内，在急诊和住院环境中登记有急性胃肠炎症状的儿童。由于德州儿童医院急诊科每年治疗来自多县地区的1082000名儿童，这些儿童在人口统计学上与大休斯顿地区的儿童相似，因此该医院非常适合开展这种监测活动。所有入组儿童的粪便标本将在入组时或通过快递收集。所有粪便标本将使用Rotaclone酶免疫分析法进行检测。粪便样本轮状病毒抗原检测呈阳性的儿童（病例患者）将与到德州儿童儿科协会接受良好儿童护理的健康患者（对照患者）进行比较。将收集病例和对照患者的完整疫苗接种史。将确定针对轮状病毒以及可能的其他疫苗可预防疾病的疫苗有效性。此外，将收集一部分病例和健康儿童的唾液标本，以评估FUT2分泌抗原状态。在拨款第2-5年期间，我们建议与疾病预防控制中心合作，协助发展和实施其他项目。这些项目可包括但不限于以下内容：将监测活动扩展到其他疫苗可预防的疾病，评价新疫苗的使用情况及其对提供者政策和实践习惯的影响，在采用新疫苗后对一组儿童进行纵向研究，开展涉及开发新研究方法的实验室研究，以及对与疫苗政策有关的保健费用进行研究。

DESCRIPTION (provided by application): Texas Children's Hospital aims to establish and operate a year round surveillance site as part of a larger national New Vaccine Surveillance Network (NVSN) to better understand the burden of vaccine-preventable disease, the impact of new vaccine and the impact of changing vaccine policies. To understand the disease burden of rotavirus or other vaccine-preventable diseases, the surveillance team at Texas Children's Hospital proposes to enroll children with symptoms of acute gastroenteritis in both emergency and inpatient settings during all grant years. As the Texas Children's Hospital emergency department treats >82,000 children per year from a multi-county area who are demographically similar to the children in the greater Houston area, the hospital is well suited to conduct such surveillance activities. Fecal specimens will be collected from all enrolled children at the time of enrollment or by courier. All fecal specimens will be tested using Rotaclone enzyme immunoassay. Children whose fecal specimens test positive for rotavirus antigen, case patients, will then be compared with healthy patients who present to the Texas Children's Pediatric Associates for well-child care, control patients. Complete vaccination histories will be collected from case and control patients. Vaccine effectiveness for rotavirus, and possibly other vaccine-preventable diseases, will be determined. Additionally, saliva specimens will be collected from a subset of case and healthy children for assessment of FUT2 secretor antigen status. During grant years 2-5, we propose to collaborate with the CDC to assist in the development and implementation of additional projects. These projects may include, but would not be limited to the following: extension of surveillance activities to other vaccine-preventable diseases, evaluation of uptake and impact of new vaccines on provider policies and practice habits, longitudinal studies involving a cohort of children following new vaccine introduction, laboratory studies involving the development of new research methods, and health care costs studies associated with vaccine policy. PUBLIC HEALTH RELEVANCE: Texas Children's Hospital (TCH) welcomes the opportunity to respond to funding opportunity RFA-IP-11010 that will establish a network of surveillance and evaluation sites to ultimately assess the impact of new vaccines and vaccine policies. As the mission of Texas Children's Hospital is to improve the health of our community, we are interested in understanding the burden of vaccine-preventable diseases and participating in a national network that will evaluate the impact of vaccines in our community.