Household Transmission Dynamics of Seasonal Human Coronaviruses.

Background: Household transmission studies inform how viruses spread among close contacts, but few characterize household transmission of endemic coronaviruses.

Methods: We used data collected from 223 households with school-age children participating in weekly disease surveillance over 2 respiratory virus seasons (December 2015 to May 2017), to describe clinical characteristics of endemic human coronaviruses (HCoV-229E, HcoV-HKU1, HcoV-NL63, HcoV-OC43) infections, and community and household transmission probabilities using a chain-binomial model correcting for missing data from untested households.

Results: Among 947 participants in 223 households, we observed 121 infections during the study, most commonly subtype HCoV-OC43.

Predicting virologically confirmed influenza using school absences in Allegheny County, Pennsylvania, USA during the 2007-2015 influenza seasons.

Background: Children are important in community-level influenza transmission. School-based monitoring may inform influenza surveillance.

Methods: We used reported weekly confirmed influenza in Allegheny County during the 2007 and 2010-2015 influenza seasons using Pennsylvania's Allegheny County Health Department all-age influenza cases from health facilities, and all-cause and influenza-like illness (ILI)-specific absences from nine county school districts.

Influenza and other respiratory viral infections associated with absence from school among schoolchildren in Pittsburgh, Pennsylvania, USA: a cohort study.

Background: Information on the etiology and age-specific burden of respiratory viral infections among school-aged children remains limited. Though school aged children are often recognized as driving the transmission of influenza as well as other respiratory viruses, little detailed information is available on the distribution of respiratory infections among children of different ages within this group. Factors other than age including gender and time spent in school may also be important in determining risk of infection but have been little studied in this age group.

Age-specific social mixing of school-aged children in a US setting using proximity detecting sensors and contact surveys.

Comparisons of the utility and accuracy of methods for measuring social interactions relevant to disease transmission are rare. To increase the evidence base supporting specific methods to measure social interaction, we compared data from self-reported contact surveys and wearable proximity sensors from a cohort of schoolchildren in the Pittsburgh metropolitan area. Although the number and type of contacts recorded by each participant differed between the two methods, we found good correspondence between the two methods in aggregate measures of age-specific interactions.

Age-specific social mixing of school-aged children in a US setting using proximity detecting sensors and contact surveys.

Comparisons of the utility and accuracy of methods for measuring social interactions relevant to disease transmission are rare. To increase the evidence base supporting specific methods to measure social interaction, we compared data from self-reported contact surveys and wearable proximity sensors from a cohort of schoolchildren in the Pittsburgh metropolitan area. Although the number and type of contacts recorded by each participant differed between the two methods, we found good correspondence between the two methods in aggregate measures of age-specific interactions.

Social Contact Networks and Mixing among Students in K-12 Schools in Pittsburgh, PA.

Students attending schools play an important role in the transmission of influenza. In this study, we present a social network analysis of contacts among 1,828 students in eight different schools in urban and suburban areas in and near Pittsburgh, Pennsylvania, United States of America, including elementary, elementary-middle, middle, and high schools. We collected social contact information of students who wore wireless sensor devices that regularly recorded other devices if they are within a distance of 3 meters.

Household transmission of influenza A and B in a school-based study of non-pharmaceutical interventions.

The effect of school-based non-pharmaceutical interventions (NPIs) on influenza A and B transmission in children's households has not been estimated in published literature. We use data from a large school-based cluster randomized trial of improved hand and respiratory hygiene measures to explore the secondary transmission of influenza A and B in households of laboratory confirmed influenza cases. Data were taken from the Pittsburgh Influenza Prevention Project, a cluster-randomized trial of NPIs conducted in ten Pittsburgh, PA elementary schools during the 2007-2008 influenza season.

Public Health Area of Concentration: a model for integration into medical school curricula.

Calls for more public health education for medical students date back at least 150 years. In recent years, medical schools have increased their required coursework in core public health topics such as epidemiology, biostatistics, and behavioral determinants of health. Some schools have created more in-depth alternatives, including combined or concurrent master's degrees; MD/PhD programs with a public health track; certificates in public health; or complete re-envisioning of the school into an integrated medical and public health institution.

Sensitivity and specificity of rapid influenza testing of children in a community setting.

Introduction: Rapid influenza testing (RFT) allows for a rapid point-of-care diagnosis of influenza. The Quidel QuickVue Influenza A+B test (QuickVue) has a reported manufacturer's sensitivity and specificity of 73% and 96%, respectively, with nasal swabs. However, investigators have shown sensitivities ranging from 22% to 77% in community settings.

The effect of grade on compliance using nonpharmaceutical interventions to reduce influenza in an urban elementary school setting.

Objectives: The Pittsburgh Influenza Prevention Project (PIPP) has previously shown that school-aged children in grades K-5 can learn hygiene-based, nonpharmaceutical interventions (NPIs) and persist in these behaviors over the duration of an influenza season. The purpose of this study was to determine whether age (as estimated by grade) plays any role in this ability.

Methods: The Pittsburgh Influenza Prevention Project is a prospective, controlled, randomized trial of the effectiveness of a suite of NPIs in 10 elementary schools.

Compliance with a multilayered nonpharmaceutical intervention in an urban elementary school setting.

Objectives: The purpose of this study was to determine to what extent school-aged children can learn hygiene-based nonpharmaceutical interventions (NPIs) and persist in these behavioral changes over the duration of an influenza season. If this can be done successfully, it may be a preferable pandemic mitigation strategy to much more disruptive strategies such as whole-scale school closure.

Methods: The Pittsburgh Influenza Prevention Project (PIPP) is a prospective, controlled, randomized trial of the effectiveness of a suite of hygiene-based NPIs in controlling influenza and related illnesses in elementary schools in the City of Pittsburgh.

Research findings from nonpharmaceutical intervention studies for pandemic influenza and current gaps in the research.

In June 2006, the Centers for Disease Control and Prevention released a request for applications to identify, improve, and evaluate the effectiveness of nonpharmaceutical interventions (NPIs)-strategies other than vaccines and antiviral medications-to mitigate the spread of pandemic influenza within communities and across international borders (RFA-CI06-010). These studies have provided major contributions to seasonal and pandemic influenza knowledge. Nonetheless, key concerns were identified related to the acceptability and protective efficacy of NPIs.

Preserving lessons learned in disease outbreaks and other emergency responses.

Background: Public health departments often miss the opportunity to both learn from outbreaks and disasters and share any 'lessons learned' with other public health partners. These missed opportunities inhibit the public health system's ability to improve, change and adapt in an organized way.

Methods: In 2003, Western Pennsylvania experienced the largest documented hepatitis A outbreak in US history.

Low sensitivity of rapid diagnostic test for influenza.

The QuickVue Influenza A+B Test (Quidel) was used to test nasal swab specimens obtained from persons with influenza-like illness in 3 different populations. Compared with reverse-transcriptase polymerase chain reaction, the test sensitivity was low for all populations (median, 27%; range, 19%-32%), whereas the specificity was high (median, 97%; range, 96%-99.6%).

Using nonpharmaceutical interventions to prevent influenza transmission in elementary school children: parent and teacher perspectives.

Objectives: Schools act as "amplifying sites" for the spread of infectious diseases, outbreaks, and pandemics. This project assessed which nonpharmaceutical interventions (NPIs) are most acceptable to parents and teachers of school children in grades K-5 to K-8 in Pittsburgh public schools.

Methods: During the spring of 2007, the Pittsburgh Influenza Prevention Project surveyed 134 teachers and 151 parents representing nine elementary schools regarding attitudes toward NPIs and their usage by adults and school children during seasonal influenza outbreaks.