Household Studies of Influenza and Other Respiratory Viruses

 描述(由申请人提供)：每年，季节性流感的爆发在美国都会产生大量的发病率、死亡率和随之而来的经济损失。家庭传播被认为是流感流行和其他呼吸道病毒传播的主要驱动因素。本应用程序的总体目标是扩大我们的理解 通过继续我们已建立的家庭队列研究，了解急性呼吸道疾病的风险、易感性和传播情况。我们已经确定了13种呼吸道病毒的检测和共同检测的频率，并表明在前一年接种过疫苗的人中，疫苗效力较低，对当前季节接种的应答较低。我们的长远目标是利用创新的实验室和统计方法，进一步利用已建立的家庭平台，监测目前公认的和新出现的呼吸道病毒(例如肠道病毒D68)。特别令人感兴趣的是对过去流感感染和疫苗接种所产生的保护决定因素的评估。我们将通过以下具体目标来实现总体目标：目标1)确定最近感染和疫苗接种历史对后续感染流感风险的影响；目标2)扩大以前对流感保护性和易感性的免疫相关性的评估，方法是测量血凝素(HA)和神经氨酸酶(NA)抗原的抗体，以及正在开发的其他新方法；目标3)估计已引入流感的家庭感染参数和影响传播的因素。登记和跟踪单个家庭长达五年，可以调查风险因素和免疫相关因素，因为它们影响多年期间的流感传播模式。这项研究将从以下几个方面解决我们对流感和其他呼吸道病毒预防和传播相关性的认识上的主要差距：(1)确定疫苗接种和感染史对随后呼吸道感染风险的贡献，并为针对流感和其他呼吸道病毒(例如RSV)的改进疫苗的开发提供信息；(2)确定关键的免疫相关因素，作为未来研究的目标，以减少普通人群中的疫苗失败；以及(3)对家庭和社区的流感传播模式提供可靠的估计，为公共卫生干预工作提供信息。我们的研究结果将促进美国社区对呼吸道病毒感染的了解和预防。

 DESCRIPTION (provided by applicant): Each year, outbreaks of seasonal influenza produce substantial morbidity, mortality and attendant economic costs in the United States. Household transmission has been proposed as a major driver of influenza epidemics, and circulation of other respiratory viruses. The overall objective of this application is to expand our understanding of acute respiratory illness risk, susceptibility, and transmission through continuation of our established household cohort study. We have identified the frequency of detection and co-detection of 13 respiratory viruses, and demonstrated lower vaccine effectiveness and reduced response to current season vaccination among those vaccinated in the prior year. Our long term goal is to further employ the established household platform for the surveillance of both currently recognized and emerging respiratory viruses (e.g. enterovirus D68) using innovative laboratory and statistical methods. Of particular interest will be the evaluation of determinants o protection produced by past influenza infection and vaccination. We will accomplish the overall objectives through the following specific aims: Aim 1) To characterize the effect of recent infection and vaccination history on the risk of subsequent influenza infection; Aim 2) To expand previous evaluations of immune correlates of protection and of susceptibility to influenza using assays measuring antibodies to the hemagglutinin (HA) and neuraminidase (NA) antigens plus additional, novel assays in development; Aim 3) To estimate household infection parameters and factors affecting transmission in households where influenza has been introduced. Enrolling and following individual households for up to five years allows for the investigation of risk factos and immune correlates as they impact influenza transmission patterns over a multiple year span. This study will address major gaps in our understanding of correlates of protection and the transmission of influenza and other respiratory viruses in the following ways: the proposed work will (1) define the contributions of vaccination and infection history to risk of subsequent respiratory infection, and inform the development of improved vaccines against influenza and other respiratory viruses (e.g. RSV), (2) identify key immune correlates which will serve as targets for future research to reduce vaccine failures in the general population and (3) provide robust estimates of influenza transmission patterns in households and communities to inform public health intervention efforts. Our results will lead to improvements in the understanding and prevention of respiratory virus infection in U.S. communities.