Enhanced Surveillance for New Vaccine Preventable Diseases

项目总结： 德克萨斯州儿童医院(TCH)旨在建立住院和急诊科监控 作为更大的国家新疫苗监测网络(NVSN)的一部分，以评估 儿科呼吸系统和胃肠道疾病住院儿童和寻求治疗的儿童 急诊科。具体来说，我们将评估流感的负担和评估疫苗 18岁住院儿童中实验室确认的流感感染的有效性(VE) 流感季节的年龄。我们还会对其他非流感病原体进行全年监测， 包括但不限于呼吸道合胞病毒、人类偏肺病毒、副流感病毒、鼻病毒、 以及新出现的呼吸道病原体，如肠道病毒D68，感染5岁的儿童。此外，我们还将 评估其他胃肠道病原体的负担，如诺沃克病毒和腺病毒。TCH是一个理想的网站 由于每年的招生人数众多(39,000人)，种族和伦理的多样性 休斯顿地区，以及TCH种群与社区的相似性。鼻咽部 将从所有受试者身上收集拭子，并使用分子生物学技术对多种病毒病原体进行检测 方法在国家儿科呼吸系统疾病专家Piedra博士的实验室进行。粪便标本 将在TCH临床实验室接受一系列病原体的分子测试。儿童 流感或其他病毒检测呈阳性的儿童将与流感检测呈阴性的儿童进行比较， 或其他病毒，以及向德克萨斯儿童儿科提供健康(对照)实践的儿童- 托儿所。将获得所有儿童的完整疫苗接种史，并将计算流感VE。 大量患有TCH流感的儿童(每年100-300人)将允许进行VE评估 按流感的特定毒株、疫苗类型(活疫苗与灭活疫苗)和患者年龄进行比较。此外，一个出生队列 纵向研究(可选部分)将建立一个有价值的母婴样本库 并有助于理解ARI的自然历史和早期生命中的年龄疾病， 母婴病原体暴露和免疫的相互作用以及宿主的评估， 病原体和环境因素，包括免疫接种，在婴儿感染和 疾病的严重程度。

Project Summary: Texas Children's Hospital (TCH) aims to establish an inpatient and emergency department surveillance site as part of the larger national New Vaccine Surveillance Network (NVSN) to assess the burden of pediatric respiratory and gastrointestinal illnesses in hospitalized children and children seeking care in the emergency department. Specifically, we will assess the burden of influenza and assess the vaccine effectiveness (VE) against laboratory-confirmed influenza infections among hospitalized children <18 years of age during influenza season. We will also operate year-round surveillance of other non-influenza pathogens, including but not limited to respiratory syncytial virus, human metapneumovirus, parainfluenza virus, rhinovirus, and emerging respiratory pathogens, such as enterovirus D68, in children <5 years of age. In addition, we will assess the burden of other gastrointestinal pathogens such as norovirus and adenovirus. TCH is an ideal site for surveillance due the large number of admissions each year (>39,000), racial and ethic diversity of the Houston area, and the similarity of the TCH population to that of the community. Nasal and throat swabs will be collected from all subjects and tested for a wide-array of viral pathogens using molecular methods in the laboratory of Dr. Piedra, a national expert in pediatric respiratory disease. Stool specimens will undergo molecular testing in the TCH clinical laboratory for a wide-array of pathogens. Children who test positive for influenza, or other viruses, will be compared with children who test negative for influenza, or other viruses, and healthy (control) children who present to Texas Children's Pediatrics practices for well- child care. Complete vaccination histories will be obtained for all children and influenza VE will be calculated. The large number of children admitted to TCH with influenza (100->300 annually) will permit VE assessments by specific strain of influenza, vaccine type (live vs. inactivated), and patient age. In addition, a birth cohort longitudinal study (optional component) will build a valuable repository of maternal and infant samples and contribute to the understanding of the natural history of ARI and AGE illnesses in early life, the interaction of maternal and infant pathogen exposure and immunity, and the assessment of host, pathogen and environmental factors, including immunization, in the infant's risk for infection and severity of disease.