Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Wisconsin Division of Public Health, Wisconsin Department of Health Services, Madison, Wisconsin, USA.
Influenza Other Respir Viruses. 2022 Mar;16(2):340-350. doi: 10.1111/irv.12920. Epub 2021 Oct 8.
Influenza viruses pose significant disease burdens through seasonal outbreaks and unpredictable pandemics. Existing surveillance programs rely heavily on reporting of medically attended influenza (MAI). Continuously monitoring cause-specific school absenteeism may identify local acceleration of seasonal influenza activity. The Oregon Child Absenteeism Due to Respiratory Disease Study (ORCHARDS; Oregon, WI) implements daily school-based monitoring of influenza-like illness-specific student absenteeism (a-ILI) in kindergarten through Grade 12 schools and assesses this approach for early detection of accelerated influenza and other respiratory pathogen transmission in schools and surrounding communities.
Starting in September 2014, ORCHARDS combines automated reporting of daily absenteeism within six schools and home visits to school children with acute respiratory infection (ARI). Demographic, epidemiological, and symptom data are collected along with respiratory specimens. Specimens are tested for influenza and other respiratory viruses. Household members can opt into a supplementary household transmission study. Community comparisons are possible using a pre-existing and highly effective influenza surveillance program, based on MAI at five family medicine clinics in the same geographical area.
Over the first 5 years, a-ILI occurred on 6634 (0.20%) of 3,260,461 student school days. Viral pathogens were detected in 64.5% of 1728 children with ARI who received a home visit. Influenza was the most commonly detected virus, noted in 23.3% of ill students.
ORCHARDS uses a community-based design to detect influenza trends over multiple seasons and to evaluate the utility of absenteeism for early detection of accelerated influenza and other respiratory pathogen transmission in schools and surrounding communities.
流感病毒通过季节性爆发和不可预测的大流行造成了重大疾病负担。现有的监测计划严重依赖于对有医疗记录的流感（MAI）的报告。持续监测特定于病因的学校缺课情况可能会发现季节性流感活动的局部加速。俄勒冈州因呼吸道疾病缺课研究（ORCHARDS；俄勒冈州，威斯康星州）在幼儿园到 12 年级的学校中实施了每日基于学校的流感样疾病特定学生缺课（a-ILI）监测，并评估了这种方法在学校和周围社区中早期发现加速流感和其他呼吸道病原体传播的效果。
从 2014 年 9 月开始，ORCHARDS 将六所学校内每日缺勤情况的自动报告与对急性呼吸道感染（ARI）的在校儿童进行家访相结合。收集人口统计学、流行病学和症状数据以及呼吸道标本。标本用于检测流感和其他呼吸道病毒。家庭成员可以选择参与补充家庭传播研究。使用同一地理区域内五个家庭医学诊所的基于 MAI 的现有且非常有效的流感监测计划进行社区比较是可能的。
在前 5 年中，a-ILI 发生在 3260461 个学生上学日中的 6634 个（0.20%）。在接受家访的 1728 名患有 ARI 的儿童中，有 64.5%的儿童检测到了病毒病原体。流感是最常检测到的病毒，在 23.3%的患病学生中发现。
ORCHARDS 使用基于社区的设计来检测多个季节的流感趋势，并评估缺勤情况在学校和周围社区中早期发现加速流感和其他呼吸道病原体传播的效用。
