Enhanced Surveillance for New Vaccine Preventable Diseases

加强对新疫苗可预防疾病的监测

• 批准号: 10345655
• 负责人: NATASHA Bassam HALASA
• 金额: $ 144.16万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10345655
• 关键词: Enhanced; Surveillance; New; Vaccine; Preventable

PROJECT SUMMARY - Mandatory Component A Acute respiratory illness (ARI) and acute gastroenteritis (AGE) are the leading causes of death worldwide in young children. Established leading viral etiologies of AGE are rotavirus and norovirus and respiratory syncytial virus (RSV) and influenza virus for ARI. Our understanding of ARI and AGE epidemiology is constantly changing due to spatiotemporal fluctuations, discovery of new or re-emerging pathogens [e.g. enterovirus D68 (EV-D68) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)], and use of rotavirus and influenza vaccines. Hence, surveillance efforts are imperative to define ARI and AGE disease burden, causative pathogens, outcomes, and vaccine impact. The primary influenza prevention strategy in the United States is vaccination for all individuals six months or older. There is a paucity of data regarding vaccine effectiveness (VE) against laboratory-confirmed influenza in children, and influenza viruses and vaccine antigenic components change annually. Therefore, perpetual assessments of VE are needed to monitor the impact of influenza vaccination on disease and inform strategies to improve magnitude, durability, and breadth of protection. Pediatric SARS-CoV-2 vaccines are an urgent public-health priority and likely will become available on an accelerated timeline in an effort to curb the COVID-19 pandemic. Rigorous, prospective surveillance of SARS-CoV-2 VE is crucial to support reliance on vaccines as primary prevention. Thus, the first main objective of this project is to conduct population-based active surveillance for respiratory and enteric viral pathogens in pediatric inpatient and emergency department settings and asymptomatic controls. Our team of Vanderbilt investigators is highly experienced in conducting prospective, population- based ARI and AGE surveillance. We propose to conduct ARI and AGE surveillance with the following specific aims: 1) To perform prospective, active surveillance to determine the etiology and burden of inpatient and emergency department (ED) acute viral respiratory and enteric diseases among the pediatric population. 2) To characterize the clinical and epidemiologic factors of pediatric infections (including in asymptomatic children) through active surveillance. 3) To evaluate vaccine effectiveness and impact of vaccines and other interventions (e.g., immunoprophylaxis with antiviral agents or other therapeutics) available or projected to become available during the period of performance. The second main objective of this project is to conduct surveillance and epidemiologic characterization of acute flaccid myelitis syndrome in children. Given the epidemiologic connection between EV-D68 infection and acute flaccid myelitis (AFM), it will be important to conduct rigorous, active, longitudinal surveillance for AFM across multiple consecutive seasons; carefully define AFM clinical spectrum, risk factors, incidence rates, and laboratory parameters; and document local circulation of EV-D68 and other ARI and AGE pathogens coincident with increased AFM occurrence. This work underpins development of preventive, diagnostic, and therapeutic strategies for AFM.

项目摘要 - 强制性组件 急性呼吸道疾病（ARI）和急性胃肠炎（年龄）是全球死亡的主要原因 年幼的孩子。年龄的已建立的领先病毒病因是轮状病毒和诺如病毒和呼吸系统疾病 ARI病毒（RSV）和流感病毒。我们对ARI和年龄流行病学的理解一直是 由于时空波动，发现新的或重新出现的病原体而发生变化[例如肠病毒D68 （EV-D68）和严重的急性呼吸综合征冠状病毒2（SARS-COV-2）]，以及轮状病毒和使用 流感疫苗。因此，监视工作必须定义ARI和年龄疾病负担， 病原体，结果和疫苗的影响。联合的主要预防流感策略 各州均为所有个人的疫苗接种六个月或更早。关于疫苗的数据很少 针对儿童实验室确认的流感的有效性（VE），流感病毒和疫苗 抗原成分每年更改。因此，需要对VE的永久评估来监视 流感疫苗接种对疾病的影响，并为提高幅度，耐用性和广度的策略提供了信息 保护。小儿SARS-COV-2疫苗是紧急的公共卫生优先事项，很可能会成为 在加速时间表上可用，以遏制COVID-19-19的大流行。严格，潜在的 SARS-COV-2 VE的监视对于支持对疫苗作为主要预防的依赖至关重要。因此， 该项目的第一个主要目的是进行基于人群的主动监视呼吸道和 小儿住院和急诊科和无症状的肠病毒病原体 控件。我们的范德比尔特调查人员团队在进行预期的人群方面经验丰富 - 基于ARI和年龄监视。我们建议通过以下特定进行ARI和年龄监视 目的：1）执行预期的，积极的监视以确定住院和负担 急诊科（ED）小儿人群中的急性病毒呼吸道和肠道疾病。 2）到 表征小儿感染的临床和流行病学因素（包括无症状儿童） 通过主动监视。 3）评估疫苗有效性和疫苗和其他疫苗的影响 可用或预计 在性能期间可用。该项目的第二个主要目标是进行 儿童急性松弛脊髓炎综合征的监测和流行病学表征。给出 EV-D68感染与急性松弛性脊髓炎（AFM）之间的流行病学联系，对 连续多个季节，对AFM进行严格，主动的纵向监视；小心 定义AFM临床范围，危险因素，发病率和实验室参数；并记录本地 EV-D68以及其他ARI和年龄病原体的循环与AFM发生的增加一致。这项工作 基于AFM的预防，诊断和治疗策略的发展。